• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1124-1139
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• 2021

The objective assessment of atrophy and the measurement of brain volume is important in the early diagnosis of dementia and neurodegenerative diseases. Recently, several MR-based volumetry software have been developed. For their clinical application, several issues arise, including the standardization of image acquisition and their validation of software. Additionally, it is important to highlight the diagnostic performance of the volumetry software based on expert opinions. We instituted a task force within the Korean Society of Neuroradiology to develop guidelines for the clinical use of MR-based brain volumetry software. In this review, we introduce the commercially available software and compare their diagnostic performances. We suggest the need for a standard protocol for image acquisition, the validation of the software, and evaluations of the limitations of the software related to clinical practice. We present recommendations for the clinical applications of commercially available software for volumetry based on the expert opinions of the Korean Society of Neuroradiology.

• Journal of Physiology & Pathology in Korean Medicine
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• v.38 no.1
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• pp.1-9
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• 2024

Cognitive reserve (CR) is a concept that can explain the discrepancies between the pathologic burden of the disease and clinical manifestations. It refers to the individual susceptibility to age-related brain changes and pathologies related to Alzheimer's disease, thus recognized as a factor affecting the trajectories of the disease. The purpose of this study was to explore the current states of clinical studies on neural substrates of CR in Alzheimer's disease using functional magnetic resonance imaging. We searched for clinical studies on CR using fMRI in the Pubmed, Cochrane library, RISS, KISS and ScienceON on August 14, 2023. Once the online search was finished, studies were selected manually by the inclusion criteria. Finally, we analyzed the characteristics of selected articles and reviewed the neural substrates of CR. Total thirty-four studies were included in this study. As surrogate markers of CR, not only education and occupational complexity, but also composite score and questionnaire-based method, which cover various areas of life, were mainly used. The most utilized methods in resting-state fMRI were independent component analysis, seed-based analysis, and graph theory analysis. Through the analysis, we demonstrated that neuroimaging techniques could capture the neural substrates associated with cognitive reserve. Moreover, functional connectivity of brain regions centered on prefrontal and parietal cortex and network areas such as default mode network showed a significant correlation with CR, which indicated a significant association with cognitive performance. CR may induce differential effects according to the disease status. We hope that this perspective on cognitive reserve would be helpful when conducting clinical researches on the mechanisms of traditional Korean medicine for Alzheimer's disease in the future.

• Therapeutic Science for Rehabilitation
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• v.13 no.2
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• pp.27-40
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• 2024

Objective : This study aimed to conduct a systematic review of the assessment tools used to assess the housing environment of older adults. Methods : Data were collected from January 2015 to August 31st, 2023, by searching databases including the Cochrane Library, PubMed, and ProQuest. From the 267 articles, nine assessment tools were selected for analysis based on their original instruments. These tools were categorized and systematically organized for analysis based on their frequency of use, assessment purposes, sub-domains, scales, and other relevant criteria. Results : Among the nine tools, HOME FAST and IPAQ-E were the most frequently used (20% each). The objectives of these tools are to assess friendliness, physical barriers, fall prevention, dementia-friendly environments, physical activity, and accessibility. The measurement scope encompassed various factors, such as outdoor spaces, buildings, transportation, housing, and community support. Conclusion : When considering the suitability of housing for the older adults population, providing foundational data for the rational selection of evaluation tools with logical validity is important. This includes factors such as the objectives and measurement scopes of housing environment assessment tools.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.17-28
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• 2008

Purpose: It was well known that cerebral blood perfusion is normal or diffusely decreased in the majority of patients with Parkinson's disease (PD). Actually we interpreted brain perfusion SPECT images of PD patients in the clinical situation, we observed various cerebral perfusion patterns in patients with PD. So we performed brain perfusion SPECT to know the brain perfusion patterns of PD patients and the difference of perfusion patterns according to the sex and the age. Also we classified PD patients into small groups based on the brain perfusion pattern. Methods and Materials: Two hundred nineteen patients (M: 70, F: 149, mean age: $62.9{\pm}6.9$ y/o) who were diagnosed as PD without dementia clinically and 55 patients (M:15, F:40, mean age: $61.4{\pm}9.2$ y/o) as normal controls who had no past illness history were performed $^{99m}Tc$-HMP AO brain perfusion SPECT and neuropsychological test. Results: At first, we compared all patients with PD and normal controls. Brain perfusion in left inferior frontal gyrus, left insula, left transverse temporal gyrus, left inferior parietal lobule, left superior parietal lobule, right precuneus, right caudate tail were lower in patients with PD than normal controls. Secondly, we compared male and female patients with PD and normal controls, respectively. Brain perfusion SPECT showed more decreased cerebral perfusion in left hemisphere than right side in both male and female patients compared to normal controls. And there was larger hypoperfusion area in female patients compared with male. Thirdly, we classified patients with PD and normal controls into 4 groups according to the age and compared brain perfusion respectively. In patient below fifties, brain perfusion in both occipitoparietal and left temporal lobe were lower in PD group. As the patients with PD grew older, hypoperfusion area were shown in both frontal, temporal and limbic lobes. Fourthly, We were able to divide patients into small groups based on cerebral perfusion pattern. There was normal cerebral blood perfusion in 32 (14.7%) of 219 patients with PD, decreased perfusion on the frontal lobe in 45 patients (20.6%), the temporal lobe in 39 patients (17.4%), the parietal lobe in 39 patients (17.9%), the occipital lobe in 40 patients (18.3%), diffuse area in 14 patients (6.4%) and unclassified in 10 patients (4.6%). Fifthly, we compared the results of the neuropsychological test and cerebral perfusion pattern. There was no correlation between two tests except visuospatial function. Conclusion: Various perfusion state were found in patients with PD according to the age and sex. Also we were able to classify perfusion state into several groups and compare the neuropsychological test with cerebral perfusion.

• Journal of the East Asian Society of Dietary Life
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• v.21 no.5
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• pp.649-660
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• 2011

The purpose of this study was to compare the dietary life and nutrient intakes among elderly persons residing at nursing homes and their homes in order to provide fundamental data for improved foodservice and dietary management. We recruited 150 subjects at a nursing home stay and 150 home stay elderly persons for a survey. The results were as follows. There was no significant difference in frequency of napping between the two groups. The frequency of going out was higher in the home stay subjects, but regular exercise was higher in nursing home stay subjects. Subjects possessed the following diseases: dementia and digestive disorders for nursing home stay elderly men, blood vessel disorder and diabetes for home stay elderly men, digestive and blood vessel disorders for nursing home stay elderly women, and blood vessel and heart disease for home stay elderly women. In a health-related assessment, smoking, drinking, and teeth condition of nursing home stay subjects were not higher than those of home stay subjects. The ratio of subjects who ate meals everyday was higher in nursing home stay elderly women than in home stay women. While most nursing home subjects ate adequate amount of meals, home stay subjects ate until they were full. The daily energy intakes of men and women were 2,229.9 kcal and 2,302.1 kcal for nursing home subjects and 1,894.0 kcal and 1,885.9 kcal for home subjects, respectively. Nutrient intake was also higher in nursing home than home stay subjects. In summary, the dietary life of elderly persons residing in a nursing home was higher than that of elderly persons residing at their home from the view point of meal frequency, meal intake, and nutrient intakes. Therefore, systematic assessment and management of nutrition for elderly staying at a nursing home or at home alone should be conducted continually.

• Journal of Life Science
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• v.30 no.3
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• pp.250-259
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• 2020

Diabetes is a well-known risk factor for dementia and cognitive impairment. Diabetic polyneuropathy (DPN) is the most prevalent microvascular complication in type 2 diabetes mellitus (T2DM) patients. The purpose of this study was to evaluate the relation between diabetic peripheral polyneuropathy and cognitive factors in T2DM patients. Retrospective chart review of type 2 diabetic patients with results of a nerve conduction study (NCS) and a neurocognitive study. A total of 19 patients were included. DPN was defined using data from a nerve conduction study: a score of less than 24 in the Korean version of the Mini-Mental State Examination (K-MMSE) was considered as an indicator of cognitive impairment (CI). The mean age of the 19 patients was 71.6±5.0 years. The mean duration of diabetes was 8.4±9.1 years, and the mean HbA1c level was 8.1±1.8%. DPN was present in 7 of the 19 patients. Based on the K-MMSE score, CI was diagnosed in eight patients. The mean K-MMSE scores and the prevalence of CI was not different between the groups with and without DPN. There was no significant difference in DPN prevalence between the groups with and without CI. Education was significantly correlated with cognitive factors. Only the digit span-forward among the cognitive factors showed a significant negative correlation with nerve conduction velocity. In conclusion, the longer education period was associated with higher cognitive function and no significant correlation was observed between diabetic peripheral neuropathy and cognitive dysfunction in type 2 diabetic patients. Further prospective research is needed in the future.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.2
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• pp.262-270
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• 2004

It is well known that long-term heavy ethanol intake causes alcoholic dementia, cerebellar degeneracy or Wernicke-Korsakoff syndrome and aggravates the conditions of many other neuro-psychotic disorders. Recently it is indicated that protein kinase C (PKC) plays an important role in the action of ethanol and in the neuro-adaptational mechanisms under chronic ethanol exposure. In order to investigate the effect of ethanol on PKC isoforms levels within the range of not showing any cytotoxicity, B103 neuroblastoma cell line trans-formed from murine central nervous system was employed and western blot analysis was carried out by using PKC isoform-specific antibodies. The changes of PKC-$\alpha$, ${\gamma}$, $\varepsilon$ and ζ level in the range of ethanol concentration 50∼200 mM were examined at the exposure time 1, 2, 8, 18 and 24 hrs in both cytosolic and membrane fraction. A typical ethanol concentration inducing the PKC isozymes was 100 mM, and the transforming time ranges of PKC isozymes could be considered as two different parts to each PKC isoform such as initial (0∼2 hrs) and prolonged (8∼24 hrs) stages. PKC-${\gamma}$ and PKC-$\varepsilon$ were clearly induced during the prolonged stages in cytosol at 18 hrs, and membrane fraction at 8 hrs and 18 hrs, respectively. On the other hand the PKC-$\alpha$ and PKC-ζ isozymes were largely induced in the prolonged stages at 18 hrs and 24 hrs, where the PKC-$\alpha$ isozyme was induced in both cytosol and membrane fractions at 200 mM ethanol concentration while the PKC-ζ isozyme was induced only in the membrane fractions at 100,200 mM. At 200 mM ethanol concentration of 24 hrs incubation in the prolonged stage, the PKC-$\alpha$ was maximally induced by 150% of the control values whereas the PKC-${\gamma}$ was significantly decreased to 47% of the control values. These results suggest that 100∼200 mM ethanol may modulate the signal transduction and neurotransmitter release in the central nervous system through the regulation of PKC isozymes, and the action of these isoforms may act differently each other in the cell.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.38-45
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• 2017

Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

• Journal of Nutrition and Health
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• v.53 no.1
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• pp.27-38
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• 2020

Purpose: This study assessed the food intake and nutritional status of the elderly in long-term care facilities in order to provide adequate food services and improve the nutritional status. Methods: The survey was carried out from August 2019 to October 2019 for the elderly in long-term care facilities located in Gwangju Metropolitan City. The survey was conducted to collect data from 199 elderly persons (34 males and 165 females) aged over 65 years old. The food intake was assessed using a 1-day 24-hour recall method. Results: More than 90% of the subjects were over 75 years old. Forty five percent of the subjects were active, 44.2% of the subjects perceived themselves as not being healthy. Dementia and Parkinson's disease were the most common diseases, followed by hypertension, musculo-skeletal disease, diabetes, and stroke. Only 25.6% of the subjects had most of their teeth intact, and 44.7% of the subjects had difficulty in chewing and swallowing. The total food intake was 1,127 g in males and 1,078 g in females. The most frequently consumed foods were kimchi, cooked rice with multi-grains, soybean soup, cooked rice with white rice, yogurt, pumpkin porridge, soy milk, and duck soup. The average energy intake of the subjects was 1,564.9 kcal in males and 1,535.5 kcal in females. The overall nutritional status of the elderly in the long-term care facilities was poor. In particular, the intake of vitamin D and calcium, vitamin C, riboflavin, and potassium were very low. The intake of vitamin D was 5 ㎍, and 86.4% of the elderly were below the estimated average requirement, while the intake of sodium was high. Conclusion: The results of this study can be used to understand the health and nutritional status and to improve the food services and nutrition management for the elderly in longterm care facilities.

• Korean Journal of Health Education and Promotion
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• v.12 no.1
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• pp.83-110
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• 1995

The purpose of this study was to investigate the status of the problematic behavior for the demented elderly and the stress among family members, and the effects of the problematic behavior upon the stress in order to offer the basic data for the adult and the elderly health education about dementia. For this purpose, 70 families who were resident in Seoul and Inchon were surveyed by quetionnaires. This was carried out from 26 July, 1994 to 11 September, 1994. Datum was analysed by using SPSS\PC+ including percentage, mean, t - test, ANOVA, Pearson correlation. So, the results of this study were as follows: 1. In view of socia-demographic characteristics, female were 82.9%, and of the female daughters-in-law of the demented elderly were 44.9%. 40th years old were 32.9% and 88.6% wase married. The christian were 34.8%, those who graduated university 47.1%, and those who had a job 32.9%. 2. Of the demented elderly, female were 74.3%, 80 years old were 37.1%, and their average age was seventy-seven point one years old. 66.2% of the elderly has been lived alone and the christian were 27.5%. In addition, those who graduated elementary school were 66.5%. 3. Of the behavior problem for the demented elderly, Activities of the Daily Living(ADL) was the most severe problem. The 2nd was cognitive function problem, the 3th, change of personality, the 4th, emotional disturbance, and the last, misconduct behavior. 4. For the status of behavior problems, females were more severe than male, and 80th years elderly ware the most severe groups. The longer disease period was, the severe problematic behaviors were, and in 4-6 years of the disease period the status was the highest(p＜0.05). Those who diagnosed the disease had more severe problems(p＜0.001). 5. The orders of the stress among family members caring for the demented elderly in this study were as follows : 1. The deficiency of supporting network 2. Decrease of elderly's cognitive activities 3. Assistance of BADL(Basic Activities of Daily Living) 6. Elderly's abnormal behavior 5. Assistance of IADL(Instrumental Activities of Daily Living), 6. As for the status of the stress among family members, female respondants were higher than male. On the ages, 20th years' stress score were the highest. Daughters-in-law were stressed more than other family members. The longer the time of caring per day was, the highest the status of the stress(p＜0.05), 7. Those who caring for female elderly and more than 80 years had more stressed. When the elderly was received the diagnosis, the family members were more stressed. On the disease period, 1-2 years was the highest and after 2 years the status of the stress was decreased and more than 6 years was the lowest(p＜0.05). 8. Behavior problems of the demented elderly were closely associated to the stress for family members. Of the problems, change of personality was the most related factor(r = 0.6552). The factors of Basic Activities of the Daily Living(BADL) was most correlated on assistance of Basic Activities of Daily Living (BADL), emotional disturbance the assistance of IADL(Instrumental Activities of Daily Living). Change of personality was most related to the stress of the decrease of cognitive activities and elderly's abnormal behavior. The deficiency of supporting network was most related to misconduct behavior.