• Title/Summary/Keyword: impairment

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Functional Impairment and Executive Dysfunction of Children with Tourette Disorder : Comparison with Attention-Deficit Hyperactivity Disorder and Non-Affected Controls (뚜렛 장애 아동 청소년의 기능장애 및 실행기능 결함 : 주의력결핍 과잉행동장애 아동 청소년과 정상 대조군과의 비교)

  • Kang, Hanna;Lee, Soyoung Irene;Lee, A Reum;Kim, Shin-Gyeom;Jung, Han-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.26 no.3
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    • pp.190-196
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    • 2015
  • Objectives : The aim of this study was to determine whether children with Tourette disorder (TD) have functional impairment and executive dysfunction in comparison to children with attention-deficit hyperactivity disorder (ADHD) and non-affected controls. Methods : From January 2006 to December 2013, 45 children and adolescents with TD and 50 children and adolescents with ADHD diagnosed at the Soonchunhyang University Bucheon Hospital and 50 non-affected controls were enrolled in this study. Functional impairment of the subjects was assessed using the Child and Adolescents Functioning Impairment Scale (CAFIS), parent and teacher versions. In addition, neuropsychological tests including Stroop color-word Test, Finger windows Test (FWT), and Digit span were administered. Outcomes were compared across the TD, ADHD, and non-affected controls. Results : No difference in CAFIS-parent and CAFIS-teacher results was observed between children with TD and non-affected controls, whereas, children with ADHD showed more impairments relative to non-affected controls in the CAFIS-parent. According to the Stroop color-word Test, FWT, and Digit span, executive function in children with TD did not differ from non-affected controls. Children with ADHD had poorer performance in measures of the Stroop color-word Test compared to children with TD. Conclusion : Children and adolescents with TD but not ADHD were not significantly different from non-affected controls on most measures of functional impairment and executive function. These findings suggest that an education program and intervention for children with TD would be important to reducing the stigma of TD.

Comparison of the Two Impairment Classes Publicized by the American Medical Association in Complex Regional Pain Syndrome Patients (복합부위통증증후군 환자에서 미국의사협회 영구장애평가지침에서 제시된 장애등급 평가방법의 비교)

  • Shin, Hwa Yong;Choi, Yong Min;Nahm, Francis Sahngun;Park, Seong Joo;Koo, Mi Suk;Suh, Jeong Hun;Sim, Sung Eun;Jo, Ji Yon;Lee, Sang Chul;Kim, Yong Chul
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.148-153
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    • 2007
  • Background: Complex regional pain syndrome (CRPS) is not regarded as an impairment in Korea. Guidelines for rating this impairment are under development by the Korean Academy of Medical Science based on that of the American Medical Association (AMA). However, no studies have been done on the validity of these guidelines in Korea. We therefore evaluated the validity of these guidelines using the criteria from the chapter on the central and peripheral nervous system (CNS-PNS class) and the worksheet for calculating total pain-related impairment score (TPRIS class). Methods: TPRIS and CNS-PNS classes were calculated through interviews of 28 CRPS patients. The correlation between the two classes was calculated. Results: TPRIS class and CNS-PNS class were well correlated (r = 0.593, P < 0.05). Conclusions: Both TPRIS or CNS-PNS classes were well correlated and could be used for evaluation of impairment. However, the CNS-PNS class is simpler and quicker to complete.

Preliminary Study of Neurocognitive Dysfunction in Adult Moyamoya Disease and Improvement after Superficial Temporal Artery-Middle Cerebral Artery Bypass

  • Baek, Hyun Joo;Chung, Seung Young;Park, Moon Sun;Kim, Seong Min;Park, Ki Suk;Son, Hee Un
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.188-193
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    • 2014
  • Objective : Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease of unknown etiology. In addition, the neurocognitive impairment of adults with MMD is infrequently reported and, to date, has not been well described. We attempted to determine both the neurocognitive profile of adult moyamoya disease and whether a superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis can improve the neurocognitive impairment in exhibiting hemodynamic disturbance without stroke. Methods : From September 2010 through November 2012, 12 patients with angiographically diagnosed MMD underwent STA-MCA anastomosis for hemodynamic impairment. Patients with hypoperfusion and impaired cerebrovascular reserve (CVR) capacity but without evidence of ischemic stroke underwent a cognitive function test, the Seoul Neuropsychological Screening Battery (SNSB). Five patients agreed to undergo a follow-up SNSB test. Data from preoperative and postoperative neurocognitive function tests were compared and analyzed. Results : Five of 12 patients were enrolled. The median age was 45 years (range, 24-55 years). A comparison of preoperative to postoperative status of SNSB, memory domain, especially delayed recall showed significant improvement. Although most of the domains showed improvement after surgery, the results were not statistically significant. Conclusion : In our preliminary study, large proportions of adult patients with MMD demonstrate disruption of cognitive function. This suggests the possibility of chronic hypoperfusion as a primary cause of the neurocognitive impairment. When preoperative and postoperative status of cognitive function was compared, memory domain showed remarkable improvement. Although further study is needed, neurocognitive impairment may be an indication for earlier intervention with reperfusion procedures that can improve cognitive function.

Influence of Clinical and Demographical Variables on Depression, Instrumental Activities of Daily Living, and Cognitive Function in Patients with Parkinson's Disease (파킨슨병 환자의 인구학적.임상적 특성에 따른 우울, 일상생활 수행능력 및 인지기능)

  • Sohng, Kyeong-Yae;Choi, Dong-Won;Park, Hea-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.249-256
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    • 2006
  • Purpose: To investigate the influence of clinical and demographical variables on depression, instrumental activities of daily living (IADL), and cognitive function in patients with Parkinson's disease. Method: Using a structured questionnaire data were collected from 100 participants registered in the neurology department of C university hospital. Duration and stage of disease, fall history, vision impairment, duration and quality of sleep, orthostatic hypotension, ambulation impairment, and use of walking aid were included in clinical variables. Depression, IADL, and cognitive function were assessed using Kee's GDSSF-K, Cho's scale, and K-MMSE. Collected data were analyzed using the SAS program. Results: The depression score for the participants was 7.78, higher than cut-off score(5). Participants who were male, living with spouse, above high school education, high economic status, with no vision impairment, and no ambulation impairment revealed high cognitive scores. Average IADL score were significantly higher for participants who were male, who had high economic status, low stage of disease, and no ambulation impairment. Depression IADL & cognitive function scores were significantly different according to ambulation impairment. Scores for ADL and cognitive function were positively correlated. Conclusion: It is recommended that make programs for patients with Parkinson's disease, clinical and demographic variables should be considered according to their individual needs.

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A Study on Medical Expenses of Modern and Korean Medicine for Dementia Patients Under National Health Care (한국 치매 환자의 건강보험 의·한의 진료 비용에 관한 연구)

  • Lee, Jung Bae;Kang, Hyung Won;Kim, Jaeuk;Kim, Gahye;Kim, Nam-Kwen
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.1
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    • pp.31-38
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    • 2019
  • Objectives: To identify the cost effectiveness of early dementia diagnosis using the 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: The medical costs of dementia between Western medical care and Korean medical care were compared through the reimbursement and non-reimbursement item code for dementia examination. In addition, the medical expenses of patients with dementia and mild cognitive impairment were compared and analyzed with respect to Western and Korean medical care. Results: There were 87,434 claims, of which 16,101 patients were diagnosed with dementia and 38,680,789,560 won was found to be the medical expenses. 12,881 patients (80.0%) with dementia, 3,144 patients (19.5%) with mild cognitive impairment, and 76 patients (0.5%) progressing from mild cognitive impairment to dementia. The proportion of medical expenses was 97.6% for dementia patients, 2.3% for mild cognitive impairment, and 1% for patients progressing from mild cognitive impairment to dementia. 86,070 claims (98.4%) were from Western medical care, with16,824 patients (98.2%), and the medical expenses was 38,546,895,400 won (99.7%). 1,361 claims (1.6%) were from Korean medical care, with 303 patients (1.8%), and the medical expenses was 133,894,160 won (0.3%). Conclusions: This study compared and analyzed the medical costs of dementia patients and the diagnosis of both Korean and Western medical care. The results of this study are expected to be used as basic research data for investigating cost effectiveness of developing early diagnosis of dementia.

Usefulness of the Clock Drawing Test as a Cognitive Screening Instrument for Mild Cognitive Impairment and Mild Dementia: an Evaluation Using Three Scoring Systems

  • Kim, Sangsoon;Jahng, Seungmin;Yu, Kyung-Ho;Lee, Byung-Chul;Kang, Yeonwook
    • Dementia and Neurocognitive Disorders
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    • v.17 no.3
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    • pp.100-109
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    • 2018
  • Background and Purpose: Although the clock drawing test (CDT) is a widely used cognitive screening instrument, there have been inconsistent findings regarding its utility with various scoring systems in patients with mild cognitive impairment (MCI) or dementia. The present study aimed to identify whether patients with MCI or dementia exhibited impairment on the CDT using three different scoring systems, and to determine which scoring system is more useful for detecting MCI and mild dementia. Methods: Patients with amnestic mild cognitive impairment (aMCI), vascular mild cognitive impairment (VaMCI), mild Alzheimer's disease (AD), mild vascular dementia (VaD), and cognitively normal older adults (CN) were included. All participants were administered the CDT, the Korean-Mini Mental State Examination (K-MMSE), and the Clinical Dementia Rating scale. The CDT was scored using the 3-, 5-, and 15-point scoring systems. Results: On all three scoring systems, all patient groups demonstrated significantly lower scores than the CN. However, while there were no significant differences among patients with aMCI, VaMCI, and AD, those with VaD exhibited the lowest scores. Area under the Receiver Operating Characteristic curves revealed that the three CDT scoring systems were comparable with the K-MMSE in differentiating aMCI, VaMCI, and VaD from CN. In differentiating AD from CN, however, the CDT using the 15-point scoring system demonstrated the most comparable discriminability with K-MMSE. Conclusions: The results demonstrated that the CDT is a useful cognitive screening tool that is comparable with the Mini-Mental State Examination, and that simple CDT scoring systems are sufficient for differentiating patients with MCI and mild dementia from CN.

The Characteristics of semantic association task performance in elderly with subjective memory impairment and mild cognitive impairment (주관적 기억장애 및 경도인지장애 노인의 의미연상과제 수행 특성)

  • Kang, Seo-Jeong;Park, Seong-Hyeon;Kim, Jung-Wan
    • Journal of Digital Convergence
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    • v.17 no.2
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    • pp.283-292
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    • 2019
  • The loss of semantic knowledge and impairments in semantic associations by semantic category is gaining increasing attention, as indicators of early-stage cognitive decline. As such, we assigned semantic association task (SAT) to normal elderly (NE) and those with subjective memory impairment (SMI) or mild cognitive impairment (MCI) to examine their performance by semantic subcategories and the differences in error patterns. We found a significant difference in the number of correct response and reaction time under the SAT categories among the three groups, with the highest performance observed in 'function' and the lowest performance in 'superordinate' and 'part/whole'. Moreover, the error frequency was the lowest in NE, followed by those with SMI and MCI, with the latter two groups showing a significant increase in no-response. Our findings demonstrate the varying extent and process of impairments in the semantic network by category over different stages of cognitive decline. Thus, we proposed SAT performance as an indicator to detect and follow-up on cognitive decline in elderly with cognitive disorder.

Effects of a Group Computerization Cognitive Rehabilitation Program on Cognitive Function in Patients with Cognitive Impairment (그룹 전산화 인지 재활 프로그램이 인지 손상 환자의 인지 기능에 미치는 효과)

  • Shin, Jae-Wook;Han, Hye-Kyung;Shin, Sang-Hwa;Park, Jae-Sung;Park, Chan-Hyo;Kim, Hye-Jin;Kim, Dong-In
    • PNF and Movement
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    • v.17 no.1
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    • pp.69-79
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    • 2019
  • Purpose: This study aims to investigate the effects of a group computerization cognitive rehabilitation program on cognitive function in patients with cognitive impairment. Methods: The subjects of this study comprised 34 patients with cognitive impairment (15 males and 19 females) who were randomized into two groups. The experimental group (n = 17) were trained with the group computerization cognitive rehabilitation program, while the control group (n=17) received traditional cognitive therapy. The interventions for both groups were performed for 1 hour per day, once a week for 12 weeks. The cognitive functions of the subjects before and after the experiment were measured using the Korean mini-mental state examination (K-MMSE), global deterioration scale (GDS), clinical dementia rating (CDR), and Lowenstein occupational therapy cognitive assessment (LOTCA). A paired t-test was conducted to examine the intragroup differences before and after the experiment, and ANCOVA was performed to check intergroup differences. Results: The intragroup comparison results showed that the cognitive function of the group that were trained with the group computerization cognitive rehabilitation program improved after the experiment more than for the group that received traditional cognitive therapy. The intergroup comparison results showed significant differences in orientation, visual perception, and visuomotor organization between the two groups. Conclusion: The results of this study confirmed that the group computerization cognitive rehabilitation program was more effective in improving cognitive function than the traditional cognitive therapy in patients with cognitive impairment. Based on the results of this study, the group computerization cognitive rehabilitation program can be used as an effective intervention method for patients with cognitive impairment.

Changes in the Level of Performance of Activities of Daily Living and Depression of the Elderly with Mild Cognitive Impairment through the Participation in the Cognitive Program (인지프로그램 참여에 따른 경도인지장애 노인들의 일상생활활동 수행과 우울 수준의 변화)

  • Son, Sung-Min;Bak, Ah-Ream
    • Journal of the Korean Applied Science and Technology
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    • v.38 no.2
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    • pp.511-520
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    • 2021
  • This study was a pre and post quasi-experimental design study using a single group about the analysis of the changes in the performance level of activities of daily living and depression of the elderly with mild cognitive impairment through the participation in the cognitive program. Study subjects were the 16 elderly with mild cognitive impairment using a W welfare center in J city and they participated in cognitive program for a total of 8 weeks, twice a week. The assessment about the performance level of activities of daily living and depression were performed through the program. As the results, after participating in the program, study subjects' performance level of activities of daily living were significantly significant improved, and depression levels were statistically significantly reduced. Thus, to improve the performance level of activities of daily living and reduce the depression levels of the elderly with mild cognitive impairment, the cognitive program should be used as a intervention program and then in the process, it is necessary to actively induce the participation of the elderly with mild cognitive impairment.

The Effect of IADL on life satisfaction in the elderly with dementia and mild cognitive impairment: Multiple Mediating Effects of Subjective Expectation and Depression

  • Lee, Hyoung-Ha
    • Journal of the Korea Society of Computer and Information
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    • v.27 no.7
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    • pp.125-135
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    • 2022
  • In this study, using KLoSA data, it was verified whether subjective expectations and depression had a multi-mediated effect on life satisfaction of the elderly with dementia and mild cognitive impairment. As a result of the analysis, first, it was analyzed that the higher the IADL of the elderly with dementia and mild cognitive impairment, the lower the subjective expectation, the higher the depression, and the lower the life satisfaction. Second, it was analyzed that as the subjective expectations of the elderly with dementia and mild cognitive impairment increased, depression decreased and life satisfaction increased. Third, it was analyzed that IADL in the elderly with dementia and mild cognitive impairment not only directly affects life satisfaction, but also indirectly affects life satisfaction through subjective expectations and depression, so it has a multi-mediated effect. Therefore, it is necessary to expand subjective expectations by expanding service providers that can support daily life restrictions for the elderly with dementia and mild cognitive impairment, providing regular programs by experts to reduce depression, and establishing new national pension benefits for dependents.