• Title/Summary/Keyword: secondary dementia

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Three Case Reports about Improving Vascular Dementia and Secondary Dementia (혈관성 치매와 속발성 치매 치험 및 호전 3례)

  • Yun Kyoung-Sun;Lee Ji-Hun;Kim Jae-Woo;Jeong Sung-Hyun;Shin Gil-Cho;Lee Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1103-1111
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    • 2003
  • Dementia is classified into Alzheimer's disease, vascular dementia and secondary dementia by its causes. Alzheimer's disease is hard to expect cognitive improvement, whereas vascular dementia and secondary dementia are reversible by medical treatments Dementia can be categorized as Chi-Mae(痴?), Geon-Mang(健忘), Huh-Ro(虛勞), Guang(狂), in the oriental medicine and treated by 'purgation therapy' when it is classified into excessive syndrome. We observed some significant improvements in the cognitive function from three patients diagnosed vascular dementia and secondary dementia by herbal medications of $\ulcorner$Dong-Eui-Su-Sheh-Bo-Won(東醫壽世保元)$\lrcorner$. We report the process of the treatment.

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A Case Report of Secondary Dementia Patient Caused by Diffuse Axonal Injury (미만성 축삭 손상으로 유발된 속발성 치매 환자 1례에 대한 증례 보고)

  • Song, Chang-Hoon;Jeong, Jong-Jin;Oh, Sung-Won;Kim, Soo-Yeon;Lee, Sang-Min;Jung, Myong-Suk;Baek, Tae-Hyun;Lee, Seul-Hee
    • The Journal of Internal Korean Medicine
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    • v.28 no.3
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    • pp.645-654
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    • 2007
  • The purpose of this study is to present a case of secondary dementia caused by diffuse axonal injury. We diagnosed this patient with diffuse axonal injury by using brain computerized tomography(CT) and magnetic resonance imaging(MRI), and also diagnosed secondary dementia based on DSM-IV. To evaluate prognosis of the patient, we used K-DRS(Korean-Dementia Rating Scale) and gave him a written test. As a result of treating this patient with oriental medicine, the K-DRS score increased and the overall clinical symptoms improved. In oriental medicine, case studies of diffuse axonal injury are yet insufficient, hence more clinical studies and researches will be needed.

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치매에 대한 한의학적 임상연구

  • Whang Wei-Wan;Kim Jong-Woo;Lee Jo-Hee;Eom Hyo-Jin;Lee Seung-Gi
    • Journal of Oriental Neuropsychiatry
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    • v.7 no.1
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    • pp.1-13
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    • 1996
  • 1. Out of 21 examples on a clinical base Alzheimer type dementia were 8 examples(38%), 11 vascular types(52%), 1 Alzheimer and vascular mixed type and rest 1 was secondary dementia type(NPH).2. Between the genders, there were 5 males and 3 females for Alzheimer types, 6 males and 5 females for the vascular types, 1 male for Alzheimer and vascular mixed type, and 1 female for secondary dementia type(NPH).3. For the degrees of Alzheimer type dementia there were 2 mild dementia, 4 moderate dementia, and 2 severe dementia. 4. Among the Alzheimer types 2 mild dementia were almost recovered back to normal in approximately 2 months, 2of 4 moderate dementia became significantly better in approximately 2 months and recovered to almost normal state in 3 to 5 months. The rest 2 have been under treatment for 3 months, but showed a little improvement. Out of 2 severe dementia examples, one showed a little improvement even if it has been under treatment over 2 years. The other example did not show any improvement, but dementia did not proceed any more.5. Among the 11 vascular examples, 7 recovered in 2 to 3 months, 1 in 5 months, 2 recovered in a year, and the treatment was stopped arbitrary for the last one.6 In the case of Alzheimer and vascular mixed type dementia, even the moderate dementia did not show any apparent result in 6 months.7. For NPHI (Normal Pressure Hydrocephalus), there was an improvement on dementia in 2 months after the treatment, but gait disturbance and urinary incontinence did not show any noticeable difference. As a conclusion, almost all the Alzheimer and vascular type patients recovered, but the treatment periods varied depending on the types of the dementia and the degree of seriousness, especially in the case of the severe Alzheimer patients, the treatment oniy suppression the progression of the dementia. The most important aspect from clinical point of view was even if almost all the patients were almost completely cired, they need to keep being cured for a long period of time. The method with respect to Four Constitutions is thought of the most desirable.

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Women Caregivers′ Experiences in Caring at Home for a Family Member with Dementia: A Feminist Approach (여성가족간호자의 치매노인 돌봄경험: 여성주의적 접근)

  • 이봉숙;김춘미;이명선
    • Journal of Korean Academy of Nursing
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    • v.34 no.5
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    • pp.881-890
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    • 2004
  • Purpose: The purpose of this study was to explore women caregivers' lived experiences in caring at home for a family member with dementia and to identify conditions that oppress women in the context of family caregiving. Method: This study was conducted within the feminist perspectives using qualitative secondary data. Ten secondary data conveying self reflective contents were selected from the 25 original data obtained in 1999 to 2000. Result: Six themes that emerged from the qualitative thematic content analysis were; androcentric view of family caregiving, undervalued family caregiving by the family members, Self rationalization in the context of family caregiving, family-centric care mechanism, exemplary caring within the family context, and inter-familial relationships among women. Conclusion: The main focus of feminist research is to provide empowerment for the women, research participants and to bring about social change of oppressive constraint through some actions. On the basis of the research findings, therefore, action strategies from feminist perspectives were suggested in some aspects of health care delivery sectors, nursing education and research sectors, and administrative sectors.

A Comparative Consideration of Treatment on Dementia in Oriental and Occidental Medicine (치매의 치료(治療)에 관(關)한 동서의학적(東西醫學的) 고찰(考察))

  • Lee, Dong-Weon;Shin, Gil-Jo;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.4
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    • pp.67-80
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    • 1995
  • This study was done in order to investigate the treatment of occidental and oriental medicine on dementia(mainly senile dementia and cerobrovascular dementia). The results were as follows ; 1. Dementia must treat a direct causes, but uncountable dementia(senile dementia) and cerobrovascular dementia can't treat at present. 2. Sciopsychological treatment in very important in dementia patient ; maintance of appropriate stimulation, psychological rest, physical examination, dietary cure and safety device is needed. On secondary mental disorder, antipsychotics, anxiolytics and antidepressants have to prescribe properly. 3. Treatments of Senile dementia(uncountable cerebral degenerative disease) proscribed hydergine which is peripheral vasodilator and physostigmine which increase cholinergic activity of brain, but this have slight effect on some patients. On treatments of cerobrovascular dementia, the medication that improved the cell metabolism and circulation of brain, this improved only a subjective symptom, but isn't foundamental treatment. 4. A tonic medicine is used basically, the methods are as follows. 1) Kenwihwadam(健胃火痰)-Sesimtang(洗心湯) 2) Bosiniksu(補腎益髓)-Hwansodan(還少丹) 3) Bosimiksin(補心益腎)-Gyuibitang(歸脾湯), Singyuo(神交湯) 4) Boheoansin(補虛安神)-Cilbokem(七福飮), sanggitang(生氣湯) 5) geoeohwalhyel(祛瘀活血)-tonggyuhwalhyeltang(通竅活血湯), 5. Acupuncture therapy on dementia used follow acupuncture point ; Yamen(啞門 GVl5), Laokung(勞宮 HC8), Tsusanli(足三里 ST36), Shenshu(腎兪 BL23), Tachui(大椎 GVl4), Chiuwei(鳩尾 CVl5), Sanyinchiao(三陰交 SP6), Yungchuan(涌泉 KI1), Shipsun(十宣), Shousanli(手三里 LI10), Taichong(太衝 LV3) In moxibustion therapy, Dachui(大椎 GVl4) point is used.

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A Prediction Model for Unmet Needs of Elders with Dementia and Caregiving Experiences of Family Caregivers (재가치매 환자의 미충족요구와 가족부양자의 돌봄경험 예측모형)

  • Choi, Sora;Park, Myonghwa
    • Journal of Korean Academy of Nursing
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    • v.46 no.5
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    • pp.663-674
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    • 2016
  • Purpose: The purposes of this study were to develop and test a prediction model for caregiving experiences including caregiving satisfaction and burden in dementia family caregivers. Methods: The stress process model and a two factor model were used as the conceptual frameworks. Secondary data analysis was done with 320 family caregivers who were selected from the Seoul Dementia Management Survey (2014) data set. In the hypothesis model, the exogenous variable was patient symptomatology which included cognitive impairment, behavioral problems, dependency in activity of daily living and in instrumental activity of daily living. Endogenous variables were caregiver's perception of dementia patient's unmet needs, caregiving satisfaction and caregiving burden. Data were analysed using SPSS/WINdows and AMOS program. Results: Caregiving burden was explained by patient symptomatology and caregiving satisfaction indicating significant direct effects and significant indirect effect from unmet needs. The proposed model explained 37.8% of the variance. Caregiving satisfaction was explained by patient symptomatology and unmet needs. Mediating effect of unmet needs was significant in the relationship between patient symptomatology and caregiving satisfaction. Conclusion: Results indicate that interventions focusing on relieving caregiving burden and enhancing caregiver satisfaction should be provided to caregivers with high levels of dementia patients' unmet needs and low level of caregiving satisfaction.

Current Status and Factors Related to Physical Activity of Older Nursing Home Residents with and without Dementia: Effects of Individual and Institutional Characteristics (장기요양시설 거주노인의 치매 여부에 따른 신체활동수준과 관련 요인: 개인 및 기관 특성의 영향)

  • Chun, Seungyeon;Kim, Hongsoo
    • Health Policy and Management
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    • v.28 no.4
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    • pp.392-401
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    • 2018
  • Background: Physical activity (PA) is critical for maintaining the health and well-being of older people in community and also institutional settings. The purpose of this study was to examine the current status of PA and related individual and organizational factors among older nursing home residents with and without dementia. Methods: This is a secondary data analysis study of a nationwide survey of 92 long-term care facilities in Korea, and the study sample includes older residents with dementia (n= 753) and without dementia (n= 480). The level of PA was measured by PA time and whether or not residents had an outdoor activity over the past 3 days. Multi-variate, multi-level analyses were conducted. Results: More than half of the sample in both groups had no or less than 1 hour of PA. About one out of four older people in our sample had no outdoor activity over the past 3 days regardless of whether or not they had dementia. Among the people without dementia, several individual-level factors were associated with PA, including dependency for activities of daily living, social activity participation, and caregivers' belief in the functional improvement of residents. Unlike the non-dementia group, individual- and organizationallevel factors including staffing level and having the relevant equipment for PA were associated with PA among those with dementia. Conclusion: Study findings provide evidence on the lack of PA among older nursing home residents, and the importance of institutional capacity with regard to human resources and physical equipment for promoting PA among people with dementia, in particular. Policies and supports are needed to promote the implementation of healthy aging programs including PA for older nursing home residents. Such programs should be person-centered with consideration to the physical and cognitive status of individual residents.

Daylighting Design Factors for Korean Dementia Nursing Homes Based on the Therapeutic Effects of Light (빛에 의한 치료적 효과 기반의 한국형 치매요양시설의 자연채광 계획 요소에 관한 고찰)

  • Jee, Soo In
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.28 no.4
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    • pp.71-87
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    • 2022
  • Purpose: This study examines the daylighting design factors of Korean dementia nursing homes, in order to realize a therapeutic environment based on the therapeutic effect of light in the rapidly aging trend with an huge increase in the population of dementia in Korea. Methods: Through literature reviews, this study aims to theoretically examine the therapeutic light environment for the elderly with dementia, derive daylighting design factors of Korean dementia nursing homes, and analyze their detailed design factors. Results: The result of this study can be summarized into two points. The first one is that the daylighting design factors reflected in dementia nursing homes are derived into six factors: building layout, windows, glazing, shading devices, spaces, and interior finishings that determine the availability of daylight. The second one is that the detailed daylighting design factors are shown as primary and secondary detailed design factors, and the main values to be considered when applying these factors into dementia nursing homes are analyzed as maximizing daylight availability, optimization of the possibility of therapeutic view, and anti-glare. Implications: The daylighting design factors will contribute to maximizing the availability of daylight, optimizing the possibility of view, and minimizing the glare in the living spaces of dementia nursing homes in Korea.

Three Case Reports of Patients with Secondary Dementia Treated with Korean Traditional Medicine, Especially Boshiniknoe-tang-gami (속발성 치매 환자에 대한 보신익뇌탕가미방의 효과 3례)

  • Bae, Go-eun;Cho, Jae-hyun;Choi, Jin-yong;Seo, Hee-jeong;Shim, So-hyun;Kwon, Jung-nam;Hong, Jin-woo;Kim, So-yeon;Choi, Jun-young;Han, Chang-woo;Yun, Young-ju;Park, Seong-ha;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.628-640
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    • 2017
  • Purpose: To describe the effectiveness of traditional Korean medicine (TKM) on the patients with secondary dementia (case 1: Rt. MCA infarction; case 2: traumatic subacute subdural hemorrhage and traumatic intracranial hemorrhage; case 3: delayed encephalopathy after carbon monoxide poisoning). Methods: We used a complete TKM treatment. The acupoints used were as follows: acupoints frequently used in hemiparesis (GV20, GV24, ST4, LI11, LI14, ST36, GB34, SP9, and LR3), and we used herbal medicine (補腎益腦湯加味, Boshiniknoe-tang-gami). The efficacy was evaluated using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Modified Barthel Index (MBI). Results: After treatment, the total MMSE-DS score was increased from 14 to 24 (case 1), 14 to 19 (case 2), and 0 to 17 (case 3). The total K-MBI was increased from 30 to 44 (case 1), 82 to 86 (case 2), and 30 to 86 (case 3) Conclusions: We suggest that TKM could positively influence cognition and improve activity of daily living (ADL). This study has limitations, so further studies are needed.

Abnormal Eye Movements in Patients with Dementia (치매 환자에서 나타나는 비정상적인 안구운동)

  • Kim, Hyun;Lee, Kang-Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.73-80
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    • 2007
  • Anumber of prior studies have reported eye movement dysfunction in patients with dementia. The eye movement test which is non-invasive can evaluate the local brain function quantitatively. Therefore, it can be a useful method for characterizing regional brain abnormalities of patients with dementia. The aim of this paper is to review the literatures on eye movement abnormalities in dementia patients. Saccade system dysfunctions in Alzheimer disease include increased latency, reduced accuracy, and increased antisaccade error rates. Patients with frontotemporal dementia showed impaired reflexive saccade inhibition and increased latency and errors of antisaccade task. And delayed initiation of voluntary saccades, slow saccades, and increased errors and latency on antisaccade task were found in Huntington's disease. Patients with Parkinson’s disease dementia and dementia with Lewy bodies have characteristics of impaired in both reflexive saccade execution and complex saccade performance. However, there were few reports of abnormal eye movements in Creutzfeldt-Jakob disease; they could be found at the later stages after symptoms of dementia came to be evident, and secondary to cerebellar and vestibular involvement. Slowing of saccades and hypometric saccades might precede the supranuclear limitation of vertical gaze in PSP. Dysfunction of voluntary eyelid movements was a characteristic finding of PSP as well. In conclusion, patients with dementia can show various abnormal eye movements and they are related with cortial and subcortical brain dysfunctions. The research on localization of brain relevant to each symptom can promise more clinical implications of eye movement of dementia.

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