• Title/Summary/Keyword: vascular dementia

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Proposal of Evidence-based East-West Integrative Medicine Manual for Vascular Dementia (혈관성 치매에 대한 근거기반 의한 협진 매뉴얼 제안)

  • Kim, Bomin;Jo, Hee-Geun;Kang, Hyung-Won;Choi, Sung-Youl;Song, Min-Yeong;Sul, Jae-Uk;Leem, Jungtae
    • The Journal of Korean Medicine
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    • v.40 no.1
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    • pp.46-62
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    • 2019
  • Objectives: This study was made by Chung Yeon Korean Medicine Hospital in order to perform appropriate East-West integrative medicine. The purpose of this manual is to support decision-making and communication in the implementation of the East-West cooperative treatment of vascular dementia. Methods: In order to carry out this study, it is based on search terms such as 'vascular dementia', 'acupuncture', 'herbal medicine', 'integrative medicine', 'chinese traditional medicine', and 'cognitive function' in databases such as MEDLINE, EMBASE, OASIS and CNKI We collected references. The drafting proceeded with the collaboration of two specialists of the Korean medicine, and the disagreement on the basis of the quotation was determined through a two person agreement. After, The draft was reviewed by a western medical doctor(rehabilitation specialist). Then, The opinions of the entire medical staff of the committee were reflected in the draft and finalized the agreement. Results: Through this study, manuals for diagnosis, treatment, and other considerations in the process of applying East-West integrative medicine to vascular dementia were derived. Conclusions: This study has significance in that it provides manual information about the decision structure, treatment contents, role distribution, etc. of East-West integrative medicine within the medical institution that conducts the vascular dementia consultation. In order for this study to function as a generalized medical guideline, it is necessary to improve the research methodology and carry out professional consensus procedures.

Case of Vascular Dementia Treated with Bojungikki-tang-gamibang (보중익기탕가미방(補中益氣湯加味方) 투여로 호전된 혈관성 치매 환자 1례 보고)

  • Park, Kyung;Kim, Hee-Jun;Son, Ji-Young;Kwak, Min-A;Kim, Seung-Mo;Kim, Dae-Jun;Byun, Joon-Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.4
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    • pp.943-947
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    • 2008
  • This study is designed to evaluate the effects of an oriental herbal medication namely Bojungikki-tang-gamibang on vascular dementia. The Clinical data was analyzed on a patient with vascular dementia due to deficiency of Spleen Gi, whose symptoms were dementia, Rt. side hemiparesis, insomnia, anorexia et al. The patient visited at the internal medicine department of Daegu Haany University affiliated Kumi Oriental Hospital on February 14, 2008 to March 28, 2008. The improvement of symptoms were checked by Mini Mental Status Examination-Korea(MMSE-K). After treatment, dementia, Rt. side hemiparesis, insomnia, anorexia got improved and MMSE-K score increased as well. This study suggests that Bojungikki-tang-gamibang is significantly effective in treatment of vascular dementia.

Panax Ginseng in the treatment of Alzheimer's disease and vascular dementia

  • Zhiyong Wang;Zhen Zhang;Jiangang Liu;Mingdong Guo;Hao Li
    • Journal of Ginseng Research
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    • v.47 no.4
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    • pp.506-514
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    • 2023
  • Dementia has become one of the most important diseases threatening human health. Alzheimer's disease (AD) and vascular dementia (VaD) have the highest incidence rates among the types of dementia, but until now, therapeutic methods have been limited. Panax ginseng has been used in China for thousands of years to treat dementia, and modern medical studies have found that it contains multiple active components, such as ginsenosides, polysaccharides, amino acids, volatile oils and polyacetylenes, many of which have therapeutic effects in treating AD and VaD. Studies have found that ginsenosides have multitarget therapeutic effects in treating dementia, such as regulation of synaptic plasticity and the cholinergic system, inhibition of Aβ aggravation and tau hyperphosphorylation, anti-neuroinflammation, anti-oxidation effects and anti-apoptosis effects. Other active components of Panax ginseng, such as gintonin, oligosaccharides, polysaccharides and ginseng proteins, also have therapeutic effects on AD and VaD. The effectiveness of ginseng-containing Chinese medicine compounds has also been confirmed by clinical and basic investigations in treating AD and VaD. In this review, we summarized the potential therapeutic effects and related mechanisms of Panax ginseng in treating AD and VaD to provide some examples for further studies.

A Review on the Trend of Clinical Research on Pharmacopuncture for Vascular Dementia in Traditional Chinese Medicine (혈관성 치매의 약침 치료에 대한 중의학 임상연구 동향)

  • Hong, Min-Ho;Kim, Man-Gi;Koo, Byung-Su;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.4
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    • pp.315-327
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    • 2020
  • Objectives: The aim of this study was to review the research trends in the treatment of pharmacopuncture for vascular dementia in Traditional Chinese medicine. Methods: We searched for articles in the China National Knowledge Infrastructure (CNKI) database from January 2000 to August 2020. Results: Among the total 63 articles, 9 articles were selected. All studies were randomized controlled trial studies. The Diagnostic and Statistical Manual of Mental Disorders (DSM) was most frequently used as diagnostic criteria. Effective rate and Activity of Daily Living (ADL) were most commonly used as outcome measurements. Angelica gigantis Radix (當歸), Salvia miltiorrhiza Bunge (丹蔘), and Astragali Radix (黃芪) were the most commonly used ingredients in pharmacopuncture. Joksamni (ST36) and Sinsu (BL23) were the most commonly used acupoints for pharmacopuncture treatment. Based on the Risk of Bias (RoB) of these 9 articles, the overall quality of studies was low. Conclusions: Pharmacopuncture could be considered for the treatment of vascular dementia. In the future, various systematic studies on dementia are needed.

Hypertension and cognitive dysfunction: a narrative review

  • Eun-Jin Cheon
    • Journal of Yeungnam Medical Science
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    • v.40 no.3
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    • pp.225-232
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    • 2023
  • Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.

Analysis of Cardiovascular Medication Use in Dementia Patients (치매환자에서의 심혈관계 약물사용 분석)

  • Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.3
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    • pp.136-142
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    • 2017
  • Background: Dementia is one of important social and economic healthcare issues in the aging age. Therefore, it signifies to analyze the relationship between chronic disease or cardiovascular drug use and the incidence of dementia to establish a basis for increasing or preventing the risk of dementia. The purpose of this study was to investigate the correlation between the prevalence of chronic diseases and the use of cardiovascular drugs in patients diagnosed with dementia. Methods: In this study, we used data from sample of elderly patients from the Health Insurance Review and Assessment Service. We analyzed by logistic regression analysis with age, gender, and medication as covariates. KCD-7 was used to diagnosis of the disease, and drugs were analyzed using ATC codes and Korean standardized drug classification codes. Results: A total of 1,276,331 patients were analyzed in the sample of the elderly population, of which 532,075 (41.7%) were male and 744,256 (58.3%) were female. The patients have the higher risk of dementia in the older, women, and lower socioeconomically status. Cerebral infarction and ischemic heart disease increases risk of dementia. Patients taking statins, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonists (ARB) showed low incidence of dementia. Conclusion: This study has been shown that ACEI, ARB, and statin drugs may associate with lower incidence of Alzheimer's and other dementia except vascular 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.

Three cases of Vascular Dementia Patients (혈관성 치매 환자 치험 3례)

  • Jang, Moon-Hee;Choi, Jae-Song;Bae, Na-Young;Ahn, Teak-Won
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.3
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    • pp.402-411
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    • 2011
  • 1. Objectives: This study is about three vascular dementia patients with disorientation, memory impairment and cognitive disorder. In this study, we evaluated the effects of Sasang constitutional treatment and suggested using the Mini Mental Status Examination - Korea (MMSE-K), Global Deterioration Scale (GDS). 2. Methods: These three patients were treated by Sasang constitutional herbal medications based on "Donguisusebowon". Acupuncture and west medications were limited as much as possible. We evaluated the symptoms through the Mini Mental Status Examination - Korea (MMSE-K), GDS (Global Deterioration Scale). 3. Results and Conclusions: Disorientation, memory impairment and cognitive disorder that were these three patients chief complaints were improved. This case study shows that Sasang constitutional herbal medications are an effective treatment for vascular dementia patients.

A Case Report of Vascular Dementia Following Acute Cerebral Infarction and Subarachnoid Hemorrhage Improved by Comprehensive Korean Medicine (급성 대뇌경색증을 동반한 지주막하 출혈 이후 발생한 혈관성 치매 한의복합치료 1례)

  • Ga-Hyun Lee;Seung-Woo Song;Se-Jin Park
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.3
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    • pp.269-278
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    • 2024
  • Objectives: Vascular dementia (VaD) is a neurodegenerative disorder associated with cognitive impairment resulting from cerebrovascular pathology. This clinical case study aimed to evaluate the efficacy of Korean medicine treatment in treating VaD following an acute cerebral infarction and subarachnoid hemorrhage. Methods: The subject, a female in her 70s, reported cognitive impairment and right-sided hemiparesis following an acute cerebral infarction and subarachnoid hemorrhage. The patient received comprehensive treatment comprising herbal medicine, acupuncture, moxibustion, and cupping therapy for 108 days. We assessed improvements in cognitive impairment and neurological symptoms using the Korean version of the Mini-Mental Status Examination (MMSE-K), Global Deterioration Scale (GDS), and Korean version of Modified Barthel Index (K-MBI). Results: After treatment, both cognitive impairment and right-sided hemiparesis improved. Scores of MMSE-K, GDS, K-MBI, and MMT also increased. Conclusions: Korean medicine treatment could be considered for patients with vascular dementia following acute cerebral infarction and subarachnoid hemorrhage.

Effect of Ghrelin on Memory Impairment in a Rat Model of Vascular Dementia (그렐린이 혈관성 치매 쥐의 기억 손상에 미치는 효과)

  • Park, Jong-Min;Kim, Youn-Jung
    • Journal of Korean Academy of Nursing
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    • v.49 no.3
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    • pp.317-328
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    • 2019
  • Purpose: The purpose of this study was to identify the effect of ghrelin on memory impairment in a rat model of vascular dementia induced by chronic cerebral hypoperfusion. Methods: Randomized controlled groups and the posttest design were used. We established the representative animal model of vascular dementia caused by bilateral common carotid artery occlusion and administered $80{\mu}g/kg$ ghrelin intraperitoneally for 4 weeks. First, behavioral studies were performed to evaluate spatial memory. Second, we used molecular biology techniques to determine whether ghrelin ameliorates the damage to the structure and function of the white matter and hippocampus, which are crucial to learning and memory. Results: Ghrelin improved the spatial memory impairment in the Y-maze and Morris water maze test. In the white matter, demyelination and atrophy of the corpus callosum were significantly decreased in the ghrelin-treated group. In the hippocampus, ghrelin increased the length of hippocampal microvessels and reduced the microvessels pathology. Further, we confirmed angiogenesis enhancement through the fact that ghrelin treatment increased vascular endothelial growth factor (VEGF)-related protein levels, which are the most powerful mediators of angiogenesis in the hippocampus. Conclusion: We found that ghrelin affected the damaged myelin sheaths and microvessels by increasing angiogenesis, which then led to neuroprotection and improved memory function. We suggest that further studies continue to accumulate evidence of the effect of ghrelin. Further, we believe that the development of therapeutic interventions that increase ghrelin may contribute to memory improvement in patients with vascular dementia.