• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.306-316
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• 1999

Objectives: In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. Methods: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase 1,356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and feinted Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. Results: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12,8%(age-adjusted rate: 13,0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.0-10.4%]), The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. Conclusions : These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.

• The Journal of Internal Korean Medicine
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• v.21 no.2
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• pp.193-201
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• 2000

Objective : In western medicine, many medication therapies and non-medication therapies have been treated for dementia. But these methods did no more than symptomatic therapies, not basic treatment, which just can better subordinate symptoms. In fact, care or control became the very point of treatment of dementia. So, to try to find oriental medical treatments for Dementia, a clinical analysis was carried out for 84 patients who were diagnosed as Dementia through MMSE-K and treated in Dong-shin Oriental Medicine Kwangju Hospital and Karitaas Sanatorium from 10. Jan. 1998 to 20. May. 2000. Methods : Regardless of patterns of Dementia, the basic treatment(本治) is to supplement encephalon deficiency(腦髓不足). And the external treatment(標治) must be accompanied by through diagnosis according to symptoms(辨證). All patients were given Yukmi-jihwanghwan gami and acupuncture treatment. Results : Dementia of cerebral vascular type shows a high distribution(51 patients, 60.7%). Women also are distributed more widely(62명, 73.8%). In Age distribition, 70-79 years-32 patients(38.1%), over 80 years-21 patients(25%), 60-69 years-17 patients(20.2%), 50-59 years-13 patients(15.5%) and under 49 years-1 patient(1.2%). From this, Dementia occurs well over 60 years and the rate of occurrence of Dementia is high as people grow older. In past history of people with Dementia, hypertension is associated much(50 patients, 64.1%). Distribution of mental state by MMSE-K examination declined in orientaion, mathmatical faculty, memory faculty and composition faculty. In therapeutic effect by treatment duration, 14 patients(93.3%) out of 15 in sanatorium show a significant effect. And 52 patients(75.4%) out of 69 in the hospital show the same result. Especially, 11 patients with Alzheimer type in sanatorium showed an good effect when treated over 4 months. 40 patients(83.3%) with cerebral vascular type out of 48 in the hospital showed the stage of betterment. Conclusions : The basic treatment(本治) for Dementia is to supplement encephalon deficiency(腦髓不足). For promoting encephalon through supplementing kindney(補腎健腦), All patients were given Yukmi-jihwanghwan gami. And the external treatment(標治) through diagnosis according to symptoms(辨證) were be accompanied by. The result is quite effective. We consider there must be more research based on this study.

• Journal of Society of Preventive Korean Medicine
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• v.24 no.1
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• pp.37-48
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• 2020

Objective : In this article, we overviewed clinical Korean Medicine studies on dementia by analyzing papers published in Korea from 2010 to 2019. Methods : We explored research articles on dementia from 5 Korean research databases using the keyword 'dementia' and 'Korean Medicine'. We included original articles and reviews of clinical Korean Medicine and excluded single case study and experiment article of animal model. Then we analyzed them according to the published year, journal type, and research topics. Results & Conclusions : Research topics were classified into 'research trend', 'treatment', 'prevention', 'evaluation', 'medical expenses', 'collaborative practice' and 'others'. The largest number of articles were published in 2011(24.4%). 'Journal of Oriental Neuropsychiatry' was the journal with the most published articles(46.3%). In research topics, the analyses of research trend accounted for the largest portion(39.0%) and the articles about treatment for dementia or evaluation index in Korean medicine had the second largest proportion(14.6%). We hope that various researches for therapeutic effects, mechanisms and preventive effects of Korean Medicine in dementia would be conducted for future study.

• Therapeutic Science for Rehabilitation
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• v.7 no.1
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• pp.51-62
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• 2018

Objective : This study was to verify the effects of occupation-based training with errorless learning and spaced retrieval on task learning and satisfaction of elderly with mild vascular dementia. Methods : The subjects of this study were 3 geriatric individuals with mild vascular dementia, ABA' + follow-up design was used. Intervention period was provided occupation-based training with errorless learning and spaced retrieval. The dependent variable was converted to ability of task performance every session and satisfaction before and after intervention. Result analysis was suggested through visual analysis and bar graph. Results : After the occupation-based training with errorless learning and spaced retrieval, Ability of task performance and satisfaction improved for all subjects. Conclusions : From this study, occupation-based training with errorless learning and spaced retrieval training was found to be an effective mediation for improving independence of task and satisfaction for people with mild dementia. This study could provide evidence for clinical application for occupation-based training.

• Journal of Preventive Medicine and Public Health
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• v.53 no.1
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• pp.56-63
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• 2020

Objectives: The objective of this study was to determine the effect of atrial fibrillation (AF) on the risk of dementia in the Korean elderly. Methods: A 10-year retrospective cohort study was conducted using the National Health Insurance Service-Senior Cohort database. We excluded those who were under 65 years of age as of January 2006 (n=46 113), those who were diagnosed with dementia between 2002 and 2005 (n=9086), and those with a history of stroke prior to AF diagnosis (n=8392). We used a Cox proportional hazards model with a time-varying covariate to determine whether AF is associated with the risk of dementia after adjusting for potential confounders. Results: In univariable Cox regression, the hazard ratio (HR) of dementia according to AF status was 1.28 (95% confidence interval [CI], 1.23 to 1.33). After adjusting for potential confounders, AF was found to increase the risk of dementia (HR, 1.12; 95% CI, 1.07 to 1.17), Alzheimer dementia (HR, 1.12; 95% CI, 1.07 to 1.17), and vascular dementia (HR, 1.10; 95% CI, 1.03 to 1.18). In patients diagnosed with AF, the incidence of dementia was lower (HR, 0.50; 95% CI, 0.47 to 0.52) in patients who were treated with oral anticoagulants. Conclusions: Investigating the potential risk factors of dementia in an aged society is important. We found a slightly higher risk of dementia in those with AF than in those without AF, and we therefore concluded that AF is a potential risk factor for dementia.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.5
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• pp.2953-2961
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• 2014

Dementia once occurred is known to be mostly irreversible but can be treated only if it is detected early; especially vascular Dementia. Thus, in this paper we have developed Dementia diagnosis and care application through inter-working between biometric sensors and smart phone. With developing serious game for the demented elderly, we proposed ons-stop solution for Dementia; smart-phone application with diagnosis, prevention and mitigation of Dementia. Since the proposed game for mitigating Dementia requires sense of space and balance using both arms instead of operating simple arrow button, a treatment effect for Dementia will be doubled. If we tried to forestall, ease and cure Dementia with the proposed application. the social losses from Dementia would be minimized as a result.

• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.359-368
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• 2023

Objectives: This study aims to establish a Korean medicine doctor's range of services in the dementia relief primary care system based on the previously developed dementia clinical practice guidelines (CPGs). Developing a dementia relief primary care Clinical Pathway (CP) can aid clinically when the Korean medicine primary care doctor conducts treatment. Methods: We analyzed Dementia Korean Medicine Primary Care Model Data and then applied CP Methodology to develop the configuration of the Korean Medicine Primary Care Model. For patients with Alzheimer's dementia (AD), vascular dementia (VD), and mild cognitive impairment (MCI), the Korean Medicine Primary Care Model focuses on improving cognitive function, everyday living abilities and easing symptoms through interventions described in CPGs. The contents of the draft model later include references to already-existing CPs. Results: The study sites were chosen as Korean medical clinics connected to primary care physicians in the dementia-friendly model. The CP used a time task matrix version to arrange the clinical chronology, which included all examinations, diagnoses, and treatment procedures, from the initial appointment to follow-ups and the end of therapy. Conclusions: It anticipates that Korean primary care doctors familiar with dementia can use the offered therapies for the first time by creating the dementia Korean medicine primary care model in this study. This is expected to maximize the range of medical services provided by Korean medicine and improve the standard of medical treatment.

• Dementia and Neurocognitive Disorders
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• v.22 no.2
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• pp.49-60
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• 2023

Background and Purpose: The National Responsibility Policy for Dementia Care was implemented in September 2017 in Korea. This study aimed to compare dementia incidence in Seoul and Gangwon-do before and after the implementation of this policy. Methods: We extracted insurance claim data from the Korean Health Insurance Review and Assessment Service for people diagnosed with diabetes, hypertension, or dyslipidemia for the first time in Seoul and Gangwon-do, Korea. We defined two enrollment groups based on the policy implementation date: 1) January 1, 2015 to December 31, 2016 (Index 1, pre-implementation), and 2) January 1, 2017 to December 31, 2018 (Index 2, post-implementation). Each group was followed up for 1 year from the time of enrollment. Then, we calculated hazard ratios to compare the incidence of dementia between the two groups, and between Seoul and Gangwon-do. Results: In Seoul, the incidence of dementia was significantly lower in Index 2 than in Index 1 (hazard ratio [HR], 0.926; 95% confidence interval [CI], 0.875-0.979). However, the incidence rate did not differ between the 2 groups (HR, 1.113; 95% CI, 0.966-1.281) in Gangwon-do. In Index 1, the incidence of dementia did not differ between Seoul and Gangwon-do (HR, 1.043; 95% CI, 0.941-1.156), but in Index 2, was significantly higher in Gangwon-do than in Seoul (HR, 1.240; 95% CI, 1.109-1.386). Conclusions: After implementing the National Responsibility Policy for Dementia Care, the dementia incidence rate decreased significantly in Seoul, consistent with other studies, but not in Gangwon-do.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.459-469
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• 2016

The purpose of this study was to examine different patterns of behavioral and psychological symptoms of dementia (BPSD) and caregiver burden according to dementia type. Data were collected from June 2014 to December 2014 from five nursing homes. In all, 214 patients [131 patients with Alzheimer's disease (AD) and 83 patients with Vascular dementia (VD)] were included in the study. BPSD and caregiver burden data were examined using NPI-NH (Neuropsychiatric Inventory Nursing Home Version). According to the results, both the AD and VD group showed the highest frequency in apathy/indifference and the frequency of anxiety, elation/euphoria, and irritability/lability was significantly higher in the AD group than in the VD group. The difference in total BPSD composite scores between the AD and VD groups was not significant but agitation/aggression was significantly higher in the AD group than in the VD group. The mean score for caregiver burden was significantly higher in the AD group than in the VD group, particularly in agitation/aggression. In conclusion, BPSD differed according to dementia type, and nurses should provide specific interventions to control BPSD; a program to reduce caregiver burden according to dementia type is also needed.

• Nutrition Research and Practice
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• v.11 no.5
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• pp.381-387
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• 2017

BACKGROUND/OBJECTIVES: Vascular dementia (VaD) caused by reduced blood supply to the brain manifests as white matter lesions accompanying demyelination and glial activation. We previously showed that arabinoxylan consisting of arabinose and xylose, and arabinose itself attenuated white matter injury in a rat model of VaD. Here, we investigated whether larch arabinogalactan (LAG) consisting of arabinose and galactose could also reduce white matter injury. MATERIALS/METHODS: We used a rat model of bilateral common carotid artery occlusion (BCCAO), in which the bilateral common carotid arteries were exposed and ligated permanently with silk sutures. The rats were fed a modified AIN-93G diet supplemented with LAG (100 mg/kg/day) for 5 days before and 4 weeks after being subjected to BCCAO. Four weeks after BCCAO, the pupillary light reflex (PLR) was measured to assess functional consequences of injury in the corpus callosum (cc). Additionally, Luxol fast blue staining and immunohistochemical staining were conducted to assess white matter injury, and astrocytic and microglial activation, respectively. RESULTS: We showed that white matter injury in the the cc and optic tract (opt) was attenuated in rats fed diet supplemented with LAG. Functional consequences of injury reduction in the opt manifested as improved PLR. Overall, these findings indicate that LAG intake protects against white matter injury through inhibition of glial activation. CONCLUSIONS: The results of this study support our hypothesis that cell wall polysaccharides consisting of arabinose are effective at protecting white matter injury, regardless of their origin. Moreover, LAG has the potential for development as a functional food to prevent vascular dementia.