• Korean Journal of Psychosomatic Medicine
• /
• v.22 no.1
• /
• pp.40-45
• /
• 2014

Objectives : Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. Methods : A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). Results : The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. Conclusions : These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.

• The Journal of the Korea Contents Association
• /
• v.17 no.1
• /
• pp.222-232
• /
• 2017

The purpose of this study is to examine the effect of music therapy using Korean traditional rhythmic modes on the upper extremity function of elderly people with dementia. The subjects of this study were 13 patients at the age of 65 or more with dementia receiving long-term care in a nursing home in B City. It was analyzed that the effects of music therapy through the evaluation of manual function test (MFT), Activities of daily living (ADL), Korea dementia rating scale-2 test before and after the experiment. As a result, both of the scores of MFT and ADL were higher than after music therapy(p <.05) as well as Korea dementia rating scale-2 test score(management part). This indicates that the music therapy using Korean traditional rhythmic modes could improve function of the upper extremity with dementia as well as activities of daily living and management of dementia care. In conclusion, music therapy would be helpful to the improvement of not only the physical but also the cognitive function of elderly people with dementia, and it could be effectively employed in clinical settings.

• Journal of the Korea Convergence Society
• /
• v.13 no.4
• /
• pp.71-78
• /
• 2022

Parkinson's disease (PD) is clinically characterized by a variety of motor and non-motor symptoms, including cognitive and neuropsychiatric symptoms. Integrating a large variety of symptoms into a small number of clinical subtypes could be valuable for appropriate and early therapeutic intervention. As a first step toward this aim, this study attempted to identify correlation patterns among motor, cognitive and neuropsychiatric symptoms in PD without dementia. One hundred four non-demented patients with PD underwent a comprehensive motor, neuropsychological, and neuropsychiatric assessments. Factor analysis was performed to identify correlation patterns among demographic, motor, cognitive and neuropsychiatric variables. The eight factors were extracted: 1 motor-related, 3 cognitive-related and 4 neuropsychiatric factors. We indentified that characteristics of correlation can have associated symptom pattern in the disease process of Parkinson's disease. The current results suggest that a broad range of motor and non-motor symptoms in PD may be reducible to a small number of clinical parameters, which may be useful for identifying clinical subtypes of PD for individual patients.

• Therapeutic Science for Rehabilitation
• /
• v.7 no.1
• /
• pp.51-62
• /
• 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 Convergence for Information Technology
• /
• v.9 no.8
• /
• pp.248-253
• /
• 2019

Early diagnosis of mild cognitive impairment (MCI) can reduce the incidence of dementia. This study developed the MCI prediction model for the elderly in Korea. The subjects of this study were 3,240 elderly (1,502 men, 1,738 women) aged 65 and over who participated in the Korean Longitudinal Survey of Aging (KLoSA) in 2012. Outcome variables were defined as MCI prevalence. Explanatory variables were age, marital status, education level, income level, smoking, drinking, regular exercise more than once a week, average participation time of social activities, subjective health, hypertension, diabetes Respectively. The prediction model was developed using Restricted Boltzmann Machine (RBM) neural network. As a result, age, sex, final education, subjective health, marital status, income level, smoking, drinking, regular exercise were significant predictors of MCI prediction model of rural elderly people in Korea using RBM neural network. Based on these results, it is required to develop a customized dementia prevention program considering the characteristics of high risk group of MCI.

• Korean Journal of Psychosomatic Medicine
• /
• v.22 no.2
• /
• pp.71-78
• /
• 2014

Objectives : Behavioral and psychological symptoms of dementia(BPSD) represent significant clinical problems, resulting in functional decline, caregiver distress, institutionalization and increased mortality. A recent study showed gender differences have important role in the development of BPSD, but relationship between BPSD and gender has never been studied in Korea. This study was designed to examine whether patients with Alzheimer's disease show gender differences in behavioral and psychological symptoms of dementia(BPSD). Methods : Ninety-eight subjects with Alzheimer's disease were included in this study. We carried out history taking and cognitive assessment for the diagnosis of Alzheimer's disease based on DSM-IV. Cognitive impairment and BPSD were measured using the Mini Mental State Examination(MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating(CDR) and the Korean Neuropsychiatric Inventory(K-NPI). Independent samples t-test was used to examine the differences across gender in BPSD. Correlation analysis between MMSE, CDR, GDS and NPI was performed using Pearson's correlation coefficient. Results : There were no significant gender differences between the gender in BPSD. We found statistically significant negative correlations between MMSE with NPI total score, and with scores of several sub-domains such as hallucination. Conclusions : This study showed that gender differences in BPSD are not significant. Further research is necessary to identify whether BPSD affect gender differences or individual differences.

• Journal of the Korean Society of Radiology
• /
• v.82 no.5
• /
• pp.1124-1139
• /
• 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 Hospice and Palliative Care
• /
• v.19 no.3
• /
• pp.201-210
• /
• 2016

Delirium is a common symptom in patients with terminal cancer. The prevalence increases in the dying phase. Delirium causes negative effects on quality of life for both patients and their families, and is associated with higher mortality. However, some studies reported that it tends to remain unrecognized in palliative care setting. That may be related with difficulties to distinguish the symptom from others with overlapping characteristics such as depression and dementia, and a lack of knowledge regarding assessment and diagnostic tools. We suggest that accurate recognition with validated tools and early diagnosis of the symptom should be highly prioritized in delirium management in palliative care setting. After diagnosing delirium, it is important to identify and address reversible precipitants such as medication, dehydration, and infection. Non-pharmacological interventions including comfortable environment for the patient and family education are also essential in the management strategy. If such interventions prove ineffective or insufficient to control hyperactive symptoms, pharmacologic interventions with antipsychotics and benzodiazepine can be considered. Until now, low levels of haloperidol remains the standard treatment despite a lack of evidence. Atypical antipsychotics such as olanzapine, quetiapine and risperidone reportedly have similar efficacy with a stronger sedating property and less adverse effect compared to haloperidol. Currently, delirium medications that can be used in palliative care setting require more clinical trials, and thus, clinical guidelines are not sufficiently available. We suggest that it is warranted to develop clinical guidelines based on well-designed clinical studies for palliative care patients.

• Korean Journal of Psychosomatic Medicine
• /
• v.22 no.1
• /
• pp.23-30
• /
• 2014

Objectives : Homocysteine has been associated with cognitive impairment and various psychiatric symptoms. This study was designed to examine the relationship exists between plasma homocysteine concentration and behavioral and psychological symptoms of dementia(BPSD). Methods : 41 subjects with dementia of Alzheimer's type were included in this study. We carried out history taking, physical examination, and cognitive assessment for the diagnosis of dementia of Alzheimer's type based on DSM-IV. We scored the Mini Mental State Examination(MMSE), Global Deterioration Scale(GDS), Clinical Dementia Rating(CDR), and the Korean Neuropsychiatric Inventory(K-NPI). We also measured levels of homocysteine, folate, and vitamin $B_{12}$ in the plasma. Results : We found statistically significant positive correlations between homocysteine concentration with NPI total score, and with scores of several sub-domains such as delusion, agitation/aggression, depression/dysphoria, and elation/euphoria. No significant correlation existed between homocysteine levels and scores of MMSE, GDS, and CDR. Conclusions : This study shows that plasma homocysteine levels are associated with BPSD. Further research is necessary to identify pathophysiologic mechanisms underlying these relationships.

• Korean Journal of Psychosomatic Medicine
• /
• v.27 no.1
• /
• pp.60-68
• /
• 2019

Objectives : The association between thyroid-related hormones and cognitive function has been controversial. The purpose of this study is to compare the levels of thyroid-related hormones in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Furthermore, we investigated the relationship between thyroid-related hormones and cognitive function. Methods : From January 2011 to December 2018, we retrospectively reviewed 105 patients who were diagnosed with AD and MCI by visiting a dementia clinic at Ilsan Paik Hospital. Thyroid-related hormones [triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH)] was measured using chemiluminescent immunoassay. An independent sample t-test was performed to analyze the mean value of thyroid-related hormones in patients of AD and MCI. To investigate whether thyroid-related hormones correlate significantly with Global deterioration scale (GDS), Clinical dementia rating (CDR) and scores of each The Korean version of the consortium to establish a registry for Alzheimer's disease items, we conducted a partial correlation analysis with geriatric depression scale-Korean version (GDS-K) scores as covariates. Results : There was no significant difference in the mean serum T3, T4 and TSH levels between patients of the AD and the MCI, but the Construction Praxis Test (CPT) showed a significant positive correlation with the serum TSH concentration (p-value=0.004). Conclusions : In our study, the positive correlation between serum TSH level and the CPT associated with executive function was found to be helpful in understanding the association between thyroid-related hormones and the pathophysiology of dementia. Prospective studies in regard of the pathophysiology of thyroid-related hormones on cognitive function will be necessary in the future.