• Title/Summary/Keyword: 임상치매평가

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Behavioral Variant Frontotemporal Dementia Phenocopy Syndrome (행동증상 아형 전측두엽 치매 표현형모사 증후군)

  • Cheon, Jin Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.3-11
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    • 2017
  • Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.

Effects of Galantamine Treatment on Attention, Activities of Daily Living, and Neuropsychiatric Symptoms between the Patients with Pure Alzheimer's Disease and Mixed Dementia (갈란타민(Galantamine) 투여 후 순수 알츠하이머병 치매와 혼합성 치매 환자의 주의력, 일상생활능력 및 신경정신행동 증상에 대한 효과 평가)

  • Kang, Hyo Shin;Yun, Ji Hae;Ahn, Inn Sook;Moon, Yu Jin;Hwang, Tae Young;Lee, Young Min;Kim, Hyeran;Kim, Doh Kwan
    • Journal of Korean geriatric psychiatry
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    • v.16 no.1
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    • pp.24-30
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    • 2012
  • Objectives : The purpose of this study was to compare the efficacy of galantamine treatment, especially attention ability between patients with pure Alzheimer's disease (AD) and Mixed dementia (MD) during a 24-week trial. Methods : A total of 40 patients were recruited for this 24-week study. The effect of galantamine on attention was measured using Seoul Computerized NeuroCognitive Function Test (SCNT) and frontal functions test of Seoul Neuropsychological Screening Battery (SNSB). Patients'activities of daily living using the Seoul-Activities of Daily Living (S-ADL) and the Seoul-Instrumental Activities of Daily Living (S-IADL) ; behavioral symptoms using the Korean version Neuropsychiatric Inventory (K-NPI) were measured at baseline and 24-week. Results : 17 pure AD patients and 23 MD patients were analyzed in this study. Attention as measured by SCNT was not significantly different from baseline after 24 weeks of treatment in both groups. There was no significant difference between two groups in mean change from baseline in the SCNT, S-ADL, S-IADL and K-NPI scores at 24-week. Conclusion : Galantamine showed a therapeutic effect on cognition, activities of daily living, neuropsychiatric symptoms in pure AD and MD. Furthermore, Galantamine may specifically help to maintain attention and it may have positive effects on other cognitive and functional abilities.

The Differences of Serum Homocysteine Levels in Mild Cognitive Impairment and Dementia of Alzheimer's Type with or without Depressive Symptoms (경도인지장애, 알쯔하이머형 치매 환자에서 우울증상 유무에 따른 혈중 호모시스테인의 차이)

  • Hwangbo, Ram;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.40-45
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    • 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.

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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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Review of the instrumental ADL for the Patients With Mild Cognitive Impairment (경도인지장애 환자의 수단적 일상생활활동에 대한 고찰)

  • Ahn, Si-Nae
    • Therapeutic Science for Rehabilitation
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    • v.2 no.2
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    • pp.37-45
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    • 2013
  • This research reviewed the instrumental ADL for patients with mild cognitive impairment, which is one of the most interested topics, and hope that this research helps evaluating and treating the mid cognitive impairment patients in occupational therapy. The treatment for dementia patients are actively in progress, but there has not been treatment approach about mild cognitive impairment patients, who are in risk of moving on to dementia. In this review, we have dealt with the foundation of matching the point to instrumental ADL from the occupational areas of mild cognitive impairment patients and normal elders. We have discussed the that essential consideration about instrumental ADL is needed to prevent mild cognitive impairment developing into dementia. In conclusion, there is a need of regular evaluation about instrumental ADL considering the occupational areas of mild cognitive impairment patient groups, who are highly in risk of developing into dementia, and occupational therapeutic approach is needed as well.

Improvement of Attention and Short-term Memory of Mild Dementia Using iPad Applications: A Single Case Study (아이패드를 이용한 경도 치매 노인의 주의집중력과 단기 기억력 증진 : 단일대상연구)

  • Hwangbo, Seung Woo;Kim, Moon-Young;Kim, Jongbae;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.47-58
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    • 2018
  • Objective : This study was conducted to investigate the effects of iPad applications on improvement of attention and short-term memory in mild dementia. Methods : A single-case experimental study using A-B-A design was conducted. A total of 20 sessions, including 5 each for baseline phase A and A' and 10 for the intervention phase, were provided to the subject. Interventions were only provided during the intervention phase and were iOS-based iPad applications named "Memorado-Moving Balls" and "Circles." "Fit Brains-Matching Pairs" and "Fit-Brains-Spot the Difference" were used for each session to evaluate attention and short-term memory. MMSE-K, K-TMT-e A and B, and DST assessment tools were used pre- and post-intervention to assess attention and memory. Result : Fit Brains scores indicated improvement in both attention and memory during the intervention phase. K-TMT-e A showed 3 increased correct points and 3 reduced error points, and B showed 7 increased correct points and 2 reduced error points in post-tests, but the DST and MMSE-K showed no meaningful change. Conclusion : This single-case study identified improvements in attention and short-term memory in a person with mild dementia using iPad applications. Further studies regarding different applications and larger samples with long-term designs are necessary.

Effect of Oral Health Care on Swallowing Function and Swallowing-Quality of Life in Patients with Dementia (치매환자의 구강관리가 삼킴기능과 구강관련 삶의 질에 미치는 영향)

  • Bae, Seong-Hwan;Baek, Ji-Young
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.449-459
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    • 2019
  • The purpose of this study was to evaluate the status of oral health care in dementia patients living in long-term care facilities and to investigate the effects of this on swallowing function and swallowing-quality of life. The subjects were 60 demented patients who were admitted to long-term care facilities in Gwangju and Jeonnam provinces. Their Oral Health Assessment Tool(OHAT), Clinical Dysphagia Scale(CDS), and Oral Health Impact Profile 14(OHIP-14) were measured. The results of this study were as follows: First, the effect of oral health care on dentition patients using long-term care facilities on swallowing function and swallowing-quality of life was significantly different according to oral care score (p<.05)(p<.01). Second, the relationship between oral health care and swallowing function of dementia patients and swallowing-quality of life. was examined. As a result, oral health care of dementia patients was affected by swallowing function (r=.405, p<.01) the swallowing-quality of life (r=.462, p<.01) and swallowing function were significantly correlated with swallowing-quality of life (r=.351, p<.01). Therefore, the oral health care of users of long-term care facilities was closely related to swallowing function and swallowing-quality of life.

Correlation Between Cognitive Impairment Screening Test (CIST), Korean-Mini Mental State Examination, 2nd Edition (K-MMSE~2) and Clinical Dementia Rating (CDR) of Patients with Stroke (뇌졸중 환자를 대상으로 한 인지선별검사(CIST), 한국판 간이정신상태검사 2판(K-MMSE~2) 및 임상치매척도(CDR)의 상관성)

  • Hwang, Do-Yeon;Ryu, Sung-Hyun;Kwon, Ki-Hyun;Choi, Cho-Rong;Kim, Soo-A
    • Therapeutic Science for Rehabilitation
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    • v.11 no.2
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    • pp.53-62
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    • 2022
  • Objective : This study aimed to present basic data that could help in selecting or using evaluation tools in clinical settings. Methods : This study included 51 patients with stroke. The Cognitive Impairment Screening Test (CIST), Korean-Mini Mental State Examination, 2nd Edition (K-MMSE~2), and Clinical Dementia Rating (CDR) were used as evaluation tools. The correlation between evaluation tool scores was analyzed using Spearman's rank correlation coefficient, and the comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores was analyzed using the Wilcoxon signed-rank test. Results : The correlation between the total CIST and K-MMSE~2 scores and global CDR scores was statistically significant (p<.01). The correlation between the sub-scores of the CIST and K-MMSE~2 showed a statistically significant correlation for all sub-scores (p<.01). The comparison of total scores between the CIST and K-MMSE~2 according to global CDR scores showed no statistically significant differences in all global CDR scores. Conclusion : This study showed that there was a correlation between CIST, K-MMSE~2, and CDR in patients with stroke. In the future, we hope that the results of this study will help to select or use cognitive function evaluation tools in clinical settings.

Validity and Reliability of Cognitive Performance Scale in Long Term Care Hospital in Korea (인지수행척도(Cognitive Performance Scale)의 타당도와 신뢰도)

  • Lee, Ji Yun;Kim, Sun Min;Kim, A Reum
    • 한국노년학
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    • v.30 no.1
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    • pp.81-91
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    • 2010
  • The purpose of this study was to test a validity and reliability of Cognitive Performance Scale(CPS), a cognitive measure generated from 5 items(comatose status, decision making, short-term memory, making self understood, and eating). Method: 393 patients in 2 hospitals for the elderly with dementia were measured with CPS by two nurses independently. The inter-rater agreement was tested by comparing two scores. The CPS score was compared with GDS, which was measured by doctors and nurses, and MMSE score which was drawn from the claim data of Health Insurance Review & Assessment Service. Result: The correlation coefficient between CPS and GDS was 0.742(p<0.0001), CPS and MMSE was -0.794(p<0.0001). The Cronbach's coefficient alpha of CPS was 0.742, Kappa value was 0.772~1.000. The CPS showed high validity and reliability in long term care hospitals of Korea.

The clinical research of dementia assessment examination-focused on the diagnosis of dementia for patient of Cheongju district. (치매평가검진 환자에 관한 임상연구 (청주 지역사회 환자의 치매진단을 중심으로))

  • Jung, In-Chul
    • Journal of Haehwa Medicine
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    • v.15 no.1
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    • pp.1-9
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    • 2006
  • For this study, we carried out dementia assessment examination of 74 patients with memory disturbance who have come to Cheongju oriental hospital of Daejeon university from April 2005 to February 2006. This study classified the patients as none-dementia(ND), questionable dementia(QD), and dementia(DA) groups and analyzed the result of examination. As a result, the following conclusion was drawn. 1. Among the 3 groups, there was no significant differences in the sex distribution. But according to age distribution, the age of QD and DA groups showed significant difference from that of ND group. 2. MMSE-K and HDS-K scores showed the significant differences among all groups, and 7 MS result showed the significant difference between ND and the other groups. 3. The DA group significantly got lower scores than ND group in the items of the MMSE-K, Orientation, Registration, Recall, Attention, Copy two pentagons and Comprehension. Especially, significant difference also was shown in the orientation item between QD and DA groups. 4. The scores in the items of 7 MS, Benton temporal orientation, Enhanced cued recall and Clock drawing showed significant difference among all groups. Category fluency score showed significant difference between ND and the other groups. 5. The results of Brain CT and clinical chemistry test didn't show significant difference among all groups.

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