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

• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1124-1139
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• 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 the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.391-404
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• 2018

The purpose of this study was to determine the status of interventional studies to prevent falling in elderly with dementia and to determine the contents and effectiveness of intervention programs to prevent falling. Existing reports published between January 1, 2000 and December 31, 2016 were searched electronically using the RISS, National Library, KISS, PubMed, and CINAHL database with the keywords dementia, Alzheimer's or Alzheimer's disease, falling, and prevention of falling. After checking the original sources of the articles, 13 articles were included in the review. Therapeutic interventions used in the articles included exercise therapy (8, 61.5%), physiotherapy and occupational therapy (2, 15.4%), complementary therapies (2, 15.4%), and music therapy (1, 7.7%). As a result of the qualitative evaluation of the papers using a checklist of the Scottish Intercollegiate Guideline Network, two studies scored 9 out of 10 points, five studies scored 8 out of 10, and six studies scored 7 out of 10. Intervention sessions were conducted for 55 minutes, on average, for a total of 37 sessions. This study found that exercise, music therapy, physical and occupational therapy, and rhythmic motion therapy were effective in preventing falling in the elderly with dementia. In the future, these findings are expected to be used as a basis for the development of a preventive intervention program for nurses in a clinical setting.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.155-163
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• 2019

Objectives : The aim of this study was to compare severity, neurocognitive functions, and behavioral and psychological symptoms of dementia (BPSD) according to the degree of temporal lobe atrophy (MTA) in Korean patients with dementia due to Alzheimer's disease and mild cognitive impairment due to Alzheimer's disease. Methods : Participants were 114 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. Severity was evaluated with Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Neurocognitive functions was evaluated with the Korean version of Short Blessed Test (SBT-K) and the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet (CERAD-K). BPSD was evaluated with the Korean version of the Neuropsychiatric Inventory (K-NPI). Independent t-test was performed to compare severity, neurocognitive functions, and BPSD between two groups. Results : The group with high severity of MTA showed significantly lower scores in CDR, SBT-K, MMSE-KC, modified Boston naming test, word list recognition, and word list memory (p<0.05). There were no differences in K-NPI scores between two groups. Conclusions : Severity and neurocognitive functions of dementia had significant positive association with MTA, but BPSD had no association with MTA. Evaluating MTA seems to have potential benefit in diagnosing and treating neurocognitive impairments in the elderly. Further evaluation is needed to confirm the association between certain brain structures and BPSD.

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

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.119-126
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• 2018

Objectives : The aim of this study is to investigate correlation between degree of white matter hyperintensities (WMH) and neurocognitive function along with behavioral and psychological symptoms of dementia (BPSD) in Korean patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods : Participants were 115 elderly subjects diagnosed with Alzheimer's disease or mild cognitive impairment in this retrospective study. WMH in brain MRI were rated with standardized visual rating scales (Fazekas scales) and the subjects were divided into two groups according to Fazekas scale. Cognitive function was evaluated with Korean version of the consortium to establish a registry for Alzheimer's Disease (CERAD-K), and BPSD was evaluated with Korean neuropsychiatric inventory (K-NPI). Independent t-test was performed to analyze the relationship between the degree of WMH and neurocognitive functions & BPSD. Results : Especially, the group with high severity of WMH showed significantly lower language fluency (p<0.05). In addition, the group with high severity of WMH showed significantly higher score in K-NPI. Conclusions : There was a significant association between WMH and neurocognitive test related with executive function. Moreover, WMH seems to affect BPSD severity. Evaluation of WMH would provide useful information in clinical settings.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.6
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• pp.530-537
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• 2007

Purpose: The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVaD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Materials and Methods: Sixteen SVaD, 46 AD and 12 control subjects participated in this study. We included the patients with SVaD and AD according to NINCDS-ADRDA and NINDS-AIREN criteria. They were all matched for age, education and clinical dementia rating scores. Three groups were evaluated by Tc-99m HMPAO SPECT using statistical parametric mapping (SPM) for measuring rCBF. The SPECT data of patients with SVaD and AD were compared with those of normal control subjects and then compared with each other. Results: SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyri in patients with SVaD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in AD compared with control subjects (uncorrected p<0.01). SVaD patients revealed significant hypoperfusion in the right parahippocampal gyrus with cingulated gyrus, left insula and both frontal subgyral regions compared with AD (uncorrected p<0.01). Conclusion: Our study shows characteristic and different pattern of perfusion deficits in patients with SVaD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness.

• Journal of Oriental Neuropsychiatry
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• v.17 no.3
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• pp.11-19
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• 2006

Objective : This study was to investigate the utility and relation of dementia rating test(K-DRS and IADL, NPI-Q(symptom), NPI-Q(suffering), CCDR, SDS Method : For this study, we carried out dementia assessment examination of 34 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. Results: 1. K-DRS and SDS, K-DRS and SDS, NPI-Q(symptom) and NPI-Q(suffering), NPI-Q(symptom) and CCDR showed clear correlations statistically each other. 2. K-DRS scores showed the significant differences from that of ND and the other groups ; attention and conceptualization showed the significant differences between ND and DA, management and memorization showed the significant differences between DA and the other groups. 3. IADL scores showed the significant differences from that of DA and the other groups, NPI-Q(symptom) scores showed the significant differences between QD and DA, NPI-Q(suffering) scores showed no differences among all groups. 4. CCDR scores showed the significant differences from that of DA and the other groups, SDS scores showed the significant differences between ND and DA 5. MMSE- K and K-DRS showed strong correlations statistically each other. Conclusion : The study results suggest that dementia rating tests is useful to esteem the dementia and the dementia rating tests have strong corelations each other. We use the above mentioned tests for correct diagnosis.

• The Journal of the Korea Contents Association
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• v.12 no.5
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• pp.280-292
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• 2012

Cognitive-pragmatic language ability decreases during the normal aging process. Evaluating the ability might be useful in testing predicting cognitive level and diseases such as dementia. The aim of this study is to analyze various assessment protocols for normal aging, and evaluate the content validity of the currently developing cognitive-pragmatic language test domains and items. Content Validity Index(CVI) was calculated based on ratings judged by 17 experts including speech-language pathologists and clinical psychologists. As a result, it was found that CVIs of all 7 domains including attention, memory, organization, reasoning, problem solving, executive function, pragmatic language were above .75. It was concluded that the test items contained the appropriate content validity to assess cognitive-pragmatic language for normal aging.

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