• Journal of Oriental Neuropsychiatry
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• v.28 no.4
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• pp.391-399
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• 2017

Objectives: To determine the effects of Korean medicine on behavioral and psychological symptoms of dementia (BPSD) of an Alzheimer's disease (AD) patient. Methods: A 85-year old female patient diagnosed with AD was treated with herbal medicine formula Chungsimyeonja-tang (淸心蓮子湯), Woohwangchungsim-won (牛黃淸心元), and acupuncture. Korean version of Mini-mental State Examination (MMSE-K) scores were used at baseline and post treatment as outcome measures to evaluate clinical symptoms of the patient. Results: Improvements in MMSE-K post treatment scores were observed compare to those at baseline. BPSD were also alleviated. Such changes were visually noticeable. Conclusions: Herbal medicine and acupuncture treatment were effective in alleviating symptoms of AD. Further studies with a larger sample size and randomized clinical trials are needed to obtain more reliable and valid treatment outcomes.

• Journal of Korean Academy of Nursing
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• v.48 no.2
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• pp.143-153
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• 2018

Purpose: The purpose of this study was to identify factors predicting behavioral and psychological symptoms of dementia (BPSD) in persons with dementia. Factors including the patient, caregiver, and environment based on the multi-dimensional behavioral model were tested. Methods: The subjects of the study were 139 pairs of persons with dementia and their caregivers selected from four geriatric long-term care facilities located in S city, G province, Korea. Data analysis included descriptive statistics, inverse normal transformations, Pearson correlation coefficients, Spearman's correlation coefficients and hierarchical multiple regression with the SPSS Statistics 22.0 for Windows program. Results: Mean score for BPSD was 40.16. Depression (${\beta}=.42$, p<.001), exposure to noise in the evening noise (${\beta}=-.20$, p=.014), and gender (${\beta}=.17$, p=.042) were factors predicting BPSD in long-term care facilities, which explained 25.2% of the variance in the model. Conclusion: To decrease BPSD in persons with dementia, integrated nursing interventions should consider factors of the patient, caregiver, and environment.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.200-207
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• 2016

Objectives : Alzheimer's disease(AD) is characterized by progressive decline of cognitive function and also by various behavioral psychological symptoms of dementia(BPSD) which causes distress to their caregivers. The purpose of this study was to investigate association between each AD patients' behavioral psychological symptoms and their caregivers' burden. Methods : Participants were 80 AD patients and their caregivers. We used Korean neuropsychiatric inventory (K-NPI) to assess the symptoms of patients and Korean version of Zarit Burden Interview(ZBI) to evaluate caregivers' burden. Results : The results showed ZBI score, which is the index for caregivers' burden, had a statistically significant positive correlation with the frequency of delusion, hallucination, agitation/aggression, depression, anxiety, disinhibition and irritability, the severity of hallucination, agitation/aggression, anxiety, disinhibition, aberrant motor, and sleep, and the global score(frequency${\times}$severity) for delusion, hallucination, agitation/aggression, depression, anxiety, disinhibition, aberrant motor, and sleep. There were significant correlations between each scale for cognitive function(i.e. MMSE-KC, CDR, GDS) and ZBI scale. Correlations between each scale for activity of daily living(i.e. Barthel -ADL, K-ADL) and ZBI scale were also significant. Conclusions : There were a significant correlation between BPSD and caregiver burden. Caregiver burden was also correlated with cognitive function and activity of daily living. Early detection and preventive treatment of these symptoms in BPSD might make improvement of caregivers' quality of life as well as AD patients'.

• 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.

• Journal of Oriental Neuropsychiatry
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• v.30 no.3
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• pp.287-293
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• 2019

Objectives: The purpose of this study was to report the clinical effectiveness of the complex Korean medicine therapy on a patient with BPSD (Behavioral and Psychological Symptoms of Dementia) due to suspected Alzheimer's disease. Methods: We experienced an age 73 female who complained of a depressive mood, insomnia, and accompanying symptoms such as abnormal behavior. During treatment, the patient received acupuncture and herbal medicine. The clinical effects were evaluated through KGDS (Korean Form of Geriatric Depression Scale) and subjective statements of the patient. Results: After the complex Korean medicine therapy, the treatments ameliorated overall symptoms that the patient complained about. The patient was more positive and slept better after the treatment. No specificities or adverse effects were reported during treatment. Conclusions: This study suggests the possibility of treating patients with BPSD with complex Korean medicine therapy.

• Korean Journal of Biological Psychiatry
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• v.14 no.1
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• pp.48-54
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• 2007

Objectives : This study aimed to examine the relationship between behavioral and psychological symptoms of dementia(BPSD) and patient and caregiver QOL in Alzheimer's disease(AD). Methods : Fifty-one AD patients and their caregivers participated. Measures about patients were Neuropsychiatric Inventory(NPI), Korean version of QOL-Alzheimer's Disease(KQOL-AD), Activities of Daily Living(ADL), Clinical Dementia Rating(CDR), and Korean version-Mini Mental State Examination(K-MMSE). Caregiver QOL was assessed with KQOL-AD and General Health Questionnaire/Quality of Life-12(GHQ/QOL-12). Results : Patient QOL-AD on patient ratings was negatively correlated with appetite/eating change and NPI scores. Patient QOL-AD on caregiver ratings was negatively correlated with hallucinations, depression/dysphoria, and NPI scores. Caregiver QOL assessed by the GHQ/QOL-12 was negatively correlated with agitation/aggression, depression/dysphoria, and NPI scores and was negatively correlated with distress related to agitation/aggression, depression/dysphoria, and NPI scores. Conclusion : BPSD of AD patients was associated with low QOL of both patients and caregivers. Thus, interventions of BPSD were needed to improve both patient and caregiver QOL.

• Research in Community and Public Health Nursing
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• v.21 no.2
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• pp.210-219
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• 2010

Purpose: The study evaluated the determinants of caregiving self-efficacy among dementia caregivers. Methods: Data were collected through a structured questionnaire survey from dementia sufferers and caregivers by nurses or social workers caring for dementia sufferers at health centers during July to September 2007. Multiple stepwise regression analysis using SAS Version 9.1 was performed to examine the determinants of caregiving selfefficacy. Results: Factors affecting caregiving self-efficacy were behavioral and psychological symptoms of dementia (BPSD), activities of daily living (ADL), and age of dementia sufferer. Conclusion: To increase dementia caregivers' self-efficacy, there is a need to reduce difficulties of dementia caregivers in caring BPSD and increasing the ADL level of dementia sufferers by providing guidelines of care and intervention programs for BPSD and ADL management.

• 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.

• Korean Journal of Biological Psychiatry
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• v.20 no.3
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• pp.97-103
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• 2013

Objectives We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients. Methods From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio. Results There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73). Conclusions The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.

• 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.