• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.166-176
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• 2009

Purpose: The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility. Methods: Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005. Results: Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, "ask question", "advise", and "directive" were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses' domination of the conversation. At the same time, "ask back", "refute", "escape", or "false promise" were used often by nurses to discourage patients from talking when patients were raising questions or demanding. Conclusion: It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in healthcare institutions for elders.

• Dementia and Neurocognitive Disorders
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• v.17 no.4
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• pp.131-136
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• 2018

Alzheimer's disease (AD) related genes have been elucidated by advanced genetic techniques. Familial autosomal dominant AD genes founded by linkage analyses are APP, PSEN1, PSEN2, ABCA7, and SORL1. Genome-wide association studies have found risk genes such as ABCA7, BIN1, CASS4, CD33, CD2AP, CELF1, CLU, CR1, DSG2, EPHA1, FERMT2, HLA-DRB5-HLA-DRB1, INPP5D, MEF2C, MS4A6A/MS4A4E, NME8, PICALM, PTK2B, SLC24A4, SORL1, and ZCWPW1. ABCA7, SORL1, TREM2, and APOE are proved to have high odds ratio (>2) in risk of AD using next generation sequencing studies. Thanks to the promising genetic techniques such as CRISPR-CAS9 and single-cell RNA sequencing opened a new era in genetics. CRISPR-CAS9 can directly link genetic knowledge to future treatment. Single-cell RNA sequencing are providing useful information on cell biology and pathogenesis of diverse diseases.

• Journal of Oriental Neuropsychiatry
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• v.23 no.2
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• pp.13-32
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• 2012

Objectives : The purpose of this study was to obtain some knowledge concerning the scalp acupuncture treatment on patients with dementia for the future practice and research from clinical studies in China. Methods : The literatures were searched using the data base-China Academic Journals(CAJ) (2001-2011). Results : We found out 1 case study, and 17 randomized controlled trials(RCT) which met the inclusion criteria in most studies. There were 3 types of scalp acupuncture-applying method, cho-si scalp acupuncture(焦氏頭鍼法), combination of using ordinary acupoints(正經鍼) and extraordinary acupoints(經外寄穴), standard method of scalp acupuncture(標準頭鍼法). The often used acupoints are Yundongqu(運動區), Ganjuequ(感覺區), Yuntingqu(暈聽區), Zuyunganqu(足運感區), Sishencong (HN23), Baihui(GV20), Shenting(GV24), Fengchi(GB20), Dingnieqianxiexian(MS6), and Dingniehouxiexian(MS7). Conclusions : There were significant improvements on the scalp acupuncture-treated groups, compared to the control groups(western medication group or other acupuncture treatment group). Results of this study could be used for future studies concerning the scalp acupuncture for dementia.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.9
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• pp.253-264
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• 2016

The aim of this study was to investigate the factors influencing nurses' pain management in patients with dementia. A total of 197 nurses were recruited from 30 long-term care hospitals in B city. Data were collected from June 25 to July 15, 2016. Data analysis was performed using the SPSS 22.0 program, which included a t-test, ANOVA, Scheffe test, Pearson's correlation, and multiple regression analyses. The levels of knowledge were low with a score of 10.73 out of 18. The level of attitudes, self-efficacy, barriers and performance were 2.98, 3.34, 2.90, and 4.09, respectively. In addition, there were significant differences in the level of performance depending on the age (p=.046), long-term care (p=.009), and pain education (p=.004). The level of attitudes (r=.21, p=.006), self-efficacy (r=.51, p<.001) and performance were positively correlated with each other. A significant negative correlation was observed between the barriers and performance (r=-.16, p=.035). The meaningful variables that influence the performance were self-efficacy, long-term care, and pain education. These factors were responsible for 30.1%. Therefore, effective programs will be necessary to enhance pain management by improving the self-efficacy and knowledge of pain in dementia patients.

• Journal of the Korea Convergence Society
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• v.10 no.7
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• pp.373-381
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• 2019

The purpose of this study is to investigate the factors that affect the social distance between the demented elderly and nursing college students. In this study, responses from 158 nursing college students in city D were collected using structured questionnaires and analyzed. As a result, the correlation between variables, social distance, and dementia attitude towards the demented elderly (r = .53, p<.001) showed a statistically correlated relationship, while ageism (r = -.41, p<.001) showed a negative correlation. The results of this study are as follows: first, the interactions between the elderly with dementia and the nursing college students were more frequent (${\beta}=.29$ p=.012), and second, attention to early prevention of dementia (${\beta}=.32$ p=.002) was significant. The explanatory power of these influential factors on the social distance toward the demented elderly was 41.0%.

• Therapeutic Science for Rehabilitation
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• v.3 no.1
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• pp.31-37
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• 2014

Objective : The purpose of this study was to look at a systematic review on the effects of occupational reminiscence therapy in Dementia offered National Long term care Insurance. Through this comprehensive study, we have to compare the studies. Methods : We systematically examined papers published in journal from 2009 to 2013, using KERIS. Main words to examine are Dementia, Long term care service, Day care center, reminiscence therapy, occupational centered, etc. Results : 6 studies were selected, All of them were occupational reminiscence therapy. Reminiscence therapy can be devided into communication centered reminiscence therapy and occupational reminiscence therapy. The results demonstrated that the intervention significantly affected the maintenance cognitive skills and reminiscence skills, decreased depression, behavioral changes, improvement of communication and interaction skills and quality of life etc. of elderly people with dementia (p<.05). Conclusions : If occupational therapists can obtain knowledge and make a program for occupational reminiscence therapy, research in this field will be further developed. In the future study, the use of occupational reminiscence therapy applied to a variety of interventions and majority of patients is needed on occupational therapy.

• 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.

• 한국노년학
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• v.38 no.3
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• pp.501-519
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• 2018

The purpose of this study was to explore perception about shared decision making of family caregivers of patients with early dementia (PWED). This study was conducted with a sample of 12 family caregivers (mean age = $71.4{\pm}10.4$) of PWED from three dementia safety centers in Seoul. In-depth interviews were done for each participant about shared decision making and data were analyzed using qualitative content analysis. Six categories and 17 sub-categories identified for participants' perception about shared decision making: means to facilitate communication with patients with dementia, means to secure autonomy of patients, opportunity to facilitate treatment, cause of increasing family caregivers' burden, cause of worsening relationship with patients, and option for choices depending on priority change. The findings of this study can provide a knowledge basis for health care professionals and policy makers to understand how family caregivers of PWED think about shared decision making. It would be of great value to develop educational programs and practical guidelines about shared decision making for PWED and their family, which may contribute to respecting PWED's self-determination right as well as reducing burden of their family.

• Journal of Oriental Neuropsychiatry
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• v.32 no.2
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• pp.111-127
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• 2021

Objectives: To review and analyze clinical and preclinical evidence of effectiveness, safety, and underlying mechanisms of yokukansan (YKS), a herbal medicine, in alleviating aggression. Methods: Classical records on YKS were searched in the Korean Traditional Medicine Knowledge Database (KTMKD). By searching five electronic databases, prospective clinical studies and preclinical studies of YKS for alleviating aggression/agitation published up to March 30, 2021 were included. Results: Only two classical records on YKS were found from the KTMKD. A total of 11 clinical studies and 15 preclinical studies were found from the five electronic databases. Among 11 clinical studies, seven enrolled patients with dementia and four enrolled patients with other neuropsychiatric disorders. Most clinical studies reported significant improvement in one or more outcomes related to aggression in the YKS group after treatment. Among 15 preclinical studies, all studies except two reported a significant decrease in aggression/agitation-related behavior of YKS or yokukansankachimpihange. Suggested underlying mechanisms of YKS or yokukansankachimpihange for aggression/agitation in these studies included regulation of serotonin receptor, amelioration of abnormal glucocorticoid level related to the hypothalamic-pituitary-adrenal axis, regulation of orexin secretion, amelioration of degeneration in brain cells including glia cells, and suppression of excessive glutamatergic or dopaminergic activity. Conclusions: There were some clinical and preclinical evidence supporting the effectiveness and safety of YKS for alleviating aggression. Given that aggression is the most frequent and destructive symptoms of behavioral and psychological symptoms of dementia, applicability of YKS as a herbal medicine should be further investigated in future high-quality research.

• Molecules and Cells
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• v.40 no.9
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• pp.613-620
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• 2017

The most common form of senile dementia is Alzheimer's disease (AD), which is characterized by the extracellular deposition of amyloid ${\beta}-peptide$ ($A{\beta}$) plaques and the intracellular formation of neurofibrillary tangles (NFTs) in the cerebral cortex. Tau abnormalities are commonly observed in many neurodegenerative diseases including AD, Parkinson's disease, and Pick's disease. Interestingly, tau-mediated formation of NFTs in AD brains shows better correlation with cognitive impairment than $A{\beta}$ plaque accumulation; pathological tau alone is sufficient to elicit frontotemporal dementia, but it does not cause AD. A growing amount of evidence suggests that soluble $A{\beta}$ oligomers in concert with hyperphosphorylated tau (pTau) serve as the major pathogenic drivers of neurodegeneration in AD. Increased $A{\beta}$ oligomers trigger neuronal dysfunction and network alternations in learning and memory circuitry prior to clinical onset of AD, leading to cognitive decline. Furthermore, accumulated damage to mitochondria in the course of aging, which is the best-known nongenetic risk factor for AD, may collaborate with soluble $A{\beta}$ and pTau to induce synapse loss and cognitive impairment in AD. In this review, I summarize and discuss the current knowledge of the molecular and cellular biology of AD and also the mechanisms that underlie $A{\beta}-mediated$ neurodegeneration.