• Title/Summary/Keyword: Dementia of Alzheimer type

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A Study on the Nutrient Intakes of Hospitalized Elderly Dementia Patients Receiving a Regular Diet

  • Lee, Jin;Na, Mi-Hee;Kim, Woo-Kyoung
    • Food Quality and Culture
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    • v.1 no.1
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    • pp.46-57
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    • 2007
  • The purpose of the present study was to examine the nutrient intake status of elderly dementia patients. We surveyed the dietary intake of 50 demented elderly patients receiving a regular diet, who were hospitalized in a geriatric hospital in Yongin, Gyeonggi-do. The average age of the subjects was $79.6{\pm}6.5$ for the males and $80.5{\pm}6.3$ for the females. The average heights were $169.5{\pm}6.0\;cm$ (males) and $154.6{\pm}5.2\;cm$ (females), and the average weights were $58.5{\pm}7.4$ (males) and $51.7{\pm}8.9\;kg$ (females). Depending on the type of dementia, the male patients showed significant differences in their intakes of vegetable protein, fiber, total iron, and non-heme iron between the Alzheimer's disease (AD) and the vascular dementia (VD) groups, and the female patients showed significant differences in their intakes of total protein, phosphorus, zinc, and vitamin $B_6$ between the two groups. The male patients showed significant differences in their intakes of animal-source calcium and carotene according to ability to self-feed. According to physical activity, the male patients showed significant differences in vegetable fat and vitamin A intake, and the females showed significant differences in their intakes of total protein, animal protein, fiber, ash, total calcium, vegetable-source calcium, animal-source calcium, phosphorous, total iron, non-heme iron, heme iron, sodium, vitamins $B_1$, $B_2$, $B_6$, niacin, vitamin C, folate, and potassium. We found that the patients consumed excessive protein, but low amounts of calcium, vitamin $B_2$, and folate. Also, the patients' physical activity abilities appeared to affect their nutrient intakes.

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Review on Wandering Behavior in Persons with Dementia (치매 노인의 배회행동에 관한 문헌 조사)

  • HongSon, Gwi-Ryung
    • Perspectives in Nursing Science
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    • v.3 no.1
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    • pp.35-45
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    • 2006
  • In Korea, about 8.3% over aged 65 are suffering from Alzheimer's disease or other type of dementia. Among dementia-related behaviors, wandering is the one of strongest factors on burden and stress of caregivers. On Lee and Kwon's report with community living persons with dementia, upto 85% of caregivers reported wandering as a problem. Wandering is a frequently encountered problem in communities and long-term care facilities, but it is among least understood dementia. related behavior. Despite the prevalence of wandering, its significant adverse outcomes, and the increase in persons with dementia in Korea, no systematic research has been conducted in Korea. The purpose of this study is to review on literature related to wandering behavior among persons with dementia. The specific topics related to wandering are included: definition, the prevalence of dementia and wandering behavior, the influencing factor on wandering, outcomes of wandering behavior, and the measurement method. Wandering is defined as "aimless walking" and "Meandering, aimless or repetitive locomotion that exposes one to harm and is incongruent with boundaries, limits, or obstacles". Wandering is viewed as a problematic behavior, however, it has to be understood as need-driven compromised behavior. For example, wandering may be an expression of searching for familiar person and/or place. Recently, in Korea, there is an effort for establishing the therapeutic environment for elders who are wanderers in long-term-care facilities. Cognitive impairment of persons with dementia is found to be a consistent factor on wandering behavior through many national and international studies. The adverse outcomes of wandering are serious problem in persons with dementia as well as their caregivers. The adverse outcomes include falls, fractures, getting lost, use of restraints, or even death. In fact, wandering is one of the major reasons for a patient to be institutionalized. For measurement of wandering behavior, two methods are broadly used: observation using stop watch, and survey form. A revised instrument of the Korean version of Algase wandering scale (K_RAWS) is established the psychometric properties (Son, Song, & Lim, 2006) demonstrating valid and reliable instrument in measuring wandering behavior among persons with dementia who are residing in communities. K_RAWS has a 39 items with six subscales including persistent walking, repetitive walking, spatial disorientation, eloping behavior, negative outcome, and mealtime impulsivity. In conclusion, studies including the prevalence of wandering behavior and predictive factors on wandering should be conducted to understand wandering clearly before developing any types of intervention.

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The Correlation of Levels of Serum Lipid, Homocysteine, and Folate with Volumes of Hippocampus, Amygdala, Corpus Callosum, and Thickness of Entorhinal Cortex in Patients with Amnestic Mild Cognitive Impairment or Dementia of Alzheimer's Type (기억성 경도인지장애 및 알츠하이머 치매 환자에서 해마, 편도체, 뇌들보, 내후각 피질과 혈중 지질, 호모시스테인, 엽산 농도와의 연관성)

  • Lee, Sang Jun;Kim, Tae Hyung;Huh, Lyang;Choi, Seung Eun;Lee, Bong Ju;Kim, Gyung Mee;Lee, Jung Goo;Kim, Hong Dae;Mun, Chi Woong;Kim, Young Hoon
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.223-232
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    • 2015
  • Objectives In this study, the authors evaluated the correlation between levels of serum lipid, homocysteine, and folate with volumes of hippocampus, amygdala, corpus callosum, and in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) type. Methods The study recruited patients who visited the dementia clinic of Haeundae Paik Hospital in Korea between March 2010 and June 2014. Among those, patients who had taken the neurocognitive test, brain magnetic resonance imaing, tests for serum lipid, homocysteine, folate, and apolipoprotein E (APOE) genotyping and diagnosed with aMCI or AD were included for analysis. Bilateral hippocampus, entorhinal cortex, amygdala and corpus callosum were selected for region of interest (ROI). The cross-sectional relationships between serum lipid, homocysteine, folate and ROI were assessed by partial correlation analysis and multiple linear regression analysis. Results In patients with aMCI, old age (> 80) and APOE ${\varepsilon}4$ carrier were associated with AD [odds ration (OR) : 12.80 ; 95% confidence interval (CI) : 2.25-72.98 and OR : 4.48 ; 95% CI : 1.58-12.67, respectively]. In patients with aMCI or AD, volumes and thickness of ROI were inversely correlated with levels of serum lipid and homocysteine. In multiple linear regression analyses, higher total cholesterol level was related to lower left, right hippocampus volume and left amygdala volume ; higher low-density lipoprotein cholesterol was related to lower right entorhinal cortex thickness ; higher homocysteine level was related to lower corpus callosum volume. Conclusions Higher serum lipid and homocysteine levels are associated with decreased volume of hippocampus, amygdala, corpus callosum and entorhinal cortex thickness in patients with aMCI or AD. These findings suggest that serum lipid and homocysteine levels are associated with AD as a modifiable risk factor.

Effect of Education on Discriminability of Montreal Cognitive Assessment Compared to Mini-Mental State Examination

  • Haeyoon Kim;Seonyeong Yang;Jaesel Park;Byeong Chae Kim;Kyung-Ho Yu; Yeonwook Kang
    • Dementia and Neurocognitive Disorders
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    • v.22 no.2
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    • pp.69-77
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    • 2023
  • Background and Purpose: The Montreal Cognitive Assessment (MoCA) has been known as a screening test for detecting mild cognitive impairment (MCI) better than Mini-Mental State Examination (MMSE). However, in previous domestic studies, no significant difference was found in the discriminability between MoCA and MMSE. Researchers have suggested that this might be because older Koreans are less educated than older Westerners. This study was conducted to examine the effect of education on the discriminability of MoCA compared to the MMSE. Methods: Participants were 123 cognitively normal elderly, 118 with vascular MCI, 108 with amnestic MCI, 121 with vascular dementia, and 113 with dementia of the Alzheimer's type. The Korean-MoCA (K-MoCA) and Korean-MMSE (K-MMSE) were administered. Multiple regression analyses and receiver operating characteristic (ROC) curve analyses were performed. Results: In all participants, education significantly affected both K-MoCA and K-MMSE scores along with age. The effect of education was re-examined by subgroup analysis after dividing subjects according to the level of education. Effect of education on K-MoCA and K-MMSE was only shown in the group with <9 years of education. ROC curve analyses revealed that the discriminability of K-MoCA to differentiate between vascular MCI and normal elderly was significantly higher than that of K-MMSE. When re-examining subgroups divided by education level, however, this higher discriminability of K-MoCA disappeared in the group with <9 years of education. Conclusions: These results indicate no difference in discriminating cognitive deficits between K-MoCA and K-MMSE in Korean elderly with <9 years of education.

Retrospective Analysis of Patients Suffering from Dementia or Mild Cognitive Impairment Treated by Collaboration between Western and Korean Medicine (한양방 협진치료를 받은 치매와 경도인지장애 환자에 대한 후향적 의무기록 분석)

  • Lee, Go Eun;Cheong, Moon Joo;Lee, Sung Ik;Kim, Nam Kwen;Kim, Jinwon;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.29 no.2
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    • pp.111-119
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    • 2018
  • Objectives: To investigate the characteristics of patients diagnosed with dementia or mild cognitive impairment who are treated by means of a blend between Western and Korean medicine. Methods: We searched for outpatients with dementia or mild cognitive impairment by means of a collaboration between Western and Korean medicine from August 1, 2015, to July 31, 2017, through electronic medical records in Wonkwang Hospital. The records were retrospectively analyzed according to the patients' demographic and clinical characteristics, pathway of medical care, diagnostic tests, treatment, and medical expenses. Results: Thirteen patients were included in the analysis. Among them, six patients were diagnosed with mild cognitive impairment, five with dementia, Alzheimer's type, one patient with frontotemporal dementia, and one patient with unspecified dementia. Twelve of the thirteen patients were over 60 years of age. The number of pathways from the Dept. of Neurology to the Dept. of Neuropsychiatry of Korean Medicine was almost the same as the opposite pathway. The most used diagnostic test in Korean medicine was a neuropsychological test such as SNSB, MMSE and GDS. In Western medicine, hematology and neuroimaging were frequently used for patients. Acupuncture in Korean medicine and medication in Western medicine were the most frequently used. In Korean medicine, uncovered service costs were much higher than covered service costs,. whereas, in Western medicine, covered service costs were higher than uncovered service costs. Conclusions: This study describes the basic characteristics of dementia and mild cognitive impairment patients treated by a collaboration between Western and Korean medicine. Based on these results, a clinical pathway of the collaborative practice system between Western and Korean medicine for dementia patients needs to be developed.

Identification of Propentofylline Metabolites in Rats by Gas Chromatography/Mass Spectrometry

  • Kwon, Oh-Seung;Ryu, Jae-Chun
    • Archives of Pharmacal Research
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    • v.23 no.4
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    • pp.374-380
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    • 2000
  • Propentofylline (PPF, 3-methyl-1-(5-oxohexyl)-7-propylxanthine) has been reported to be a compound for treatment of both vascular dementia and dementia of the Alzheimer type. The short half-life (about 15 min) of PPF at the terminal elimination phase and poor bioavailability after oral administration of PPF to rabbits (Kim et al., 1992) suggest in part that this drug takes the extensive first-pass metabolism in the liver. In addition, the metabolic pathway for PPF remains unclear. The objective of this experiment is to identify urinary metabolites of PPF in rats. For the identification of the metabolites, rat urine was collected after oral administration of 100${m}g/kg$ PPF. PPF metabolite, 3-methyl-1-(5-hydroxyhexyl)-7-propylxanthine, was synthesized and confirmed by gas chromatography/mass spectroscopy (GC/MS) and $^1H$ nuclear magnetic resonance spectroscopy. The urinary metabolites of PPF were extracted with diethyl ether and identified by electron impact and chemical ionization GC/MS. One urinary metabolite was confirmed to be 3-methyl-1-(5-hydroxyhexyl)-7-propylxanthine by synthesized authentic compound. Several metabolites of monohydroxy- and dihydroxy-PPF were identified based on mass fragmentation of both intact and trimethylsilylated derivatives of PPF metabolites and the novel structure of these metabolites is suggested based on mass spectra.

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A study on cytotoxicity of Ti-Nb alloys (Ti-Nb계 합금의 세포독성에 관한 연구)

  • Park, Hyo-Byeong
    • Journal of Technologic Dentistry
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    • v.25 no.1
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    • pp.89-94
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    • 2003
  • The use of titanium alloys as biomaterials is increasing due to their superior biocompatibility and enhanced corrosion resistance compared to conventional stainless steels and cobalt-based alloys. Ti-6Al-4V ($\alpha+\beta$type) alloy instead of pure titanium ($\alpha$type) is being widely used as biomaterials has some characteristics such as high fatigue strength, tensile strength and corrosion resistance. It also has similar characteristics to Ti in inducing bony ingrowth. But it has been reported recently that the vanadium element expresses cytotoxicity and carcinogenicity and the aluminium element is related with dementia of Alzheimer type and neurotoxicity. In order to overcome their detrimental effects, $\beta$-phase stabilizer Nb was chosen in the present study. CP-Ti(ASTM grade 2), Ti-3wt.%Nb($\alpha$type), Ti-20wt.%Nb ($\alpha+\beta$type) and Ti-40 wt.%Nb($\beta$type) alloys were melted by vacuum arc furnace. Biocompatibility of Ti-Nb alloys was evaluated by cytotoxicity test. The results can be summarized as follows: 1. For the cytotoxicity test, Ti-Nb alloys showed excellent biocompatibility compared to CP-Ti(ASTM grade 2), 316L STS and Co-Cr alloys.

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Assessment of Metabolic Impairment in Alzheimer's Disease with [$^{18}F$]FDG PET: Validity and Role of Simplified Tissue Radioactivity Ratio Analysis (알쯔하이머병에서 양전자방출단층촬영을 이용한 국소뇌포도당대사의 변화에 관한 연구)

  • Kim, Sang-Eun;Na Duk-Lyul;Lee, Jeong-Rim;Choi, Yong;Lee, Kyung-Han;Choe Yearn-Seong;Kim, Doh-Kwan;Kim, Byung-Tae;Lee, Kwang-Ho;Kim, Seung-Tai P.
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.3
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    • pp.299-314
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    • 1996
  • The purpose of the present study was to validate the use of tissue radioactivity ratios instead of regional metabolic rates for the assessment of regional metabolic changes in Alzheimer's disease(AD) with [$^{18}F$]FDG PET and to examine the correlation of ratio indices with the severity of cognitive impairment in AD. Thirty-seven AD Patients(age $68{\pm}9 yrs$, $mean{\pm}s.d.$; 36 probable and 1 definite AD), 28 patients with dementia of non-Alzheimer type(age $66{\pm}7 yrs$), and 17 healthy controls(age $66{\pm}4 yrs$) underwent [$^{18}F$]FDG PET imaging. Two simplified radioactivity ratio indices were calculated from 37-66 min image: region-to-cerebellar radioactivity ratio(RCR) and a composite radioactivity ratio(a ratio of radioactivity in the most typically affected regions over the least typically affected regions: CRR). Local cerebral metabolic rate for glucose(LCMRglu) was also measured using a three-compartment, five-parameter tracer kinetic model. The ratio indices were significantly lower in AD patients than in controls(RCR in temporoparietal cortex, $0.949{\pm}0.136$ vs. $1.238{\pm}0.129$, p=0.0004; RCR in frontal cortex, $1.027{\pm}0.128$ vs. $1.361{\pm}0.151$, p<0.0001; CRR, $0.886{\pm}0.096$ vs. $1.032{\pm}0.042$. p=0.0024). On the RCR analysis, 86% of AD patients showed a pattern of bilateral temporoparietal hypometabolism with or without frontal involvement; hypometabolism was unilateral in 11% of the patients. When bilateral temporoparietal hypometabolism was considered to be suggestive of AD, the sensitivity and specificity of the RCR analysis for the differential diagnosis of AD were 86% and 73%, respectively. The RCR was correlated significantly with the macroparameter K [$K_1k_3/(k_2+k_3)$] (r=0.775, p<0.0001) and LCMRglu(r=0.633, p=0.0002) measured using the kinetic model. In patients with AD, both average RCR of cortical association areas and CRR were correlated with Mini-Mental Status Examination(r=0.565, p=0.0145; r=0.642, p=0.0031, respectively), Clinical Dementia Rating(r=-0.576, p=0.0124; r=-0.591, p=0.0077), and total score of Mattis Dementia Rating Scale (r=0.574, p=0.0648; r=0.737, p=0.0096). There were also significant correlations between memory and language impairments and corresponding regional RCRs. The results suggest that the [$^{18}F$]FDG PET ratio indices, RCR and CRR, reflect global and regional metabolic rates and correlate with the severity of cognitive impairment in AD. The simplified ratio analysis may be clinically useful for the differential diagnosis and serial monitoring of the disease.

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A study on corrosion resistance of Ti-Nb alloys by Nb contents (Nb 함량에 따른 Ti-Nb계 합금의 내식성에 대한 연구)

  • Park, Geun-Hyeung
    • Journal of Technologic Dentistry
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    • v.28 no.1
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    • pp.61-66
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    • 2006
  • Titanium alloys have been used for dental materials due to it's very good biocompatibility. Ti-6Al-4V alloy instead of pure titanium is being widely used as biomaterials has some characteristics such as high fatigue strength, tensile strength and corrosion resistance. But it has been reported recently that the vanadium element expresses cytotoxicity and carcinogenicity and the aluminium element is related with dementia of Alzheimer type and neurotoxicity. The Ti-Nb alloys has designed and examined corrosion resistance. Ti-3wt.%Nb($\alpha$type), Ti-20wt.%Nb(${\alpha}+{\beta}$type) and Ti-40wt.%Nb($\beta$type) alloys were melted by vacuum arc furnace. The corrosion resistance of Ti alloys was evaluated by potentiodynamic polarization test in the solution of 0.9% NaCl and 5% HCl. The results can be summarized as follows: 1) For the corrosion test in the solution of 0.9% NaCl and 5% HCl, the corrosion behaviour of Ti-Nb alloys was similar to ASTM grade 2 CP Ti. 2) The corrosion resistance of Ti-20Nb alloy was better than that of CP-Ti, Ti-3Nb, Ti-40Nb alloy in 0.9% NaCl and 5% HCl, solutions.

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The Clinical Analysis on 32 Cases of Dementia (치매환자(患者) 32례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee, Y.W.;Kang, H.J.;Cho, M.R.;Jin, C.S.;Hong, S.;Kim, J.S.
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.301-317
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    • 1998
  • A clinical analysis was carried out for 32 patients who were treated in Dept. of Dong-shin Oriental Medicine Hospital from 10st January to 16st May in 1998 and ruled out as dememtia. The results were summarized as follows. 1. In the distribution of sex, female was more than male. And the age of seventies(17 cases, 53.125%) was highest in the frequency of age. 2. In the distribution of having history of drinking and smoking were each 4 cases(12.5%) and 7 cases(21.875%). 3. In the distribution of seasons, the ratio of spring and winter were each 16 cases(50.0%), 15 cases(46.875%), that of summer and fall were comparatively low. 4. In the period from onset to admission, the period within a week had 20 cases(62.5%) as top, and the most period of treatment was 2 and 3 weeks(28.125%). 5. The number of cases that had preceding disease was 35 cases(71.875%), a major portion of preceding diseases were hypertension, diabetes mellitus, stroke. 6. The most common symptom was disorientation(78.125%), and the next common symptom was motor desability(71.875%), and memory disturbance, verbal disturbance was each 59.375 and 47.1%. 7. In the distribution of the CT scan films, 15 cases(46.875%) showed cerebral infarction and that of another 5cases (15.625%) showed cerebral hemorrhage, that of another 2 cases(6.25%) showed brain atrophy. 8. In the lipid density of blood, T-Cholesterol, TG, HDL-Cholesterol, LDL- Cholesterol was within normal limit. 9. In the MMSE-K, the most score was from 16 point to 20 point, and second only was from 11 point to 15 point, and the next was from 6 point to 10 point. 10. In the Ischemic score, 20 cases(62.5%) was diagnosed as brain vascular type dementia, and mixed type dementia was 9 cases(28.125%), Alzheimer type dementia was 3 cases(9.375%). 11. The most used recipes were a sort of recipes to activate of flow the vital energy and the blood, to remove the phlegm(41 cases 33.9%), especially DODAMHOALHEL TANG (12 cases, 9.9%), ANSINCHUNGNOITANG (8 case, 6.6%) was the most used recipe. 12. In the judgement of efficacy, 17 cases(53.125%) showed excellent efficacy, 10 cases(31.25%) showed good efficacy, 5 cases(15.625%) showed no change and that according to MMSE-K, 4 case(18.18%) showed excellent efficacy, 15 cases(68.18%) showed good efficacy, 15 cases(68.18%) showed no change.

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