• Title/Summary/Keyword: Dementia patients

Search Result 639, Processing Time 0.032 seconds

A Study on the Combination Effect of Herbal Medicine and Western Medicine on BPSD in Patients with Alzheimer's Disease: A Systematic Review (알츠하이머병 환자의 이상행동심리증상(BPSD)에 대한 한약과 양약의 병용 효과에 대한 연구: 체계적 문헌 고찰)

  • Kim, Man-Gi;Chang, Seok-Joo;Hong, Min-Ho;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
    • /
    • v.31 no.4
    • /
    • pp.301-314
    • /
    • 2020
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of herbal medicine combined with western medicine for BPSD. Methods: Studies were identified by searching CNKI, Pubmed, EMBASE, Cochrane Library, SCIENCEON, RISS, KMbase, KISS, OASIS. Literature searches of Chinese, English, and Korean databases were performed. Two authors independently extracted the data and evaluated the quality of each study. Results: The literature search identified 203 articles. Of these, 7 were selected for the analysis. The risk of bias in most studies was unclear. The most frequently used diagnostic tools were the NINCDS-ADRDA and DSM-IV. The most commonly used results indicator was NPI. In 6 of the 7 papers, combination treatment (herbal & Western medicine) was statistically significantly more effective than single treatment (Western medicine alone) for BPSD. No significant adverse events were reported. Conclusions: Herbal medicine in combination with Western medicine is more effective for treating BPSD than Western medicine alone. However, the quality of the studies used in this study was uncertain and the sample size was too small. Based on the findings of this study, more high-quality clinical trials are needed to confirm the efficacy of combination treatment.

Improvements in Cognitive and Motor Function by a Nutrient Delivery System Containing Sialic Acid from Edible Bird's Nest (제비집 시알산 유래 영양전달체(Nutrient Delivery System)의 인지기능 및 운동기능 개선 효과)

  • Kim, Dong-Myong;Jung, Ju-Yeong;Lee, Hyung-Kon;Kwon, Yong-Seong;Baek, Jin-Hong;Han, In Suk
    • The Korean Journal of Food And Nutrition
    • /
    • v.33 no.6
    • /
    • pp.614-623
    • /
    • 2020
  • The objective of this study was to produce a nutrient delivery system (NDS) using sialic acid extracted from edible bird's nest (EBN), which improves brain function in patients with Alzheimer's disease and Parkinson's disease, by affinity bead technology (ABT). The inhibitory activity of acetylcholinesterase (AChE) and pyramidal cells in the dentate gyrus of the hippocampus were analyzed to investigate the effect of a sialic acid NDS on Alzheimer's disease. Also, the effect of a sialic acid NDS on Parkinson's disease was evaluated by rota-rod test and pole test in an animal model. Among the groups treated with donepezil, EBN, and sialic acid NDS, the AChE activity was the lowest in the sialic acid NDS-treated group. The results of the hippocampus analysis of the rat model confirmed that the sialic acid NDS inhibited amyloid-beta accumulation depending upon the concentration. Also, the sialic acid NDS group showed more improvement in motor deterioration than the1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced group in both the rota-rod test and pole test. Therefore, the sialic acid NDS had an effect of protecting not only Alzheimer's disease by inhibiting AChE and amyloid-beta accumulation, but Parkinson's disease by preventing neurotoxicity induced by MPTP.

A Systematic Review of the Correlation between Hand Dexterity and Cognitive Function in Elderly (노인의 손의 기민성과 인지기능과의 상관성에 대한 체계적 문헌고찰)

  • Ho-Soung Kwak
    • Journal of The Korean Society of Integrative Medicine
    • /
    • v.11 no.3
    • /
    • pp.49-57
    • /
    • 2023
  • Purpose : This study aimed to systematically review the correlation between hand dexterity and cognitive function in the elderly, and summarize various evaluation tests and results analysis methods for manual dexterity tests applied to this population. Methods : We searched published studies in the Korean Studies Information Service System and PubMed databases from January 2013 to March 2023. The main keywords used were "dexterity," "fine motor," "elderly," "cognitive function," and "correlation." A total of 10 studies were selected for analysis from the 1,524 searched articles. The included studies consisted of a cohort study, a longitudinal study, and eight cross-sectional studies which were analyzed for patients, intervention, comparison, and outcomes. Results : Analyzing the qualitative level of 10 studies, 8 articles (80%) were non-randomized two-group studies that provided level II evidence whereas the remaining 2 studies (20%) were non-randomized single-group studies (level III evidence). Therefore, these results indicated that the level of evidence in this field is generally high. The Purdue pegboard test was the most commonly used evaluation test for manual dexterity, and velocity speed was the most frequently employed analysis method. Results indicated that there were significant differences in manual dexterity test between the normal elderly, those with mild cognitive impairment, or dementia. Conclusions : These results can be used as a basis for selecting dexterity test evaluation items and methods to analyze it in the elderly while screening for cognitive impairment. In addition, this study highlights potential areas for future research on the development of manual dexterity evaluation tools and techniques for analysis and the need for more reliable and valid methods for assessing cognitive function in the elderly.

Domestic polysomnography operation status and problem analysis -Focusing on the characteristics of each type of medical institution- (국내 수면다원검사 운영현황 및 문제점 분석 -의료기관 유형별 특징을 중심으로-)

  • YU, TAE GYU
    • The Journal of the Convergence on Culture Technology
    • /
    • v.9 no.1
    • /
    • pp.443-448
    • /
    • 2023
  • Over the past five years, the number of patients with sleep disorders has increased by about 250,000 from 840,000 in 2017 to 1.09 million in 2021. In addition, sleep disorder is a factor that causes dementia risk factors, and furthermore, the population with sleep disorder is a very important policy issue in terms of stable health insurance financial management in the future in terms of national health management in the super-aging trend. Therefore, this study aims to establish an efficient treatment environment in medical institutions responsible for the current status of polysomnography and effective reimbursement policies for the recently increasing population with sleep disorders, and appropriate sleep management policies for future sleep disorders through correct implementation. We are trying to find out the actual condition and improvement plan through interviews with related organizations and experts.

The Effect of Treadmill Exercise on Tau Hyperphosphorylayion in an Aged Transgenic Mouse Model of Taupathies

  • Wang, Seong-Hwan;Kang, Eun-Bum;Kwon, In-Su;Koo, Jung-Hoon;Shin, Kwang-O;Jang, Yong-Chul;Um, Hyun-Sub;Oh, Yoo-Sung;Kim, Chul-Hyun;Cho, In-Ho;Cho, Joon-Yong
    • Korean Journal of Exercise Nutrition
    • /
    • v.16 no.2
    • /
    • pp.93-100
    • /
    • 2012
  • Alzheimer's disease (AD) is the most common cause of dementia in adults. Microtubule associated protein tau is abnormally phosphorylated in AD and aggregates as paired helical filaments (PHFs) in neurofibrillary tangles (NFTs). NFTs are the most common intraneuronal inclusion in the brains of patients with AD and have been implicated in mediating neuronal cell death and cognitive deficit. Aberrant phosphorylation of tau is an early pathological event in AD, but the underlying mechanisms are unclear. MAP kinases are a family of Serine/Threonine (Ser/Thr) kinases that involved hyper - phosphorylation of tau in AD. The purpose of this study was to investigate the effect of treadmill exercise on phosphorylation of tau level and activation of MAPKs including JNK, ERK, p38-MAPK. To address this, Tg mouse model of AD, Tg-NSE/hTau 23, which expresses human tau 23 in the brain, was chosen. Animals were subjected to treadmill exercise for 12 weeks from 24 months of age. Treadmill exercise in Tg group improved cognitive function compared with Tg-SED group in watermaze test. In addition, treadmill exercised Tg mice significantly reduced the activation of JNK54/46, p38-MAPK and tau (Ser404, Ser202, Thr231), and increased activation of ERK44/42 in cerebral cortex. These results suggest that treadmill exercise may provide a therapeutic potential to alleviate the tau pathology like AD.

Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
    • /
    • v.36 no.1
    • /
    • pp.1-7
    • /
    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

The Effects of Sleep Apnea and Variables on Cognitive Function and the Mediating Effect of Depression (수면무호흡증과 수면변수가 인지기능에 미치는 영향과 우울증의 매개효과)

  • Park, Kyung Won;Kim, Hyeong Wook;Choi, Mal Rye;Kim, Byung Jo;Kim, Tae Hyung;Song, Ok Sun;Eun, Hun Jeong
    • Sleep Medicine and Psychophysiology
    • /
    • v.24 no.2
    • /
    • pp.86-96
    • /
    • 2017
  • Objectives: This study aimed to analyze causality among sleep apnea, depression and cognitive function in patients with obstructive sleep apnea. Methods: We reviewed the medical records of 105 patients with sleep apnea and snoring who underwent overnight polysomnography (PSG). We analyzed various biological data, sleep variables (sleep duration and percentage) and respiratory variables [arousal index (AI), periodic leg movement index (PLM index), snoring Index (SI), mean SpO2, minimum SpO2, apnea-hypopnea index (AHI), and respiratory disturbance index (RDI)]. We also analyzed various data by sleep, cognition, and mood related scales: Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), snoring index by scale (SIS), Montreal Cognitive Assessment-Korean (Moca-K), Mini-mental State Examination-Korean (MMSE-K), clinical dementia rating (CDR), and Beck Depression Inventory (BDI). We analyzed causation among sleep, and respiratory, mood, and cognition related scales in obstructive sleep apnea patients. We analyzed the mediating effects of depression on sleep apnea patient cognition. Results: As Duration N1 increased and Total sleep time (TST) decreased, MOCA-K showed negative causality (p < 0.01). As BDI and supine RDI increased, causality was negatively related to MOCA-K (p < 0.01). As PSQI (p < 0.001) and SIS (p < 0.01) increased and as MMSE-K (p < 0.01) decreased, causality was positively related to BDI. BDI was found to mediate the effect of age on MOCA-K in patients with obstructive sleep apnea. Conclusion: Duration N1, total sleep time, BDI, and supine RDI were associated with cognitive function in obstructive sleep apnea patients. Depression measured by BDI partially mediated cognitive decline in obstructive sleep apnea patients.

Survey for the Understanding of Elderly Disease and Work Environment for Physical Therapists in Elderly Care Facilities (노인요양시설물리치료사들의 노인복지정책과 노인질환에 대한 이해도 및 직무 환경에 대한 조사)

  • Kim, Soon-Ja;Kim, Jeong-Seon
    • Journal of Korean Physical Therapy Science
    • /
    • v.14 no.1_4
    • /
    • pp.25-36
    • /
    • 2007
  • The results of researching on duties of physical therapist, understanding of elderly diseases and policies related with elderly welfare came out from the survey before beginning of education to physical therapists who attended National Elderly Welfare Physical Therapist Workshop during Sep. 11th to 14th, 2007. They have already understood about long-term elderly care insurance from the policy, and responded that those policies will bring more advantage to elders. On contrary, negative response had reason of low service quality. About elderly care system, there were positive answer of appropriate alternatives to support them, but also other critics had opinion of inevitable choice for living conservation. About understanding of elderly diseases, there were more comprehension of diseases as age gets higher, but most did not understand dementia and paralysis. Past experience and process of medical treatment for their disease were such arthritis, paralysis, broken bone, and dislocation of joint. Prognosis of technical training was mostly answered positively, but linking with other related disease programs were not welcomed. Most respondents thought that professional training were needed. The results of understanding diseases during senescent had high percentage of understanding as age and education was high, and it had eye upon statistics of the survey (p < 0.05) Most of those questioned responded that it is appropriate to have six working days per week and eight hours of daily work, however, present wage is not reasonable. Most of those questioned had negative response of work independence, and had an-swered that there should be certificates needed in related fields. For difficulties during work period, they had hardship instituting direction of treatment by lack of program, level of wage, and physical difficulties. Physical therapists averagely wished to have fewer than thirty patients per therapist. After the research, physical therapists who work in those facilities of elderly care systems agreed on policies, though it should not lower service quality. In addition, they were pros to have elderly care system, yet they are still inevitable option to maintain living. For work environment, the period of work was appropriate, but had different opinions for work independence and regular number of patients. Therefore, there should be more organized treatment program that also should be linked to other practical programs at this beginning point of the policy enforcement and the time that many therapists hope to work in elderly care system.

  • PDF

Study of 4 Cases with Changes of Unified Parkinson's Disease Rating Scale, Heart Rate Variability and Quality of Life in Parkinson's Disease Patients through Whole Body Gi-Hyeol Therapy (전신기혈요법 치료를 통해 Unified Parkinson's Disease Rating Scale, Heart Rate Variability 및 삶의 질이 변화된 파킨슨 환자 4례에 대한 증례보고)

  • Mok, Seo-Hee;Lee, Ji-Won;Lee, Tae-Jong;Seo, Jung-Bok;Kim, Kyoung-Ah;Kim, Joe-Young;Park, Byung-Jun;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.35 no.2
    • /
    • pp.71-80
    • /
    • 2021
  • Parkinson's disease is one of the typical neurodegenerative disease and it is caused by the destruction of substantia nigra in brain leading to lack of dopamine secretion, and it presents 4 major motor symptoms such as tremor, bradykinesia, stiffness, postural instability. Furthermore, it causes many non-motor symptoms such as anosmia, REM sleep conduct disorder, orthostatic hypotension, dementia and autonomic ataxia such as lack of adjusting blood pressure, hyperhydrosis, constipation. Dopaminergic therapy is the most commonly used strategy, but long term treatment of levodopa induce various adverse effects. Thus, many people are focusing on new therapies other than established therapies, and there are many tries and approaches with paradigm shift. Our medical team was able to get 4 cases of PD patients who are hospitalized in our hospital, treated by Whole Body Gi-Hyeol Therapy consisting of acupuncture therapy, herbal therapy, and mental therapy, and their conditions improved in perspective of Unified Parkinson's Disease Rating Scale(UPDRS), Heart Rate Variability(HRV), and Quality of life. Among all 4 cases, UPDRS score and quality of life score is gotton better, and among 2 cases SDNN, RMS-SD, TP, LF, HF scores are finely increased. And PDQ-39 score which shows quality of life is also improved. However, in spite of these improvements and positive results, there were no meaningful improvement in a hurt from a fall which is important to the aged, muscular atrophy which causes bone fracture and SMI(Skeletal Muscle Mass Index) which is indicator of osteoporosis. Thus, supplementary treatment about Whole Body Gi-Hyeol Therapy such as more active nutrition intervention, safe and effective kinesitherapy is needed, and from now on continuous case reports and systematic clinical research which has control group must be carried out.

The Trend of Overseas Studies on the Intervention of Multisensory Environment: Systemic Review (다감각환경중재에 관한 국외 연구의 경향: 체계적 고찰)

  • Cho, Eun-Hee;Song, Hyun-Eun;Yoo, Doo-Han
    • The Journal of Korean Academy of Sensory Integration
    • /
    • v.17 no.1
    • /
    • pp.54-64
    • /
    • 2019
  • Objective : The purpose of this study is to study the effects of multisensory environment interventions, to provide information about clinical applications, and to aid South Korean research on the multisensory environment. Methods : PubMed, Cochrane, and Google Scholar were used to search for papers published from 2008 to 2018. The main search terms were "multisensory environment" and "snoezelen", a total of 10 foreign research articles were selected. And they were summarized according to Patient, Intervention, Comparison, Outcome (PICO). Results : Among the 10 papers, 6 included participants with dementia. The other studies examined patients with intellectual disabilities, patients with schizophrenia, and pregnant women. The study periods ranged from 3 weeks to 10 months. Most of the interventions included 2 or 3 sessions per week. The duration of each intervention session was 30 to 60 minutes. The dependent variables were psychological factors (such as anxiety and depression), social factors (such as quality of life), and cognitive and physical domains. The multisensory environment used for the interventions in the studies consisted of visual, auditory, and tactile senses, as well as additional olfactory and taste sensations, and vestibular sensations. Conclusion : In the future, the research should be applied to various target groups, especially children, who are interested in multisensory environmental intervention in South Korea.