• 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.

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.122-131
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• 2004

Purpose: The purpose of the study is to explore the socio-psychological coping process and experiences of families before and after institutionalization by applying the Corbin and Strauss ground research method. Method: Data collection from 9 participants with elderly institutionalized dementia with approval from directors of the institute was done by in depth interviews during a seven month period from May, 2003 to December, 2003. Data analysis was done by repeated reading of the transcribed interviews, and 344 concepts and 39 subcategories were generated. Results: Family members of the dementia elderly experienced various degrees of exhaustion, physically, mentally, and socially. The degree of their exhaustion was related to the severity of the family member's symptoms, and length of the dementia. Coping strategies were effected by economic status, social support from blood related families or neighbors, depth of their relationship with elderly institutionalized dementia. They were even affected by the elderly family members institutionalization. Conclusion: After institutionalization participants felt some guilt from not assuming their responsibilities as children. On the other hand they regained privacy, freedom, security, and comfort, so that their life returned to normal. They even felt more comfort because their elderly were living in a safer environment, and received a better quality of care. Participants had better composure, so that they could even take care of neighbors in need. They hope that there is more governmental involvement in terms of subsidy and numbers of institutes. Findings of the study will be a ground for the development of a coping program for families with elderly institutionalized dementia. Further studies are recommended to explore types of family, and to develop programs for the families to help them interact with each other.

• The Journal of Bigdata
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• v.6 no.1
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• pp.37-49
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• 2021

The number of dementia patients in Korea is estimated to be over 800,000, and the severity of dementia is becoming a social problem. However, no treatment or drug has yet been developed to cure dementia worldwide. The number of dementia patients is expected to increase further due to the rapid aging of the population. Currently, early detection of dementia and delaying the course of dementia symptoms is the best alternative. This study presented a methodology for early diagnosis of dementia by measuring and analyzing amyloid plaques. This vital protein can most clearly and early diagnose dementia in the retina through AI-based image analysis. We performed binary classification and multi-classification learning based on CNN on retina data. We also developed a deep learning algorithm that can diagnose dementia early based on pre-processed retinal data. Accuracy and recall of the deep learning model were verified, and as a result of the verification, and derived results that satisfy both recall and accuracy. In the future, we plan to continue the study based on clinical data of actual dementia patients, and the results of this study are expected to solve the dementia problem.

• Korean Journal of Adult Nursing
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• v.19 no.1
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• pp.24-34
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• 2007

Purpose: The objective of this study was to define the predictors of health related quality of life(HRQoL) of women caregivers of the demented elderly patients. Methods: The subjects of this study were 140 pairs of patients with dementia and their caregivers. The characteristics of dementia patients and caregivers, Barthel index and SF-36 were measured in this study. T-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression were used for data analysis. Results: The health related quality of life(HRQoL) score of women caregivers was $288.35{\pm}66.10$ for norm based scoring. HRQoL of women caregivers was correlated with patients' ADL, severity of dementia, caregivers' age, burden, and family support. The major factors that affected the physical components of women caregivers of patients with dementia was the age of the caregiver, burden, and ADL which explained 36.0% of HRQoL. The main predictors of women caregivers' emotional state was the caregiver's burden. Conclusion: Patients' support systems must be implemented to improve the physical HRQoL of caregivers. A caregivers' burden relief program needs to be prepared to increase their emotional HRQoL and further studies and efforts will be needed to evaluate those effects.

• The Journal of Internal Korean Medicine
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• v.37 no.4
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• pp.678-684
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• 2016

Objectives: This clinical study describes the effect of Korean medicine on a patient with alcohol-related dementia.Methods: A patient with cognitive disorder and memory impairment due to alcohol abuse was treated with the herbal medicine “Gami Gwibi-tang”, acupuncture, and moxibustion, together with basic Western medicine. The patient’s cognitive function was evaluated by the Mini-Mental State Examination-Korean (MMSE-K) and Clinical Dementia Rating (CDR). Brain Magnetic Resonance Imaging (MRI) was used to estimate the severity of structural brain damage.Results: Following treatment with Gami Gwibi-tang, patent’s MMSE-K score and CDR improved.Conclusion: This clinical case study provides evidence of the effect of Korean medicine, including Gwibi-tang-gami, on alcohol-related dementia.

• Journal of Korean Academy of Nursing
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• v.52 no.2
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• pp.121-133
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• 2022

Purpose: This study examined the impact of a virtual reality intervention program based on psychological needs on behavioral and psychological symptoms, apathy, and quality of life (QOL) in patients with dementia or mild cognitive impairment living in nursing facilities. Methods: This study is nonequivalent control group pretest-posttest design of quasi-experimental study. The study collected data from November 18, 2020 to July 24, 2021 from patients with dementia or mild cognitive impairment (30 in the experimental group and 30 in the control group) at three nursing facilities in G city using self-reporting and caregiver-informant reporting methods. The analysis employed the chi-square test, Fisher's exact test, paired t-test, independent t-test, Wilcoxon signed rank test, Mann-Whitney U, repeated measures ANOVA, GEE, using SPSS/WIN 27.0. Results: The severity of behavioral and psychological symptoms (Wald 𝛘² = 2.68, p = .102) and the care burden of caregivers (Wald 𝛘² = 1.72, p = .190) were not significant and was no significant time and group interaction effect (Wald 𝛘² = 0.63, p = .426, Wald 𝛘² = 0.52, p =. 471). The difference in apathy and QOL score were statistically significant for the group-time interaction (F = 43.65, p < .001; F = 4.35, p = .041). Conclusion: The virtual reality intervention program of this study shows a positive effect on the apathy reduction and QOL of patients with dementia or mild cognitive impairment residing in nursing facilities.

• 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 Health Education and Promotion
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• v.25 no.2
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• pp.1-18
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• 2008

Objectives: The objective of this study is to identify the gender differences of risk factors for falls among the elderly in community dwellings. Methods: We analyzed the data on 3,278(male 1,255, female 2,023) persons, including 497 persons who have experienced falls, drawn from the 2004 National Elderly Survey. We conducted a cross-tabulation analysis, $X^2$-test and hierarchical regression analysis of the impact of the socio-economical characteristics, environmental characteristics, the number of chronic diseases, usage of supplementary devices, activities of daily living, dementia, and the severity of problem behavior. Results: For the entire sample of the elderly, gender, age, the size of the cities of residence, the number of chronic diseases, and the severity of problem behavior were identified as risk factors for falls. The number of chronic diseases and the severity of problem behavior were found to be significant for the male subsample, while age, the size of cities of residence, dwelling types, and the number of chronic diseases were found to be significant for the female subsample. Conclusion: The number of chronic diseases was identified as a common risk factor for falls in the male and female elderly. Chronic diseases were also found to aggravate the risk for falls when they concur with other diseases.

• 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'.

• Dementia and Neurocognitive Disorders
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• v.16 no.3
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• pp.72-77
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• 2017

Background and Purpose Although sleep disturbances are common and considered a major burden for patients with Alzheimer's disease (AD), the fundamental mechanisms underlying the development and maintenance of sleep disturbance in AD patients have yet to be elucidated. The aim of this study was to examine the correlation between regional cerebral blood flow (rCBF) and sleep disturbance in AD patients using technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT). Methods A total of 140 AD patients were included in this cross-sectional study. Seventy patients were assigned to the AD with sleep loss (SL) group and the rest were assigned to the AD without SL group. SL was measured using the sleep subscale of the Neuropsychiatric Inventory. A whole-brain voxel-wise analysis of brain SPECT data was conducted to compare the rCBF between the two groups. Results The two groups did not differ in demographic characteristics, severity of dementia, general cognitive function, and neuropsychiatric symptoms, with the exception of sleep disturbances. The SPECT imaging analysis displayed decreased perfusion in the bilateral inferior frontal gyrus, bilateral temporal pole, and right precentral gyrus in the AD patients with SL group compared with the AD patients without SL group. It also revealed increased perfusion in the right precuneus, right occipital pole, and left middle occipital gyrus in the AD with SL group compared with the AD without SL group. Conclusions The AD patients who experienced sleep disturbance had notably decreased perfusion in the frontal and temporal lobes and increased rCBF in the parietal and occipital regions. The findings of this study suggest that functional alterations in these brain areas may be the underlying neural correlates of sleep disturbance in AD patients.