• 동의신경정신과학회지
• /
• 제30권1호
• /
• pp.31-38
• /
• 2019

Objectives: To identify the cost effectiveness of early dementia diagnosis using the 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: The medical costs of dementia between Western medical care and Korean medical care were compared through the reimbursement and non-reimbursement item code for dementia examination. In addition, the medical expenses of patients with dementia and mild cognitive impairment were compared and analyzed with respect to Western and Korean medical care. Results: There were 87,434 claims, of which 16,101 patients were diagnosed with dementia and 38,680,789,560 won was found to be the medical expenses. 12,881 patients (80.0%) with dementia, 3,144 patients (19.5%) with mild cognitive impairment, and 76 patients (0.5%) progressing from mild cognitive impairment to dementia. The proportion of medical expenses was 97.6% for dementia patients, 2.3% for mild cognitive impairment, and 1% for patients progressing from mild cognitive impairment to dementia. 86,070 claims (98.4%) were from Western medical care, with16,824 patients (98.2%), and the medical expenses was 38,546,895,400 won (99.7%). 1,361 claims (1.6%) were from Korean medical care, with 303 patients (1.8%), and the medical expenses was 133,894,160 won (0.3%). Conclusions: This study compared and analyzed the medical costs of dementia patients and the diagnosis of both Korean and Western medical care. The results of this study are expected to be used as basic research data for investigating cost effectiveness of developing early diagnosis of dementia.

• 사물인터넷융복합논문지
• /
• 제6권4호
• /
• pp.27-32
• /
• 2020

인구 고령화에 따라 치매환자가 크게 늘어나고 있으며, 이에 따른 사회 경제적 부담이 커지고 있다. 현재 치매환자를 효과적으로 관리하는 방법은 조기에 치매 초기 환자를 파악하는 것이다. 그러나 의료진이 부족한 농촌과 섬 지역에서는 병원을 방문해서 조기 검사를 받기 어려운 문제가 있다. 이 문제를 해결하는 방법으로 본 논문에서는 원격 치매 조기 검사 시스템을 제안한다. 원격 치매 조기 검사 시스템은 환자가 실시간 화상 통신을 기반으로 한 원격 의료 기술을 활용하여 원격의 치매 전문가에게 검사 및 진료를 받을 수 있는 시스템이다. 치매 원격 조기 검진 시스템은 섬 지역의 보건지소 의료진이 사용하는 로컬 클라이언트 시스템, 영상을 전송 및 저장/관리하는 화상 서버, 원격 치매 전문가가 활용하는 전문가 클라이언트로 구성된다. 로컬 클라이언트는 환자가 보건지소의 의료진과 같이 사용할 수 있도록 함으로써 현 의료법의 원격협진 기준을 만족시킨다. 또한 전문가 클라이언트는 치매 전문가가 사용하며, 환자의 정보를 저장/관리하고, 환자의 이력 정보를 분석하고 향후 치매 진행 정도를 예측할 수 있다.

• Journal of Audiology & Otology
• /
• 제24권1호
• /
• pp.40-47
• /
• 2020

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

• 대한청각학회지
• /
• 제24권1호
• /
• pp.40-47
• /
• 2020

Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.

• 대한핵의학회지
• /
• 제37권1호
• /
• pp.13-23
• /
• 2003

Neurodegenerative disorders cause a variety of dementia including Alzheimer disease, frontotemporal dementia, dementia with Lewy bodies, corticobasal degeneration, progressive supranuclear palsy, and Huntington's disease. PET scan is useful for early detection and differential diagnosis of these dementing disorders. Also, it provides valuable information about clinico-anatomical correlation, allowing better understanding of function of brain. Here we discuss recent achievements PET studies regarding these dementing disorders. Future progress in PET technology, new tracers, and image analysis will play an important role in further clarifying the disease pathophysiology and brain functions.

• BMB Reports
• /
• 제53권1호
• /
• pp.47-55
• /
• 2020

Alzheimer's disease (AD) is a multifactorial neurodegenerative disease and has become a major socioeconomic issue in many developed countries. Currently available therapeutic agents for AD provide only symptomatic treatments, mainly because the complete mechanism of the AD pathogenesis is still unclear. Although several different hypotheses have been proposed, mitochondrial dysfunction has gathered interest because of its profound effect on brain bioenergetics and neuronal survival in the pathophysiology of AD. Various therapeutic agents targeting the mitochondrial pathways associated with AD have been developed over the past decade. Although most of these agents are still early in the clinical development process, they are used to restore mitochondrial function, which provides an alternative therapeutic strategy that is likely to slow the progression of the disease. In this mini review, we will survey the AD-related mitochondrial pathways and their small-molecule modulators that have therapeutic potential. We will focus on recently reported examples, and also overview the current challenges and future perspectives of ongoing research.

• 한국산학기술학회논문지
• /
• 제15권6호
• /
• pp.3832-3840
• /
• 2014

고령화 사회로 급격히 진행 함에 따라 치매 환자 또한 급속히 증가하고 있으나 진행이 되면 완치가 어려운 실정이다. 초기에 발견하고 진행 과정을 늦추는 것이 치료의 목표이고 환자의 안전, 지속적인 보살핌, 일상 생활, 건강 관리지원이 중요하다. 본 논문의 스마트 케어 시스템은 동작 감지 센서, 가스 누출 감지 센서를 활용한 블루투스 통신 기술을 사용하여 화재, 가스 누출, 가출시 배회등의 각종 응급 상황에 대처 할 수 있게 해주고, 스마트폰을 통해 환자의 일상 생활 수행능력을 지속적으로 관찰, 관리 함으로써 한국의 효 문화의 특성상 환자가 입원 전 가정에 더 오래 머물 수 있도록 하면서도 치매 환자의 부양자들이 갖는 경제적, 신체적, 심리적 부양 부담을 줄일 수 있다. 시스템 내에서 축적된 개인별 데이터베이스는 전문의에게 상담, 치료 가능하며 전문 치료 기관 및 복지 시설과의 연계를 통한 전문 서비스를 지원 받을 수 있다.

• 대한의생명과학회지
• /
• 제21권1호
• /
• pp.1-8
• /
• 2015

Alzheimer's disease is a common form of dementia occurring among the elderly population and can be identified by symptoms such as cognition impairments, memory loss and neuronal dysfunction. Alzheimer's disease was found to be caused by the deposition of $\beta$-amyloid plaques and neurofibrillary tangles. In addition, mutation in the APP (Amyloid precursor protein), Presenilin 1 (PSEN1) and Presenilin 2 (PSEN2) genes were also found to contribute to Alzheimer's disease. Since the potential conformational diagnosis of Alzheimer's disease requires histopathological tests on brain through autopsy, potential early diagnosis still remains challenging. In recent years, several researches have proposed the use of biomarkers for early diagnosis. In cerebrospinal fluid (CSF), $\beta$-amyloid(1-42), phosphorylated-tau and total tau were suggested to be effective biomarkers for Alzheimer's disease diagnosis. However, a single biomarker might not be sufficient for potential diagnosis of Alzheimer's disease. Thus, the use of RNA interference (RNAi) through microRNAs (miRNAs) has been proposed by several researchers for simultaneous analysis of several biomarkers using microarray technology. These miRNA based biomarkers can be analysed from both blood and CSF, but miRNAs from blood are advantageous over CSF as they are non-invasive and simple for collection. Moreover, the RNAi based therapeutics by siRNA (short interference RNA) or shRNA (short hairpin RNA) have also been proposed to be effective in the treatment of Alzheimer's disease. This review describes the promising application of RNAi technology in therapeutics and as a biomarker for both Alzheimer's disease diagnosis and treatment.

• 농촌의학ㆍ지역보건
• /
• 제44권1호
• /
• pp.11-27
• /
• 2019

치매는 세계적으로 주요 유행 질환이 되었다. 한국의 2010년 치매 유병률은 8.7%에서 2050년 15.1%로 예측되고 있으며, 2017년 현재 725,000명의 치매환자가 추정되고 있다. 이 글은 한국의 국가치매 예방관리사업을 현황을 리뷰하고 그에 따른 정책과제 등을 살펴보고자 하였다. 한국은 치매에 대하여 2008년, 2012년, 2016년에 걸쳐 세 차례의 국가치매계획을 개발하였다. 제1차 치매계획은 치매에 대한 예방, 조기진단, 하부구조개발 및 조정, 관리, 인지도 개선 등에 초점을 맞추었으며, 제2차 치매계획은 치매환자 가족지원에 역점을 두었고, 치매관리법의 제정과 더불어 포괄적인 사업의 근거를 마련하였다. 제3차 치매계획은 치매 친화적 지역사회 구축에 목표를 두었으며, 가족부담을 줄이고, 연구, 통계, 기술개발 등에 지원을 마련하였다. 2017년 한국 정부는 국가치매책임제를 도입하였으며, 경증 치매에 대한 장기요양보험제도 혜택을 확대하고, 보건소 치매안심센터의 설치, 운영, 국가 및 공공치매관리시설의 확장 등을 추진하고 있으나 정책의 급속한 추진에 따르는 재정확보 등 많은 과제들이 남아 있다.

• 융합정보논문지
• /
• 제9권8호
• /
• pp.248-253
• /
• 2019

노인성 치매의 전 임상단계인 경도인지장애(MCI)를 조기 진단하고, 조기 개입한다면, 치매의 발병률을 줄일 수 있다. 본 연구는 우리나라 지역사회 노인의 MCI 예측 모형을 개발하고 노년기 인지장애의 예방을 위한 기초자료를 제공하였다. 연구대상은 2012년 Korean Longitudinal Survey of Aging(KLoSA)에 참여한 65세 이상 지역사회 노인 3,240명(남성 1,502명, 여성 1,738명)이다. 결과변수는 MCI유병으로 정의하였고, 설명변수는 성, 연령, 혼인상태, 교육수준, 소득수준, 흡연, 음주, 주1회 이상의 정기적인 운동, 월평균 사회활동 참여시간, 주관적 건강, 고혈압, 당뇨병을 포함하였다. 예측모형의 개발은 Restricted Boltzmann Machine(RBM) 인공신경망을 이용하였다. RMB 인공신경망을 이용하여 우리나라 지역사회 노인의 MCI 예측 모형을 구축한 결과, 유의미한 요인은 연령, 성별, 최종학력, 주관적 건강, 혼인상태, 소득수준, 흡연, 규칙적 운동이었다. 이 결과를 기초로 MCI 고위험군의 특성을 고려한 맞춤형 치매 예방 프로그램의 개발이 요구된다.