• Title/Summary/Keyword: Geriatric Syndrome

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Mild Impairments in Cognitive Function in the Elderly with Restless Legs Syndrome (노인 하지불안증후군에서의 인지기능 저하)

  • Kim, Eun Soo;Yoon, In-Young;Kweon, Kukju;Park, Hye Youn;Lee, Chung Suk;Han, Eun Kyoung;Kim, Ki Woong
    • Sleep Medicine and Psychophysiology
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    • v.20 no.1
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    • pp.15-21
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    • 2013
  • Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.

Protein Intake Recommendation for Korean Older Adults to Prevent Sarcopenia: Expert Consensus by the Korean Geriatric Society and the Korean Nutrition Society

  • Jung, Hee-Won;Kim, Sun-Wook;Kim, Il-Young;Lim, Jae-Young;Park, Hyoung-Su;Song, Wook;Yoo, Hyung Joon;Jang, HakChul;Kim, Kirang;Park, Yongsoon;Park, Yoon Jung;Yang, Soo Jin;Lee, Hae-Jeung;Won, Chang Won
    • Annals of Geriatric Medicine and Research
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    • v.22 no.4
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    • pp.167-175
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    • 2018
  • Sarcopenia, a common clinical syndrome in older adults, is defined as decreased muscle mass, strength, and physical performance. Since sarcopenia is associated with the incidence of functional decline, falls, and even mortality in older adults, researchers and health care providers have been keen to accumulate clinical evidence to advocate the screening and prevention of sarcopenia progression in older adults. The factors that may accelerate the loss of muscle mass and function include chronic diseases, inactivity, and deficiency in appropriate nutritional support. Among these, nutritional support is considered an initial step to delay the progression of muscle wasting and improve physical performance in community-dwelling older adults. However, a nationwide study suggested that most Korean older adults do not consume sufficient dietary protein to maintain their muscle mass. Furthermore, considering age-associated anabolic resistance to dietary protein, higher protein intake should be emphasized in older adults than in younger people. To develop a dietary protein recommendation for older adults in Korea, we reviewed the relevant literature, including interventional studies from Korea. From these, we recommend that older adults consume at least 1.2 g of protein per kg of body weight per day (g/kg/day) to delay the progression of muscle wasting. The amount we recommend (1.2 g/kg/day) is 31.4% higher than the previously suggested recommended daily allowance (i.e., 0.91 g/kg/day) for the general population of Korea. Also, evidence to date suggests that the combination of exercise and nutritional support may enhance the beneficial effects of protein intake in older adults in Korea. We found that the current studies are insufficient to build population-based guidelines for older adults, and we call for further researches in Korea.

Clinical and Electrophysiological Study on Guillain-Barr$\acute{e}$ Syndrome (Guillain-Barr$\acute{e}$ 증후군의 임상적 및 전기생리학적 연구)

  • Yun, Sung-Hwan;Hah, Jung-Sang;Joo, Sung-Gyun;Cho, Yong-Kook;Kim, Jung-Hyun;Chung, Ji-Yeun
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.52-61
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    • 2005
  • Background: Guillain-Barre syndrome is defined as a recognizable clinical entity that is characterized by rapidly evolving symmetric limb weakness, the loss of tendon reflexes, absent or mild sensory signs, and variable autonomic dysfunctions. This study evaluated the clinical and electrophysiological findings retrospectively. Materials and Methods: Forty-five patients with Guillain-Barre syndrome, who were admitted to the Yeungnam University Hospital for six years from Jan. 1994 to Dec. 1999 were investigated. The correlation between the clinical manifestation and the electrophysiological study was evaluated. Results: The male to female ratio was 1.8:1 and there was a peak seasonal incidence in the winter. A preceding illness was noted in 66.7 % of cases, and an upper respiratory tract infection was the most common one. The most common clinical manifestations were a loss of tendon reflex and ascending muscle weakness and paralysis. The cerebrospinal fluid examinations revealed, albuminocytologic dissociation in 33 cases (73.3 %). Intravenous immunoglobulin therapy was performed in 29 cases (64.4 %). The sequential electrophysiological abnormalities were most marked at 2 to 4 weeks after onset. At that time the most significant change was a decrease in the compound muscle action potential amplitude. These 45 patients with Guillain-Barre syndrome were subclassified using the clinical and electrophysiological data. Conclusion: The result in this study, concured with other research on the clinical and electrophysiological data of Guillain-Barre syndrome. However, an extensive and dynamic investigation is necessary to determine the reason for the peak seasonal incidence in winter.

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The Relationship Factors Geriatric Syndrome of the Elderly Women in Poverty (빈곤층 노인여성의 노인증후군 관련요인 분석)

  • Hwang, Hye-Jeong;Lee, Moo-Sik;Kim, Nam-Song;Na, Bak-Ju;Bae, Seok-Hwan;Roh, Young-Soo;Hong, Jee-Young
    • Proceedings of the KAIS Fall Conference
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    • 2010.11b
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    • pp.669-672
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    • 2010
  • 본 연구는 방문건강관리사업 대상자 중 취약한 노인여성과 노인증후군 관련요인에 대한 인과관계 모형을 규명하여 취약한 노인 여성의 보건의료서비스 제공 시 효율적인 방안제시를 위한 기초자료로 활용하고자 시행하였다. 연구대상자는 2008년 7월 1일부터 9월 30일까지의 기간 동안 전국 보건소에 등록된 방문건강관리사업 대상자 중 동의된 65세 이상 노인여성 1,350명을 선정하여 훈련된 조사원이 직접면담을 통해 조사하였다. 수집된 자료 중 불충분한 29명을 제외한 1,321명을 최종 분석대상으로 하였다. 수집된 자료는 SPSS 17.0 프로그램을 이용하여 빈도분석 및 카이제곱 검정, t-검정, ANOVA, 사후검정은 Tukey를 이용하였으며, 유의한 변수들을 선정하여 로지스틱 회귀분석을 이용하여 분석 하였다. 연구결과를 요약하면 다음과 같다. 첫째, 허약과 관련 있는 노인증후군위험요인은 우울, 요실금, 낙상력, 일상적 수행활동(ADL)으로 나타났다(p<0.05). 둘째, 허약에 영향을 미치는 요인으로는 연령이 75세 이상의 고령일수록, 우울과 요실금의 증상이 있을 때, 최근 낙상경험이 있을 때 허약의 증가 위험이 높은 것으로 나타났다(p<0.05). 셋째, 노인증후군의 위험요인 증가에 영향을 미치는 요인으로는 평생 동안 담배를 5갑 이상 피웠을 때, 당뇨병이 있을 때로 나타났다(p<0.05). 이상 결과를 볼 때, 취약 노인 대상으로 노인증후군, 허약의 향상을 위해서는 만성질환관리 프로그램 뿐 만 아니라 체계적인 근력강화 운동 및 정신건강관리 프로그램의 충분한 확대보급이 반드시 필요하다.

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Comparison of Smartphone Addiction, Anterior Head Posture, Quality of Life, and Headache Impact according to the Presence or Absence of Tension Headaches in College Students (대학생들의 긴장성 두통 유무에 따른 스마트폰 중독, 전방 머리 자세, 삶의 질, 두통 영향 및 두통 장애 지수 비교)

  • Kim, Chihwan;Lee, Donggeon
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.117-123
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    • 2020
  • Purpose : VDT (visual display terminal syndrome) can affect individuals who monitor or who work or play using video screens, including those of smartphones. In general, headache symptoms from overuse of these screens can appear due to eye fatigue, muscle pain in the joints of wrists or fingers, and muscle pain in the neck or shoulders. Many studies in the literature have supported standards that seek to prevent these symptoms. The incidence of musculoskeletal diseases caused by the use of smartphones is expected to increase rapidly, particularly among children and young adults, and these diseases are expected to develop into a societal problem. Therefore, in this study we investigate whether tension headaches that develop from smartphone usage can affect forward neck posture, neck pain, and quality of life. Methods : A total of 93 students from University participated in this study. We divided participants into two groups, those with tension headaches (n = 25) and those without (n = 68) and took forward neck measurements. Headaches were classified according to criteria from the International Headache Society and involved bilateral headache position, quality of pressing or tightening pain, mild or moderate pain intensity, and none due to daily physical activity. We surveyed participants using the smartphone addiction diagnosis questionnaire, the Neck Disability Index (NDI), the Headache Impact Test (HIT-6), and the Quality of Life Questionnaire. Results : Although we found no significant differences in tension headaches due to smartphone addiction diagnosis (p = 0.25), SF-36 life quality assessment (p = 0.06), and cranio-vertebral angle (p = 0.07), we found significant differences from the HIT-6 and the NDI (p <.05). Conclusion : Tension headaches are not correlated with smartphone addiction, quality of life, and forward neck angle but do have a correlation with the degree of cervical dysfunction and the effects of the headaches.

A Classification Method of Delirium Patients Using Local Covering-Based Rule Acquisition Approach with Rough Lower Approximation (러프 하한 근사를 갖는 로컬 커버링 기반 규칙 획득 기법을 이용한 섬망 환자의 분류 방법)

  • Son, Chang Sik;Kang, Won Seok;Lee, Jong Ha;Moon, Kyoung Ja
    • KIPS Transactions on Software and Data Engineering
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    • v.9 no.4
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    • pp.137-144
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    • 2020
  • Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

Research Trends on the Therapeutic Potential of Cordycepin, an Active Ingredient of the Insect Fungus Cordyceps spp., for the Prevention of Sarcopenia (동충하초(Cordyceps spp.)의 유효 생리활성 성분인 cordycepin의 근감소증 예방에 대한 연구 동향)

  • Kim, Sung Ok;Choi, Yung Hyun
    • Journal of Life Science
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    • v.32 no.6
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    • pp.482-490
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    • 2022
  • Sarcopenia, a geriatric and multifactorial syndrome characterized by progressive systemic skeletal muscle disorder, may be associated with many comorbidities. Sarcopenia caused by a decrease in muscle mass and muscle strength is accompanied by the aggravation of various pathological conditions, and as life expectancy increases, its prevalence will continue to increase in the future. During the aging process, chronic oxidative stress and increased inflammatory responses act as major contributors to skeletal muscle loss. In addition, disruption of autophagy and apoptosis signals associated with dysfunction of mitochondria, which are essential for energy metabolism, accelerates the loss of muscle proteins. The pharmacological effect of cordycepin, a major physiologically active substance in the genus Cordyceps, which has been widely used for the prevention and treatment of various diseases for a long time, is directly related to its antioxidant and anti-inflammatory actions. In this review, we present the correlation between apoptosis, autophagy, protein catabolism, and satellite cell activity important for muscle regeneration using cordycepin for the prevention and treatment of sarcopenia. Although there have been few studies so far on the use of cordycepin for sarcopenia, previous studies suggest that cordycepin may contribute to inhibiting the age-related weakening of mitochondrial function and blocking the breakdown of muscle proteins. In addition, the protective effect of cordycepin on muscle cell damage is considered to be closely related to its antioxidant and anti-inflammatory activities. Therefore, it is considered that more continuous basic research is needed, focusing on the molecular biological mechanism of cordycepin, which is involved in the anti-aging of muscle cells.