• Title/Summary/Keyword: Management of dementia

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Behavioral Variant Frontotemporal Dementia Phenocopy Syndrome (행동증상 아형 전측두엽 치매 표현형모사 증후군)

  • Cheon, Jin Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.3-11
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    • 2017
  • Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.

The Effect of Mild Cognitive Impairment Management Program on Traditional Korean Medicine in a Public Health Center (일개 보건소 한의약 경도인지장애 관리프로그램의 효과분석)

  • Kim, Kyeong Han;Lee, Su-In
    • The Journal of Korean Medicine
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    • v.34 no.3
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    • pp.106-118
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    • 2013
  • Objectives: The aim of this study was to evaluate the effect of a mild cognitive impairment (MCI) management program on traditional Korean medicine in a public health center. Methods: In order to examine the effect of the MCI management program, we investigated MCI patients who participated in the program. MCI patients were treated with Jodeung-san (JDS) or Dangguijagyag-san (DGJYS) for 6 weeks. Mini Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Quality of Life-Dementia (GQOL-D), Geriatric Depression Scale in Korea (GDS-K), and biochemical examination of blood were conducted at intervals of 6 weeks. A satisfaction survey was collected after this program. Results: MMSE-DS mean score increased significantly, by 4.09 (p=0.000) in the JDS group and by 4.15 (p=0.000) in the DGJYS group. GQOL-D mean score also increased significantly, by 5.90 (p=0.000) in the JDS group and by 5.07 (p=0.000) in the DGJYS group. GDS-K mean score decreased significantly, by 10.63 (p=0.000) in the JDS group and by 9.69 (p=0.000) in the DGJYS group. MMSE-DS, GDS-K and GQOL-D scores were not significantly different between the JDS and DGJYS groups. All of the participants were satisfied with the program, and 90% of the participants expressed a high intention to participate in the program again. Conclusions: Both Jodeung-san and Dangguijagyag-san treatment showed improvement on cognitive function, depression and quality of life in this program. Additional studies with more subjects will be required to prove credibility and validity more clearly.

Electroencephalography for Early Detection of Alzheimer's Disease in Subjective Cognitive Decline

  • YongSoo Shim;Dong Won Yang;SeongHee Ho;Yun Jeong Hong;Jee Hyang Jeong;Kee Hyung Park;SangYun Kim;Min Jeong Wang;Seong Hye Choi;Seung Wan Kang
    • Dementia and Neurocognitive Disorders
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    • v.21 no.4
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    • pp.126-137
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    • 2022
  • Background and Purpose: Early detection of subjective cognitive decline (SCD) due to Alzheimer's disease (AD) is important for clinical research and effective prevention and management. This study examined if quantitative electroencephalography (qEEG) could be used for early detection of AD in SCD. Methods: Participants with SCD from 6 dementia clinics in Korea were enrolled. 18F-florbetaben brain amyloid positron emission tomography (PET) was conducted for all the participants. qEEG was performed to measure power spectrum and source cortical activity. Results: The present study included 95 participants aged over 65 years, including 26 amyloid PET (+) and 69 amyloid PET (-). In participants with amyloid PET (+), relative power at delta band was higher in frontal (p=0.025), parietal (p=0.005), and occipital (p=0.022) areas even after adjusting for age, sex, and education. Source activities of alpha 1 band were significantly decreased in the bilateral fusiform and inferior temporal areas, whereas those of delta band were increased in the bilateral cuneus, pericalcarine, lingual, lateral occipital, precuneus, posterior cingulate, and isthmus areas. There were increased connections between bilateral precuneus areas but decreased connections between left rostral middle frontal area and bilateral frontal poles at delta band in participants with amyloid PET (+) showed. At alpha 1 band, there were decreased connections between bilateral entorhinal areas after adjusting for covariates. Conclusions: SCD participants with amyloid PET (+) showed increased delta and decreased alpha 1 activity. qEEG is a potential means for predicting amyloid pathology in SCD. Further longitudinal studies are needed to confirm these findings.

Analysis of periodontal pathogens in care facilities for the elderly with dementia (Real-time PCR을 이용한 요양보호시설 치매 노인의 구강 병원성 미생물 분석)

  • Ko, Hyo-Jin;Jeon, Eun-Suk;Kim, Hye-Jin
    • Journal of Korean society of Dental Hygiene
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    • v.17 no.1
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    • pp.155-168
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    • 2017
  • Objectives: The purpose of this research is to examine oral pathogen distribution among elderly with dementia in a care facility to understand the importance of preventively managing oral diseases in terms of preventively managing senile diseases. Methods: From 11th August 2015 to 11th October 2015, gingival crevicular fluid was collected from 130 subjects consisting of demented/non-demented elderly people aged above 65 in care facilities located in the regions of Busan/Gyeonggnam. Based on collected data, real-time PCR analysis on oral pathogen was conducted. Results: The demented elderly group consisting of female patients aged from 0 to 79 indicated higher ratios of T. denticola in comparison to the non-demented elderly group, and the demented elderly group consisting of female patients aged above 80 indicated a high ratio of S. mutans. It was confirmed that P. gingivalis and T. forsythensis categorized under the red complex are correlated, and that bacterial species categorized under the orange complex and bacterial species categorized under the red complex are correlated. Conclusions: Because eldery people with demntia are exposed to periodontal disease and dental caries, their oral environments are more vulnerable. In order to improve such environments, it is necessary to provide care facility personnel with an opportunity to receive education to become aware of the importance of oral health, and it is also necessary to compulsorily assign dental hygienists to care facilities so that they can serve as personnel specializing in oral health management.

Characteristics of Interior Space and Planning for Elderly Day Care Center in Korea (우리나라 노인주간보호시설의 실내공간 특성과 계획안)

  • 이선주;권오정
    • Journal of Families and Better Life
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    • v.21 no.1
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    • pp.1-12
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    • 2003
  • Day care center for the elderly is an alternative for community care for frail elderly who need social participation and physical cares and services outside the family. The purpose of this study was to identify the present situation of day care center for the elderly and to suggest desirable interior space plans for elderly day care center. Data were collected by two ways; a mail survey and case studies of existing day care centers. Five cases of day care centers were analyzed to find out Physical and space problems, available programs and services. Also, the staffs in 96 day care centers for the elderly in nationwide were selected for a mail survey and 68.8 percentage of all was collected and analyzed. From the result of case studies, narrow space and lack of accessibility features for wheelchair or other prosthetic devices were the major problems. From the result of a mail survey analysis, the elderly users were over 73 years old, and high proportion had suffered from dementia and apoplexy Also, staffing ration was 1:7 In other words, one staff was caring of 7 old people, and supporting staff was insufficient. Therefore, supportive, therapeutic environment Was more important issue to improve quality of care. Separate program room and outdoor space, lounging space, treatment room by gardening, separate counselling room, bedroom, a simple kitchen unit, staff office, separate physical treatment room, resting room for staff was indicated more necessarily. When priority of planning interior space was safety followed by accessability and convenience, it was also reported that sire of each room was generally narrow. The most serious problem in interior space was the lack and narrowness of space, and accessible features for mobility. Based on the literature review and the findings of this study, two types of floor plans for elderly day care center were suggested;‘a mixed type for the elderly with and without dementia’and‘a separate type for the elderly with dementia.’The main goals for designing interior space for two types of elderly day care center were to provide safe environment, encouraging environment for remaining abilities of users, sanitary environment, therapeutic environment, familiar environment, and socially-encouraging environment. The recommendations for further studies were suggested.

Relevance between cognitive function and oral health status in the elderly: Focusing on Korean Longitudinal Study of Aging (노인의 인지기능과 구강건강상태의 관련성: 고령화연구패널조사(Korean Longitudinal Study of Aging)를 중심으로)

  • Kim, In-Ja;Moon, Hee-Jung
    • Journal of Korean society of Dental Hygiene
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    • v.22 no.5
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    • pp.333-340
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    • 2022
  • Objectives: This study aimed to confirm the association between cognitive function and oral health status in the elderly. Methods: In this study, 5,794 respondents, aged 55 or older, who had participated in the 7th aging research panel survey were used. Statistical analyses were performed using a complex samples cross-tabulation analysis, complex samples general linear model, and a complex sample multinomial logistic regression analysis. Results: After analyzing the cognitive function of the elderly according to their oral health conditions, it was found that suspicions of dementia (19.6%) and cognitive function decline (25.9%) were more common for those who wore dentures than for those who did not wear dentures (p<0.001). Compared to those who did not wear dentures, those who wore dentures were linked to a 1.665 times higher suspicion of dementia (p<0.001). In comparison, cognitive decline was 0.964 times lower when the number of natural teeth increased by 1, and it was 0.941 times lower when the oral health evaluation index for the elderly increased by 1 point (p<0.001). Conclusions: As a result of this study, it was confirmed that cognitive function and oral health status are related in the elderly. Therefore, systematic measures for oral health management and oral health promotion should be prepared in tandem with awareness of possible cognitive decline in the elderly.

The Difference of Socio-demographic Variables and Health-related Behaviors among Groups of Body Mass Index (여성의 BMI에 따른 인구사회학적 특성 및 건강행동 특성비교)

  • Sohn, Ae-Ree;Jin, Ki-Young
    • Korean Journal of Health Education and Promotion
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    • v.25 no.4
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    • pp.1-11
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    • 2008
  • The purpose of this study was to identify the variables which affect BMI and the relationships among BMI and socio-demographic variables and health-related behaviors among women in Pajoo city. A self-report questionnaire was used covering questions regarding health, eating habits and health related behaviors such as smoking and drinking behavior, exercise, weight management, etc. Test of significance for differences between the groups were performed with $X^2$-test and hierarchial regression. The level of BMI has a positive relationship with age, married status, and weight management among Pajoo citizens in Korea. This study may be utilized in preparation and planning for dementia prevention programs and policies of older people. Also it can be useful for developing and enhancing various health programs and policies and policies when applied appropriately.

Comparison in Care Burden, Fatigue, and Life Contentment of Caregivers by Gender Relationship with Demented Elders (치매노인과 주부양자의 성별 관계에 따른 주부양자의 부양부담감, 피로 및 생활만족도 비교)

  • Lee, Young-Whee;Cho, In-Sook;Kim, Hwa-Soon
    • Women's Health Nursing
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    • v.15 no.3
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    • pp.196-204
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    • 2009
  • Purpose: This study was done in order to examine the differences in gender respect to care burden, fatigue, and life contentment of family caregivers of elderly with dementia. Methods: The setting of the study was a community-based dementia care center providing daycare services. One hundred ninety four caregivers were recruited for the survey. A structured questionnaire was used which included demographic information, care burden, fatigue, and general contentment scales. Caregivers were classified into 4 groups by gender relationship with care recipients. Results: The majority of the caregivers were middle-aged and elderly. More than twice as many were female rather than male caregivers. The results showed that women caregivers expressed more fatigue than men overall (p < .05). In the gender relationships, a different combination of man-woman appeared to have more burdens than that of a woman-woman group (p < .05). For fatigue, the man caregiver-woman elderly group showed a higher fatigue score than a woman-man group (p < .05). However, there was no significant difference in life contentment among groups. Conclusion: These results suggest that caregiver's gender and gender relationship with elders could be considerable factors when the nurses make a plan in the community for dementia nursing management services.

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A Study on Learning Transfer and Its Influencing Factors of Job Training Program Participants: Focusing on the Geriatric Care Worker who Received the Dementia Job Training (교육훈련대상자의 학습전이와 그 영향요인에 관한 연구: 치매전문교육을 받은 요양보호사 중심)

  • Lee, Jin;Kim, Chulwoo
    • Journal of Digital Convergence
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    • v.16 no.1
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    • pp.63-72
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    • 2018
  • This paper examined the learning transfer of job training participants and its influencing factors. A survey of 279 care workers in the city of Seoul and Kyeong Gi province who recently participated dementia job training was conducted. The results of multiple regression analysis indicated that the self-efficacy of the care workers, the capability of instructor, the training methods and the transfer opportunity positively influenced the level of learning transfer. The findings suggested increasing care workers' self-efficacy, enhancing practical skill-based training program, hiring instructors with high workplace experiences, fostering work environment with higher transfer opportunity are required.

Development of a Wandering Management Guideline for Family Caregivers of Community-dwelling Elders with Dementia (재가 치매노인 가족을 위한 배회관리 지침 개발)

  • Cheon, Hong Jin;Song, Jun-Ah
    • 한국노년학
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    • v.36 no.4
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    • pp.1089-1108
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    • 2016
  • The purpose of this study was to develop a wandering management guideline for family caregivers of community-dwelling elders with dementia (EWD). In the first stage of the study, focus group and individual interviews (n=10) were performed to analyze family caregivers' experiences about wandering of the EWD under their care. In the second stage, preliminary contents for the guideline were made based on the interview results of family caregivers and reviews of literature. Final version of the guideline with 86 items was established after experts' review using the Content Validity Index analysis. In the final stage, a pilot test was conducted to evaluate the guideline using a sample of 13 family caregivers of EWD. Family caregivers were educated about how to use the guideline and asked to complete a set of questionnaire to examine their knowledge about wandering, degree of application of the guideline, and satisfaction with the guideline. Family caregivers' knowledge score was significantly improved (p=0.014) and the average scores in the process evaluation (9 items) and user satisfaction (7 items) about the guideline were 2.69-3.46 (range: 1-4), and 2.85-3.38 (range: 1-4), respectively. Further study with a large random sample is necessary to confirm the results of this study.