OBJECTIVES: There have been several previous studies that the pathology of Alzheimer's disease (AD) might be in part caused or exacerbated by metals. But inconsistent results are often seen in evaluation of levels of metals in Alzheimer's disease patient's blood and control group. So, we conducted a systematic review using a comprehensive search strategy to find out whether there is significant difference between cognitive decline elderly people and normal control group. METHODS: Studies were searched in Pubmed, CINAHL and EMBASE with predefined words according to MeSH and purpose of this study. 996 studies were selected as primary screening, and two reviewers extracted relevant data independent of each other. 172 studies fulfilled the inclusion criteria. 32 studies about aluminum, copper, lead, mercury, cadmium finally selected. The Newcastle-Ottawa Scale (NOS) was used for assessing the quality of studies. To synthesize the results of this study, summarized table was made. RESULTS: In most studies, blood levels of mercury were high in cognitive decline group. But the majority study shows lead was not that different between cognitive decline group and control group. Measurements of other metal levels in whole blood, plasma, serum were inconsistent. However, there are not enough evidences to generalize with just number of studies since the studies have various degrees of validity. CONCLUSION: There is lack of evidences, till now, to use blood levels of metals as diagnostic purpose or predicting prognosis. Further studies which are supplemented limitations of previous studies are needed.
Aged ; Aluminum ; Alzheimer Disease ; Cadmium ; Copper ; Humans ; Mass Screening ; Metals ; Plasma ; Prognosis

OBJECTIVES: This study was conducted to prove the validity of the Korean version of the Executive Interview (K-EXIT) which was developed by Donald Royall as a bed-side test to measure the executive function. METHODS: The K-EXIT was developed and applied to 169elderly people with other executive functiontests.The internal consistency,reliability and the validity of the K-EXIT were analyzed. RESULTS: The K-EXIT showed high internal consistency (Crohnbachalpha= 0.766) and high inter-rater reliability (r=0.997, p<0.01).The K-EXIT total score was well correlated with verbal fluency test (r=-0.460, p<0.001), and the initiation-perseveration-change score (r=-0.598, p<0.005). CONCLUSION: The K-EXIT is a reliable and valid instrument for assessing executive function of the Korean elderly people. It may be also useful for the less well-educated people.
Aged ; Dementia ; Executive Function ; Humans

OBJECTIVES: This study aimed to compare the prevalence and severity of clinically relevant neuropsychiatric symptoms between subjects with Alzheimer's disease (AD) and subcortical vascular dementia (SVD). METHODS: The CREDOS (Clinical Research for Dementia Of South Korea) is a multicenter longitudinal cohort study organized to evaluate the long-term outcome of dementia patients. Out of a total 3,080 subjects, we selected 1,392 AD subjects and 247 SVD subjects with mild to moderate levels of dementia. The Neuropsychiatric Inventory (NPI) and Clinical Dementia Rating Scale (CDR), and CDR sum of box scores were used for evaluation. RESULTS: After controlling for severity of dementia and duration of education, SVD subjects had relatively more symptoms of apathy compared to AD subjects (OR : 1.397, p=0.025). SVD subjects also had relatively higher NPI composite scores in the apathy domain compared to AD subjects, after controlling for severity of dementia, age and duration of education (F=7.88, p=0.01). Subjects with moderate levels of dementia had more frequent and severe neuropsychiatric symptoms compared to those with mild dementia. CONCLUSION: Symptoms of apathy were more prevalent and severe in subjects with SVD, compared to subjects with AD.
Alzheimer Disease ; Apathy ; Cohort Studies ; Dementia ; Dementia, Vascular ; Deoxycytidine ; Humans ; Prevalence

OBJECTIVES: To identify the factors that are most significantly associated with the decline of Activities of Daily Living (ADL) status in subjects with Mild Cognitive Impairment (MCI) and early dementia of primary degenerative cause. METHODS: Medical records, results of neuropsychological tests, and Activities of Daily Living scale were retrospectively analyzed in 134 subjects meeting the diagnostic criteria of MCI or early dementia, respectively. Demographic factors, memory functions, depressive symptoms and executive functions of the participants were also analyzed. RESULTS: Correlations revealed that measures of executive functions were significantly associated with ADL status in participants with MCI, while both memory and executive functions were significantly associated in early demented elderly. Stroop test which measures the ability of inhibition showed the closest relation to executive function. Depressive symptoms did not have a significant influence on ADL status. CONCLUSION: Among participants with MCI, the early functional difficulties are associated mainly with executive function, which enables inhibition in particular. In participants with early dementia, on the contrary, the ADL status was associated with both executive function and memory. Further studies on the symptom pattern and related neuropathology in process of dementia progression are needed for Quality of Life (QoL) in elderly population.
Activities of Daily Living ; Aged ; Dementia ; Demography ; Depression ; Executive Function ; Humans ; Medical Records ; Memory ; Mild Cognitive Impairment ; Neuropsychological Tests ; Quality of Life ; Retrospective Studies ; Stroop Test

No abstract available.
Dementia* ; Neuropsychiatry* ; Pathology*

No abstract available.
Dementia* ; Neuropsychiatry* ; Pathology*

Frontotemporal lobe dementia have been underevaluated because of various clinical features, changing diagnostic criteria, and indifference of clinicians. It is important that frontotemporal lobe dementia patient showing behavioral and lingual problems should be early diagnosed and treated. Because frontotemporal lobe dementia patients often confused with Alzheimer's disease, senile depression, schizophrenia, drug abuse. We have presented a case of frontotemporal lobe dementia. He had typical clinical history and symptoms which deserve to be considered frontotemporal lobe dementia. He showed appropriate findings of frontotemporal lobe dementia in the neuropsychological tests and brain magnetic resonance imaging and single photon emission computed tomography. This case is thought to be helpful for clinicians to give attention to early diagnosis and appropriate treatment of frontotemporal lobe dementia.
Alzheimer Disease ; Brain ; Depression ; Early Diagnosis ; Frontotemporal Dementia* ; Humans ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Pick Disease of the Brain ; Schizophrenia ; Substance-Related Disorders ; Tomography, Emission-Computed, Single-Photon

The average age of frontotemporal dementia onset is much younger than that of the Alzheimer's disease. Behavioral disturbances occur at the early stage of frontotemporal dementia, and social dysfunction and personality deterioration may ensue. For this reason, it may be misdiagnosed as other psychiatric disorders. Therefore, more careful observation and concern is required for proper diagnosis. This report is about the case of a patient who had been misdiagnosed of disorders like schizotypal personality disorder, schizophrenia, obsessive compulsive disorder etc., and therefore have been treated for those. We reviewed this case based on the data of neuropsychiatric history, family history, neuropsychological test, brain MRI, and SPECT, and considered this case as frontotemporal dementia with family history. This is the first frontotemporal dementia case with family history in Korea, so hereafter we may discover the gene locus associated with this case. This study can be very useful for the following frontotemporal dementia studies in Korea.
Alzheimer Disease ; Brain ; Dementia ; Diagnosis ; Frontotemporal Dementia* ; Humans ; Korea ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Obsessive-Compulsive Disorder ; Schizophrenia ; Schizotypal Personality Disorder ; Tomography, Emission-Computed, Single-Photon

OBJECTIVE: To analyze characteristics of depressive symptom manifestation in Korean elderly by use of the Psychogeriatric Assessment Scale-Korean Version (PAS-K). METHOD: In the two epidemiological studies conducted in Yoncheon and Ulsan separately, PAS-K (Psychogeriatric Assessment Scale-Korean Version) was used as a common screening tool for depression in aged persons (65+). We analyzed the symptom characteristics in total subjects (n=1.641) by factor analysis and compared depressive symptomatology between male and female, urban and rural, educated and uneducated persons. Chi-square method was used to evaluated the differences in positive response rates of each depressive symptoms, and also item response theory was used to compare depressive symptomatology between male and female subject groups. RESULTS: Two factor structure that comprises 'combined emotional, cognitive and somatic factor' and 'sleep factor' was found in female, rural and uneducated groups. While, three factor structure composed of 'emotional factor', 'combined cognitive and somatic factor' and 'sleep factor' was found in male, urban and educated groups. Women endorsed significantly more depressive symptoms than men. Depressive mood, fatigue, restlessness, thoughts mixed up and suicide idea were more prevalent in female group. However, women reported their symptoms, especially emotional symptoms like depressive mood, restlessness, suicide idea, in less severe state of depression than men. In the evaluation of each item characteristics, most items were relevant in their item characteristics for the assessment of depressive symptoms in Korean elderly. However, 'hypnoticsalcohol use' item had very low correlation coefficient with total symptom score and it was less discriminative than other symptom items. CONCLUSION: Symptom characteristics of depression in Korean aged persons were different between groups according to sex, urbanicity and education level. An influence of Confucian culture on different symptom expression between male and female groups should be considered.
Aged* ; Depression* ; Education ; Epidemiologic Studies ; Factor Analysis, Statistical ; Fatigue ; Female ; Humans ; Male ; Mass Screening ; Psychomotor Agitation ; Suicide ; Ulsan

OBJECTIVES: The caregiver burden means emotional, social, financial, psychological, physical problems which could be experienced by occupational caregivers or families who cared disable patients. The caregiver burden affected by primary stressors (severity of disability in dementia patients) and secondary stressors (withdrawal from society, conflict between job and caregiving, loss of personal identity) may result in physical ill-health, depression, anxiety for the caregivers. The aims of this study were to assess caregiver burden in dementia, and to identify affecting factors. METHOD: 30 caregivers for dementia patients who had been treated at the "Dementia-Geriatric Mental Health Clinic" in the Kosin University Gospel Hospital and 44 healthy volunteers were selected. Using the Screen for Caregiver Burden (SCB), the degree of caregiver burden was measured. The demographic data was obtained by structured interview. Primary and secondary stressors were also analyzed. The severity of depression and anxiety was assessed by the Hamilton Depression Scale (HDS) and Hamilton Anxiety Scale (HAS). The severity of cognitive dysfunction (MMSE, CDR, GDS), behavioral symtoms (Revised Memory and Behavior Problems Checklist, RMBPC), daily functional disability (ADL, IADL) for the dementia patients were evaluated. RESULTS: 1) The SCB scores were significantly (p<0.001) higher in dementia caregivers (8.71+/-4.90) than in controls (0.23+/-0.48). 2) The SCB scores were not correlated with age of caregivers (gamma=0.081), education (gamma=-0.163), duration of caregiving (gamma=0.275). The RMBPC scores had statistically significant positive correlation with SCB scores (gamma=0.545, p<0.01), while age of dementia patients (gamma=-0.234), onset age of dementia (gamma=-0.280), duration of dementia (gamma=0.029), CDR (gamma=0.080), GDS (gamma=-0.125), MMSE (gamma=-0.212), ADL (gamma=-0.315), IADL (gamma=0.155) had not. 3) The SCB scores had statistically significant positive correlation with degree of secondary stress (gamma=0.581, p<0.01) and anxiety (gamma=0.376, p<0.05). The degree of secondary stress had statistically significant positive correlation with degree of emotional stress (gamma=0.757, p<0.01), depression (gamma=0.482, p<0.01), anxiety (gamma=0.376, p<0.01). CONCLUSIONS: The caregiver burden in dementia seemed to be originated from primary stressors related to the behavioral symptoms as well as secondary stressors (degree of emotional stress, depression, anxiety, etc.). Therefore, active intervention by the geriatric specialists might be helpful to reduce their strain.
Activities of Daily Living ; Age of Onset ; Anxiety ; Behavioral Symptoms ; Caregivers* ; Checklist ; Dementia* ; Depression ; Education ; Healthy Volunteers ; Humans ; Memory ; Mental Health ; Specialization ; Stress, Psychological