1.Effect of Community-Based ‘Goal-Achieving Program’ in Patient with Late-Life Depression : Preliminary Study.
Gyu Ha KANG ; Ki Jung CHANG ; Hyun Kook LIM ; Jinjoo HAN ; Eun Hee LEE ; Hyun Woong ROH ; Jai Sung NOH ; Young Ki CHUNG ; Ki Young LIM ; Chang Hyung HONG ; Sang Joon SON
Journal of Korean Geriatric Psychiatry 2017;21(1):35-40
OBJECTIVE: This study aimed to investigate the effect of community-based Goal-Achieving program in geriatric depressive symptoms preliminarily. METHODS: We obtained data from elderly Korean subjects with major depressive disorder (n=51) aged 60 years or older at baseline, taking case management from community mental health center. Subjects were randomly assigned to intervention group (n=24) and control group (n=27). We investigated depressive symptoms through Short Form Geriatric Depression Scale-Korean version (SGDS-K) at baseline and every month for 3 months to all subjects. We tested interaction between group and time in SGDS-K score to evaluate the effect of program. And post hoc test examined between group differences of SGDS-K at each time points. RESULTS: In quadratic linear mixed effects model analysis, interaction between group and time was statistically significant (Total SGDS-K score : coefficient=0.29, p<0.001 ; SGDS-K dysphoria subscale : 0.18, p<0.001 ; SGDS-K hopelessness subscale : 0.05, p=0.089 ; SGDS-K cognitive impairment subscale : 0.06, p=0.003). And significant between group difference was shown in post hoc test at time points of third month (SGDS-K score of control group : SGDS-K score of intervention group=10.74±3.482 : 7.25±4.475, p=0.0184). CONCLUSION: These results may suggest that ‘Community-based the Goal-Achieving program’ has efficacy in reducing geriatric depressive symptoms.
Aged
;
Case Management
;
Cognition Disorders
;
Depression*
;
Depressive Disorder, Major
;
Humans
;
Mental Health
2.Neuropsychiatric Symptoms and Increased Risks of Progression from Amnestic Mild Cognitive Impairment to Alzheimer's Dementia.
Jin SHIN ; Seung Ho RYU ; Jee Hyun HA ; Doo Heum PARK ; Jaehak YU
Journal of Korean Geriatric Psychiatry 2017;21(1):29-34
OBJECTIVES: Neuropsychiatric symptoms (NPS) are common in dementia and in mild cognitive impairment (MCI). They might be a predictor of progression to dementia. This study aimed to investigate the effects of NPS on the natural course in MCI. METHODS: 306 community-dwelling Korean elderly with MCI from local dementia center were assessed for NPS using Neuropsychiatric Inventory (NPI). Subjects were assessed again after more than a year from baseline. 52 subjects (17.0%) were progressed to dementia. We compared baseline NPI scores between stable and deteriorated groups. RESULTS: Subjects progressing to dementia had a significantly higher prevalence of NPS (45.3% vs. 65.4%) than subjects who remained stable. Delusion (2.8% vs. 9.6%), agitation/aggression (14.6% vs. 26.9%), depression (21.7% vs. 40.4%) and disinhibition (4.3% vs. 19.2%) were more common in deteriorated group. After adjustment for other variables, on logistic regression analysis, only disinhibition at baseline was shown to be a risk factor for progression to dementia (OR=4.88, 95% CI=1.37-17.36, p=0.01, R²=302). CONCLUSION: These findings suggest that NPS in MCI may be a predictor of progression to dementia. NPS may be a useful item including delusion, agitation/aggression, depression, and disinhibition. To study course and nature of NPS may lead to better understanding of Alzheimer's disease.
Aged
;
Alzheimer Disease
;
Delusions
;
Dementia*
;
Depression
;
Humans
;
Logistic Models
;
Mild Cognitive Impairment*
;
Prevalence
;
Risk Factors
3.Comparative Study of the Effects of Supportive Educational Programs : for Family Caregivers of the Elderly with Dementia.
Heup SONG ; Jae Myeong KANG ; Steven B KIM ; Seong Jin CHO ; Seonkyung YUN ; Hyejin YOON ; Byeong Kil YEON
Journal of Korean Geriatric Psychiatry 2017;21(1):17-28
OBJECTIVE: We studied the effect of Hyu-Sig-Gong-Gan and Hye-Ah-Rim on several evaluations and compared the two programs. We then investigated factors associated with the difference between pre- and post-ratings. METHODS: Thirty-six patients were randomized to Hyu-Sig-Gong-Gan (n=23) or Hye-Ah-Rim (n=13). We tested for the effect of each program on several evaluations and compared the two programs through Zarit Burden Interview (ZBI), Center for Epidemiologic Studies-Depression Scale, Dementia Attitude Scale (DAS)-intelligence, DAS-comfort and DAS-total. We then investigated whether the difference between pre- and post-rating depends on other factors. RESULTS: We observed significant positive effect of Hyu-Sig-Gong-Gan on DAS-comfort (t=1.843, p=0.039) and significant positive effect of Hye-Ah-Rim on ZBI (t=-2.327, p=0.019), DAS-comfort (t=2.241, p=0.022), and EuroQol-5 Dimensions-Visual Analogue Scale (t=2.537, p=0.013). For comparing the two programs, we found a lack of evidence for the difference in any of the five commonly observed evaluations. In the secondary analysis, we observed a strong trend that the two programs were particularly effective for caregivers with negative pre-ratings. CONCLUSION: The two programs showed positive effects on the various evaluations, but some evaluations could not reach statistical significance. The programs appear to be particularly helpful for those who are in need before the program participation.
Aged*
;
Caregivers*
;
Dementia*
;
Humans
;
Program Evaluation
4.The Effects of Spouse Support and Conflict on Depression in Older Adults and Their Gender Difference.
Journal of Korean Geriatric Psychiatry 2017;21(1):8-16
OBJECTIVE: The purpose of this study is to investigate the effects of spouse support and conflict on the depression in older adults, and also to explore whether there are any differences between men and women in these effects. METHODS: The participants of this study were normal and married older adults who participated in the first wave of Korean Social Life, Health, and Aging Project. Participants consisted of 221 men and 210 women. The effects of support and conflict in spousal and other relationships on depression were analyzed using hierarchical regression analysis, separately in men and women. RESULTS: In the men group, the spouse conflict was especially influential in depression. More spouse conflict resulted in greater depression among men. In the women group, however, support from individuals other than spouse (kin support and friends support) had significant effects on depression. Less support received from individuals other than spouse was associated with higher levels of depression among women. CONCLUSION: The results of this study suggest that the quality of spousal and other relationships is related to depression in older adults. Moreover, there is a gender difference in the effect of support and conflict experienced in the relationship.
Adult*
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Aging
;
Depression*
;
Female
;
Friends
;
Humans
;
Male
;
Spouses*
5.Psychological Characteristics of Elderly Visited to the Department of Psychiatry : Focused on the Cluster Analysis of The Minnesota Multiphasic Personality Inventory-2.
Sula YOOK ; Jung Mi BAEK ; Sang Woo HAHN
Journal of Korean Geriatric Psychiatry 2017;21(1):1-7
OBJECTIVE: This study aimed to analyze psychological characteristics of elderly patients. METHODS: The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) data of 110 elderly patients who visited the department of psychiatry was analyzed. We examined differences of MMPI-2 score according to sex and age. The elderly were classified into four clusters with similar characteristics. RESULTS: Depression, suicidal ideation, low motivation score was high in total sample. Depression, subjective depression, mental dullness, lassitude-malaise, psychasthenia, and fears score was higher among females than males. Through the cluster analysis, elderly were classified into four types of ‘high profile’, ‘1-2-7 profile’, ‘6-7-8-0 profile’, and ‘low profile’. CONCLUSION: The elderly patients who visited the department of psychiatry complain depression and helplessness. Females complained depression and anxiety more than males. Elderly were classified into four types of patients with high somatic complaints ‘high profile’, patients with high depression and helplessness ‘1-2-7 profile’, patients who were dissatisfied and could blame others ‘6-7-8-0 profile’, and patients who needed additional interview and projective test ‘low profile’.
Aged*
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Anxiety
;
Cluster Analysis*
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Depression
;
Female
;
Humans
;
Male
;
Minnesota*
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Motivation
;
Suicidal Ideation
6.The Clinical Usefulness of Beta-Amyloid Positron Emission Tomography Imaging in the Elderly Patients: Case Series & Brief Review.
Ji Hoon OH ; Sae Jung NA ; Seung Yup LEE ; Hae Kook LEE ; Kyoung Uk LEE ; Yong Sil KWEON ; Ryu Yeon AHN ; Sung Yong LEE ; Chung Tai LEE
Journal of Korean Geriatric Psychiatry 2016;20(1):38-44
The aim was to evaluate the diagnostic utility of beta-amyloid positron emission tomography (PET) in elderly patients with cognitive impairment in the clinical setting. Five subjects underwent beta-amyloid PET imaging to explore the cerebral beta-amyloid deposition. The two male patients with minor neurocognitive disorder due to Alzheimer's disease, who displayed similar degree of cognitive impairment and medial temporal atrophy but different in apolipoprotein E4 status, both showed negative for beta-amyloid PET. On the other hand, a female major neurocognitive disorder due to probable Alzheimer's disease patient was tested positive for beta-amyloid PET, with increased beta-amyloid density in frontal and parietal lobes. Beta-amyloid PET was also used for the differential diagnosis of neurocognitive disorder from other psychiatric disorders in two elderly patients. The results were negative but assisted the diagnositic confirmation. A female patient was determined to be a case of late-onset schizophrenia and a male patient was determined as delirium due to minor traumatic brain injury, persistent. Beta-amyloid PET imaging was able to demonstrate cerebral beta-amyloid deposition in major neurocognitive disorder due to probable Alzheimer's disease in visual scale. However, further studies are needed for its clinical utility in the minor neurocognitive disorders. Moreover, beta-amyloid PET imaging may provide additional information in diagnosing primary psychiatric disorders with new onset in the old age.
Late Onset Disorders
;
Aged*
;
Alzheimer Disease
;
Amyloid beta-Peptides
;
Apolipoprotein E4
;
Atrophy
;
Brain Injuries
;
Delirium
;
Diagnosis, Differential
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Electrons*
;
Female
;
Hand
;
Humans
;
Male
;
Parietal Lobe
;
Positron-Emission Tomography*
;
Schizophrenia
7.The Relationship between Temporal Discounting and Well-Being in the Elderly.
Seok Joo HONG ; Ki Jung CHANG ; Hyun Woong ROH ; Jai Sung NOH ; Young Ki CHUNG ; Ki Young LIM ; Chang Hyung HONG ; Sang Joon SON
Journal of Korean Geriatric Psychiatry 2016;20(1):33-37
OBJECTIVE: This study aims to examine association of temporal discounting with well-being of Korean community-dwelling elderly. METHODS: The subjects of this research were 4,373 community-dwelling older persons without dementia. Each subject was administered the questionnaires regarding the socio-demographic characteristics, temporal discounting which was measured using standard questions in which participants were asked to choose between an immediate, smaller payment and a delayed, larger one. Outcome variable is Korean version of the World Health Organization Five Well-Being Index (WHO-5). Statistical analyses including the Pearson's correlation test and logistic regression were performed in this study. RESULTS: At baseline, temporal discounting was negatively associated with WHO-5 in the Pearson's correlation test (r=-0.04, p=0.006). In a adjusted model for confounding variables, temporal discounting was negatively associated with WHO-5 [odd ratio (95% confidence interval)=0.57 (0.35–0.92), p=0.021]. CONCLUSION: Elderly individual with a higher temporal discounting (which indicates impulsivity) may have a lower quality of life.
Aged*
;
Confounding Factors (Epidemiology)
;
Dementia
;
Humans
;
Logistic Models
;
Quality of Life
;
World Health Organization
8.Effect of Cognitive Function, Social Activity Participation and Social Support on Quality of Life of Community-Dwelling Elderly.
Jisoon KIM ; Rhayun SONG ; Ki Woong KIM ; Jeong Lan KIM
Journal of Korean Geriatric Psychiatry 2016;20(1):25-32
OBJECTIVE: This study aimed to explore the effect of cognitive function, social activity participation and social support on quality of life (QoL) of community-dwelling elderly. METHODS: The data on 194 elderly were selected from the nationwide community cohort named Korean Longitudinal Study on Cognitive Aging and Dementia. All subjects were assessed QoL-Alzheimer's Disease (QoL-AD), Cumulative Illness Rating Scale, exercise habit, Mini-Mental State Examination, social activities, The Medical Outcomes Study-Social Support Survey. The data were analyzed with SPSS WIN V. 21.0 program. RESULTS: The mean of QoL among community-dwelling elderly was 35.49 (24–46) for QoL measured by QoL-AD. The variables of professional, residence status, physical health, exercise, cognitive function, social activity participation and social support explained 29.3% of variance in QoL of community-dwelling elderly. Among these factors, the significant predictors of QoL were social support (β=0.322, p<0.001), cognitive function (β=0.152, p=0.021), and religion activity (β=0.152, p=0.025). CONCLUSION: The study suggests that the focus of intervention program should be on cognitive function and social activity participation to improve QoL for elderly. Improving cognitive function and social activity will lead to the network of social support, consequently to increase QoL for elderly living in the community.
Aged*
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Aging
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Cohort Studies
;
Dementia
;
Humans
;
Longitudinal Studies
;
Quality of Life*
9.Association between Alcohol Use Disorder and Cognitive Function According to Gender in the Elderly.
Dong Soo KIM ; Ki Jung CHANG ; Chang Hyung HONG ; Hyun Woong ROH ; Jai Sung NOH ; Young Ki CHUNG ; Ki Young LIM ; Mi JANG ; Sang Joon SON
Journal of Korean Geriatric Psychiatry 2016;20(1):20-24
OBJECTIVE: This study aims to investigate the association between alcohol use disorder and cognition in Korean community-dwelling elderly, especially the gender-specific difference. METHODS: Data obtained from 1,141 subjects (976 men and 165 women) aged above 60 years was analyzed from the Gwangju Dementia and Mild Cognitive Impairment Study. All subjects completed the study questionnaire including demographic characteristics, history of current and past illnesses, drug history, Korean Mini-Mental State Examination (K-MMSE), and cut down, annoyed, guilty feelings, eye-opener (CAGE), Short Form of Geriatric Depression Scale-Korean version (SGDS-K). RESULTS: Of the 1,141 subjects (mean age 72.17±6.20, mean educational level 6.50±4.48), 267 demonstrated alcohol use disorder (23.40%) and 874 were non-alcohol use disorder (76.60%). The mean of K-MMSE for alcohol use disorder group was 23.23±4.99, and for non-alcohol use disorder group was 23.70±3.94. When alcohol use disorder is accompanying, the decrement of K-MMSE score was 3.07 for female, and 0.35 for male. And we confirmed the interactive effect on K-MMSE score between sex and alcohol use disorder after adjusting for age, education level, depression (F=5.798, p=0.016). CONCLUSION: In conclusion, our study demonstrates an association between alcohol use disorder and cognitive impairment by gender in the elderly.
Aged*
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Alcohols
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Cognition
;
Dementia
;
Depression
;
Education
;
Female
;
Gwangju
;
Humans
;
Male
;
Mild Cognitive Impairment
10.The Relationship between Late-Life Depression and Resilience.
Mi JANG ; Chang Hyung HONG ; Ki Jung CHANG ; Changsu HAN ; Sang Won JEON ; Hyun Woong ROH ; Jai Sung NOH ; Young Ki CHUNG ; Ki Young LIM ; Dong Soo KIM ; Sang Joon SON
Journal of Korean Geriatric Psychiatry 2016;20(1):16-19
OBJECTIVE: The aim of this study was to examine the relationship between late-life depression and resilience in the Korean community-dwelling elderly with depression. METHODS: The subjects were 102 depressed elderly people who lived in Suwon and Gwangju, Korea. Each subject was administered the questionnaires regarding the socio-demographic characteristics, Korean version of the Mini-Mental State Examination for Dementia Screening (MMSE-DS), Brief Resilience Scale (BRS), and Short Form Geriatric Depression Scale-Korean version (SGDS-K). RESULTS: In a cross-sectional aspect, BRS score were negatively correlated with SGDS-K score in the Pearson's correlation test (r=-0.301, p=0.002). After multivariable adjustments, linear mixed model analysis showed that subjects with baseline higher BRS score had significantly lesser SGDS-K score (β=-0.16, p=0.006). CONCLUSION: The level of resilience should be considered in predicting the change of depressive symptoms in the elderly.
Aged
;
Dementia
;
Depression*
;
Gwangju
;
Gyeonggi-do
;
Humans
;
Korea
;
Mass Screening