No abstract available.
Aged* ; Humans ; Long-Term Care*

No abstract available.
Dementia*

Disturbances in memory are the most common problem in patients with an organic mental syndrome. Other patients with significant psychiatric disorder also often have memory. So it is very important in the clinical practice of psychiatry to understand the biological and neurocognitive mechanisms of memory proessing, and to develop the assessment tools with which memory function can be evaluated reliably and validly. Moreover, memory researches provide an important viewpoint from which we can understand the pathophysiological mechanisms of major neuropsychiatric illnesses. This article focuses on our understanding of memory function in clinical and neurobiological aspects. The relevant material will be presented in four pats : 1) terminologies needed in defining major stages of various types of memory processing : 2) neurochemical and neuroanatomical basis of memory processing : 3) brief bedside screening and more comprehensive neuropsychological tests for the evaluation of memory function : 4) the characteristics of memory dysfunction in several major psychiatric illnesses.
Humans ; Mass Screening ; Memory* ; Neuropsychological Tests ; Neuropsychology

The decline of cognitive functions uses to follow the increase in incidence of various organic mental disorders and systemic diseases, and administration of drugs with increasing age. The assessments of cognitive functions are needed to discriminate normal aging from other cognitive disorders and to differentiate the organic mental disorders. We have to be cautious to interpret the test results of elderly patients who are easily fatigue and frequently have sensory disturbances. There are two basic approaches to assess cognitive function of the elderly patients. One is to use standardized test batteries and another is to use several tests that are relevant to diagnostic purposes. Many assessment tools of cognitive functions have been developed and used clinically but there are a few available standardized test in Korea. It is eagerly needed to develope standardized tests that are pertinent our culture.
Aged* ; Aging ; Neurocognitive Disorders ; Fatigue ; Humans ; Incidence ; Korea

No abstract available.
Acetylcholinesterase* ; Aluminum* ; Animals ; Brain* ; Choline O-Acetyltransferase* ; Choline* ; Rats*

It has been widely known that the elderly suffer very mild cognitive impairment including memory function that cannot satisfy the criteria of dementia. Koivisti and Hannien et al reported that the prevalences of age-associated memory impairment and age-associated cognitive decline were 38.6% and 26.6%, respectively. The prevalence rate of male was more than that of female and the prevalence rate was increased in younger elderly. The risk factors of age-related cognitive decline were age and myocardiac infarction whereas education and smoking decreased the risk of age-related cognitive decline. The small portion of age-associated memory impairment progressed toward dementia but the most of them were nonprogressive. The probability of progression toward dementia could be predicted by detailed neurocognitive function test. The further epidemiologic studies will reveal the nature of age-associated memory impairment.
Aged ; Dementia ; Education ; Epidemiologic Studies ; Epidemiology* ; Female ; Humans ; Infarction ; Male ; Memory* ; Mild Cognitive Impairment ; Prevalence ; Risk Factors ; Smoke ; Smoking

As Alzheimer's disease is the most common cause of dementia in older people, many efforts for accurate and reliable clinical diagnoses have been made all over the world. Generally diagnostic process of Alzheimer's disease is constituted with two steps : 1) to determine whether a patient is actually demented, 2) to determine whether the dementia actually caused by Alzheimer's disease. Newly developed diagnostic criteria, such as diagnostic criteria of the National Institute on Aging-Alzheimer's Association improve their specificity to diagnose Alzheimer's disease. We need Korean specific guideline for diagnosing Alzheimer's disease compatible in Korean clinical situation.
Alzheimer Disease ; Dementia ; Humans ; Sensitivity and Specificity

Older persons are at higher risk for suicide than any other age group and elderly suicide is a critical public health problem. Attempted suicide in elderly is very lethal, therefore it's management must be accompanied by prevention. Though, there are few reports about risk factors in elderly suicide, and significant differences in the data between western and eastern world. So, there should be researches about risk factors influenced by peculiar cultural and regional circumstances, and these make it possible to detect elderly suicide early by education and community efforts.
Aged* ; Education ; Humans ; Public Health ; Risk Factors ; Suicide* ; Suicide, Attempted

OBJECTIVES: This study aims to confirm the reliability and validity of the GMS-AGECAT(Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy in a Korean elderly population. METHODS: Translation committee developed Korean version GMS translating GMS-A3 after preliminary studies. Few changes from the original English version were necessary. A random sample(N= 1256 of the elderly(65+ years in Asan, community was assessed for diagnostic validity. A two-phase study was designed: Korean version of GMS-AGECAT, MMSE and GDS rated by lay interviewer and clinical assessment by psychiatrists according to DSM-IV. A consecutive hospital sample(N=28 of the elderly(65+ years admitted in Hangang Sacred Heart Hospital was assessed for reliability, concurrent & procedural validity. RESULTS: Reliability coefficients of GMS-AGECAT diagnosis were Inter-rater kappa 0.78 and test-retest kappa 0.56. Correlation coefficients for concurrent validity were 0.76 with MMSE and 0.73 with GDS. Procedural validity of psychiatrist's GMS-AGECAT diagnosis and lay-interviewers' were as follow: case/ no case distinction sensitivity 95.5%, specificity 75%; organicity distinction sensitivity 100%, specificity 83.3% and depression distinction, sensitivity 92.3%, specificity 100%. Diagnostic validity of DSM-IV diagnoses and GMS-AGECAT diagnoses were: case/ no case distinction sensitivity 92.7%, specificity 81%, dementia distinction sensitivity 77.3%, specificity 92.1% and depression distinction sensitivity 83.6%, specificity 84.1%. CONCLUSIONS: This study confirms the reliability and validity of the GMS-AGECAT in Korean elderly. Korean version GMS can be used in the international comparison studies.
Aged ; Chungcheongnam-do ; Classification ; Dementia ; Depression ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart ; Humans ; Psychiatry ; Reproducibility of Results* ; Sensitivity and Specificity ; Translating

BACKGROUNDS: Depression in old age has significant negative impact on physical health and social activities, which may greatly burden a society with increased costs of use of health care resources and may seriously hamper individual's quality of life. This study aimed to identify the prevalence and risk factors of depression in older community population. METHOD: By the random sampling, study population(n=1,300) was selected out of total population of the elderly aged 65 years or older in Asan city(N=14,977). Two-phase community survey method was used; the Korean version of the Geriatric Mental State Schedule(GMS-K) was used as a screening instrument to define caseness group by trained interviewers, while board-certified psychiatrists confirmed clinical diagnoses according to the DSM-IV criteria by face-to-face interview of subjects for the Stage 2 study. RESULTS: Of 1,300 subjects, 1,246 elderly completed the stage 1 screening interview(=95.9%). Prevalence of all depressive disorders were 10.5%(male 7.4%, female 12.8%); 8.7% in major depression(male 6.3%, female 10.6%), 0.5% in dysthymic disorder(male 0.4%, female 0.6%), and depressive disorder NOS 0.5%(male 0.2%, female 0.7%). A high risk of depressive disorder was found among elderly women(OR= 1.54, 95% CI 1.08-2.20) and among those with physical illnesses(OR=1.82, 95% CI 1.33-2.48), especially those with vascular risk factors(OR=1.96, 95% CI 1.43-2.69). CONCLUSION: The association between physical health and depression in old age is a consistent finding across world. Systemic efforts to reduce incidence of depression and especially to prevent and treat vascular risk factors may be able to improve mental health in the elderly.
Aged ; Chungcheongnam-do ; Surveys and Questionnaires ; Delivery of Health Care ; Depression* ; Depressive Disorder ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Incidence ; Mass Screening ; Mental Health ; Prevalence ; Psychiatry ; Quality of Life ; Risk Factors