The Mini Mental State Examination (MMSE; Folstein et al., 1975) is a quick and easy measure of cognitive functioning that has been widely used in clinical evaluation and research involving patients with dementia. The present study was conducted to examine the validity of the newly constructed Korean version of the MMSE (K-MMSE) in dementia patients. The K-MMSE was administered to 84 patients with Alzheimer's a disease, 64 patients with vascular dementia, and 23 patients with a diagnosis of pseudo-dementia. The result showed that of the cognitive components of the K-MMSE, Orientation, Attention and Calculaton, Recall, and Visual Construction are impaired in dementia patients. The sensitivities of the K-MMSE in detecting dementia were .70-83. Factor analysis indicated that the multiple cognitive components of the K-MMSE can he explained by one or two factors. The K-MMSE was also highly correlated with another brief measure of cognitive functioning, the Blessed Orientation Memory-Information(r=.78). The result, however, further suggested that the K-MMSE is relatively insensitive to detect the early stage of dementia, causing an increase in false negatives.
Dementia* ; Dementia, Vascular ; Diagnosis ; Humans

BACKGROUND: Dementia has emerged as a major healthy challenge, not only for clinicians but for society as a whole. So, there is a growing need for study of dementia. Evaulating the patients with dementia, examination of the sense of smell is not routinely performed. However, one of several neurologic changes include alterations in olfaction. OBJECTIVES: The aim of this study was to evaluate the value of olfactory function test in demented patients as diagnostic tool. MATERIALS AND METHOD: We studied the olfactory functions in 35 patients with dementia of the Alzheimer's type(DAT) and 20 patients with vascular dementia(VD) and compared with normal controls(n=30). These subjects were divided according to the Mini-Mental State Examination(MMSE). We used the T & T olfactometer for the olfactory function test. RESULTS: In the group of questionable DAT, the detection and recognition threshold were 0.25+/-0.95, 2.38+/-1.87, in the group of definitive DAT, 1.51+/-1.52, 3.91+/-1.55 and in the group of definitive vascular dementia, 2.03+/-1.48, 4.53+/-1.45. But, in the normal controls, the detection and recognition threshold was 0.66+/-0.90, 1.55+/-0.81 respectively. CONCLUSION: These findings suggest that olfactory function test are valuable in demented patients as diagnostic tool, but not specific in DAT group and that early detection of DAT is possible by olfactory function test.
Dementia* ; Dementia, Vascular ; Humans ; Smell

BACKGROUND: Alzhiemeranjx disease (AD) and vascular dementia (VD) are common types of dementia. As a result of the development of new specific agents for AD, and because vascular dementia is a potentially preventable dementia, differentiating these diseases is of great importance. The role of EEG spectral analysis in the differential diagnosis between Alzheimer type and vascular dementia is still controversial. Since there have been few studies concerning the differential diagnosis of dementia by EEG, the present study has focused on this aspect. Usefulness of EEG in differen-tial diagnosis of dementia will be elucidated by clarifying relationship between type of dementia and spectral profile of EEG. METHODS: We analyzed the power spectra taken from 16 derivations and spectral profile was constructed by averaging twenty 2 sec epochs in three study groups (normal controls, AD and VD). Spectral profile was divided into three groups; (I) type A, showing a dominant 6.5-12 Hz peak (ii) type B, lacking a dominant peak in the 6.5-12 Hz (iii) type C, corresponding to a flat, low voltage, spectrum. To elucidate the relationship between spectral profile and other factors including diagnosis, statistical test was done. RESULTS: (1) In AD, type C profile was statistically more prevalent than in VD and type A profile was reversed. (2) In AD, Mini-Mental State Examination (MMSE) score was statistically lower in type C profile. (3) Spectral profile was not associated with age, age of symptom onset, and symptom duration. CONCLUSIONS: This study suggested that spectral profile is a useful tool for the differential diagnosis of dementia (AD and VD) and correlated with the severity of disease in AD.
Dementia ; Dementia, Vascular* ; Diagnosis ; Diagnosis, Differential* ; Electroencephalography*

BACKGROUND AND PURPOSE: The closing-in phenomenon is the tendency to draw near or on the target when copying figures, which has been found mostly in patients with Alzheimer's disease (AD). We attempted to quantify the degree of closing-in and to compare it between patients with AD and vascular dementia (VaD). METHODS: The subjects (55 AD, 39 VaD and 38 normal controls) were asked to copy the figure of alternating square and triangle, starting at the designated point and continuing from left to right. The patients with AD and VaD did not differ in age, education, severity of dementia or Rey Complex Figure Test copy score. The proximity (Y-axis) of the subject's drawing to the target was plotted at intervals of 2 mm along the X-axis and the degree of closing-in was computed from the slope of the regression line. RESULTS: The AD and VaD patients showed a steeper slope than the controls. There was no significant difference, however, in the magnitude of closing-in of the AD and VaD patients. When closing-in was defined as a slope that was greater than the mean+2SD of the slope observed for the controls, 32.7% of the AD and 25.6% of the VaD patients showed closing-in. CONCLUSIONS: Our study, using a new method of measuring the degree of closing-in, suggests that this phenomenon is not specific to AD.
Alzheimer Disease* ; Dementia ; Dementia, Vascular* ; Education ; Humans

Vascular dementia (VaD) is a dementia syndrome produced by vascular damage to the brain and increases in incidence with advancing age. Early Identification and diagnosis of VaD is particularly importent since its course may be modifiable through controlling vascular risk factors. VaD is heterogeneous and consists of several syndromes : multi-infarct dementia, strategic single infarcts dementia, and subcortical vascular dementia. The diagnosis of VaD is based on several features 1) dementia, 2) evidence of cerebrovascular disease, and 3) temporal relationship between dementia and cerebrovascular disease. Treatment of VaD includes control of vascular risk factors, prevention of further vascular injury and treatment of cognitive impairment. Cholinesterase inhibitors provide symptomatic benefits in treatment of VaD.
Brain ; Cholinesterase Inhibitors ; Dementia ; Dementia, Multi-Infarct ; Dementia, Vascular ; Incidence ; Risk Factors ; Vascular System Injuries

BACKGROUND: The Korean-Boston Naming Test (K-BNT) is a popular measure of the confrontational naming ability. It is particularly sensitive to the early cognitive changes in Alzheimer's disease (AD) and Vascular dementia (VaD). The current study was conducted to develop parallel short forms for the K-BNT used in repeated assessments as well as in situations where the administration of the complete K-BNT is not practical. METHODS: Four 15-item short forms were newly constructed based on the item difficulties of the K-BNT measured from 565 normal elderly aged over 55. The K-BNT was administered to 130 dementia patients (75 AD, 55 VaD) and 130 healthy community-dwelling elderly whose age, sex, and education level were matched with the dementia patients. Scores for the short forms were derived by dividing up the items of the K-BNT. RESULTS: On each short form, normal elderly performed better than dementia patients, and scores on each could be extrapolated to a complete 60-item K-BNT score. Significant correlations were found between short forms and the K-BNT. To compare the probabilities of correctly identifying dementia, the areas under Receiver Operating Characteristic (ROC) curves of each form and the K-BNT were compared. It was found that all the short forms were as efficient as the 60-item K-BNT in identifying dementia. CONCLUSIONS: These results confirm that the four 15-item short forms developed in the current study are parallel and valid as the short forms of the K-BNT.
Aged ; Alzheimer Disease ; Dementia ; Dementia, Vascular ; Education ; Humans ; ROC Curve

Neuroimaging is a vascular and became an essential method to detecting and evaluating brain pathology. It is also important in evaluation of dementia, especially of vascular dementia. This article review characteristic features of methodological problems of CT and MRI, and of various dementias, especially vascular dementia.
Brain Diseases ; Dementia ; Dementia, Vascular* ; Magnetic Resonance Imaging ; Neuroimaging*

BACKGROUND: Clinicians broadly accept the Global Deterioration Scale (GDS) as a staging measure for dementia. The aim of this study is to test the inter-rater reliability and concurrent validity of the Korean version of GDS. METHODS: Participants included 34 subjects without dementia and 41 patients with Alzheimer's disease, in addition to 37 patients with vascular dementia. A rater, using a semi-structured clinical interview, interviewed the participants and their informed collateral sources. To obtain the concurrent validity, all participants received the Korean Mini-Mental State Examination (K-MMSE), the Korean version of Syndrome Kurz Test (K-SKT) and a 15-items abbreviated Korean-Boston Naming Test (K-BNT) on the same day. We also tested the inter-rater reliability among the four raters using a videotape design. RESULTS: The agreements of the overall GDS ratings by the four raters were high (kappa, 0.93-1.0). GDS correlated significantly with K-MMSE, K-SKT, and the abbreviated K-BNT and Clinical Dementia Rating scale. CONCLUSION: The Korean version of GDS may be a reliable and valid tool to be used as a staging measure for Korean patients with Alzheimer's disease as well as vascular dementia.
Alzheimer Disease ; Dementia ; Dementia, Vascular ; Humans ; Videotape Recording

BACKGROUND: The neuropsychiatric derangements in dementing patients are common and troublesome in their managements. The purpose of this study is to compare the behavioral changes in patients with subcortical vascular dementia (SVaD) and to those in patients with Alzheimer's disease (AD) by using the Korean version of the neuropsychiatric inventory (K-NPI). METHODS: The K-NPI was administrated to the close caregivers of 19 patients with AD (who met the criteria of the NINCDS-ADRDA for probable AD) and 14 patients with SvaD (who met the criteria of the NINDS-AIREN criteria for probable or possible VaD). Groups were matched for age, education and dementia severity. We evaluated the prevalence, the composite score (frequency X severity) of each behavioral domain in K-NPI between two groups. RESULTS: The most common behavioral disturbances were anxiety (63%) in AD and apathy/indifference (93%) in SVaD. Patients with SVaD had significantly greater total K-NPI scores than patients with AD and exhibited apathy/indifference, agitation/aggression and anxiety more frequently. Composite score of apathy/indifference over 4.7 point discriminates between AD and SVaD with accuracy of 75.8%. CONCLUSIONS: The K-NPI provides behavioral profiles that differentiate patients with SVaD from patients with AD. Patients with SVaD are more behaviorally disturbed. Clinicians need to pay more attention to the behavioral disturbances when managing the patients with SVaD.
Alzheimer Disease* ; Anxiety ; Caregivers ; Dementia ; Dementia, Vascular* ; Education ; Humans ; Prevalence

BACKGROUND: The Clinical Dementia Rating (CDR) scale is broadly accepted by clinicians as a staging measure for dementia. The aim of this study was to test inter-rater reliability and concurrent validity of the Korean version of the CDR. METHODS: Participants included 34 persons without dementia and 41 patients with Alzheimer's disease, and 37 patients with vascular dementia. The participants and their informed collateral sources were interviewed by a rater using a semistructured clinical interview. To obtain concurrent validity, all the participants received K-MMSE, K-SKT (Syndrom Kurz Test), and a 15-items abbreviated K-BNT on the same day. We also tested inter-rater reliability among four raters using a videotape design. RESULTS: Agreements of the overall CDR ratings (kappa, 0.86-1.0) and Sum of Boxes of CDR (CDR-SB) (gamma, 0.89-1.0) by the four raters were high. Both global CDR and CDR-SB correlated significantly with K-MMSE, K-SKT and the abbreviated K-BNT. The Orientation and Memory box score correlated significantly with orientation and memory scores of K-MMSE. CONCLUSIONS: The Korean version of CDR appears to be a reliable and valid tool as a staging measure for Korean dementia patients.
Alzheimer Disease ; Dementia* ; Dementia, Vascular ; Humans ; Memory ; Videotape Recording