No abstract available.
Nootropic Agents*

OBJECTIVES: To develop the Korean version of Disability Assessment for Dementia Scale(DAD-K), an instrument for functional disability for use with proxy-respondents of community-dwelling persons who have Alzheimer`s disease METHOD: Community-dwelling elderly and their caregivers with memory impairment(N=341) participated in this study to evaluate reliabilities and validities of DAD-K. RESULTS: The DAD-K demonstrated a high degree of internal consistency(Cronbach`s alpha=0.88) and excellent interrater(ICC=0.96) and test-retest(ICC=0.96) reliability and good concurrent validity. In addi- tion, it was found not to have age, education and gender bias. CONCLUSION: The DAD-K is valid and reliable instrument in Korean elderly with Alzheimer`s disease, that may help clinicians and caregivers of the population with Alzheimer`s disease make decisions regar- ding the choice of suitable interventions.
Aged ; Caregivers ; Dementia* ; Education ; Humans ; Memory ; Sexism

BACKGROUND: The present study aims to examine the reliability and validity of a Korean version of the CAMCOG-R(CAMCOG-RK) in a clinical setting and an institution, that have been widely used to detect early dementia. METHODS: Study participants included 243 dementia sufferers, 68 mild cognitive impairment(MCI) suffers and 354 non-demented subjects. DSM-IV clinical criteria for dementia and Petersen's criteria for MCI were used as the 'gold' standards. The CAMCOG-R was translated into Korean and then back to English. Six items needed modifications for local usage. RESULTS: Interrater and test-retest scores calculated as intraclass correlation coefficients showed excel- lent for total score and all subscale scores of CAMCOG-RK. A strong concurrent validity was found with the MMSE-K score(r=0.82, p<0.01). Examination of the association between CAMCOG-R scores and socio- demographic variables(age, sex, and education) shows that age and education exerts a significant, and independent, effect upon performance. The eight age and education-specific cutoff point for dementia and MCI provided excellent sensitivity and specificity mostly more than 90%. CONCLUSION: The CAMCOG-RK was found to be an appropriate instrument to discriminate between demented and non-demented individuals and between individuals with MCI and without MCI in a clinical setting. Further studies should examine the psychometric characteristics of the CAMCOG-RK in a more varied sample.
Dementia* ; Diagnosis* ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Korea ; Psychometrics ; Reproducibility of Results ; Sensitivity and Specificity

OBJECTIVES: To develop the Korean version of Alzheimer`s Disease Assessment Scale(ADAS-K), an instrument for assessment of cognitive decline and behavioral symptoms seen in persons with Alzheimer`s disease METHOD: Community-dwelling elderly with Alzheimer`s disease(n=198) and mild cognitive impairment (n=30) participated in this study to evaluate reliabilities and validities of ADAS-K. RESULTS: The ADAS-K demonstrated a high degree of internal consistency and excellent interrater and test-retest reliability and high concurrent validity. Optimal cutoff points for the ADAS-K and ADAS-K-cog were 20/21(sensitivity 91%, specificity 83%) and 17/18(sensitivity 91%, specificity 93%). CONCLUSION: The ADAS-K is valid and reliable instrument in Korean elderly with Alzheimer`s disease, that may have potential to improve research outcomes and reduce the time and costs of research.
Aged ; Behavioral Symptoms ; Cognition* ; Dementia* ; Humans ; Mild Cognitive Impairment ; Sensitivity and Specificity

OBJECTIVES: Alcohol-induced oxidative stress has been known to injure various tissues or organs. This stress is related with free radicals which are produced as the result of long-term alcohol consumption. Malonyldialdehyde(MDA) is produced by the interaction of free radicals and cell membrane lipids, and indicates the degree of lipid peroxidation indirectly. The purpose of this study was to investigate the relationship between red blood cell(RBC) membrane lipid peroxidation by free radicals, and associated hepatic injuries and hematologic changes. METHODS: Thirty-three subjects diagnosed as alcohol dependence according to DSM-IV diagnostic criteria were evaluated within 72 hours after discontinuing alcohol drinking. Clinical characteristics were evaluated by CAGE questionnaire and Korean Michigan Alcoholism Screening Test(MAST). RBC membrane MDA level was measured as the marker of RBC membrane lipid peroxidation. Aspartate aminotransferase(AST), alanine aminotransferase(ALT) and gamma-glutamyltransferase(GGT) were used as the biochemical markers of liver damage due to alcohol ingestion. The alcohol-induced hematologic change was assessed by mean corpuscular volume(MCV). RESULTS: The results were as follows. Clinical characteristics were not different between two groups having normal and abnormal levels of AST, ALT, GGT or MCV. The levels of MDA were not correlated with the clinical characteristics and serum levels of AST, ALT and GGT. However, there was a significant correlation between the levels of MDA and the value of MCV(p=0.017). CONCLUSIONS: These findings suggest that oxidative stress in alcohol dependence may not be reflected in liver enzyme markers such as AST, ALT and GGT, but may be reflected in MCV.
Alanine ; Alcohol Drinking ; Alcoholism* ; Aspartate Aminotransferases ; Aspartic Acid ; Biological Markers ; Diagnostic and Statistical Manual of Mental Disorders ; Eating ; Erythrocyte Indices* ; Erythrocytes* ; Free Radicals ; Humans ; Lipid Peroxidation* ; Liver* ; Mass Screening ; Membrane Lipids ; Membranes* ; Michigan ; Oxidative Stress ; Surveys and Questionnaires

Alzheimer's disease (AD) is the most common cause of dementia in the elderly. AD afflicts 0.3 to 0.5 million people in Korea, and the number is projected to increase to 2 million by the year of 2050. This article provides a brief overview of the most popular drug therapies in the treatment of AD including cholinesterase inhibitors (AchEIs) (donepezil, galantamine, rivastigmine), NMDA receptor antagonist (memantine), acetyl-l-carnitine, antioxidant vitamins, and Ginko biloba. Based on a review of relevant papers in the literature, this article presents pharmacological and clinical safety profiles of these agents and prescribing tips as well as a final summary on the effectiveness, safety, and alerts for clinicians. AchEIs as well as memantine will continue to play an important role in the treatment armamentarium for AD, even though newer strategies are being explored. There is not enough evidence supporting the continuous use of other drugs such as acetyl-l-carnitine, antioxidant vitamins, and Ginko biloba for the treatment of AD.
Acetylcarnitine ; Aged ; Alzheimer Disease* ; Cholinesterase Inhibitors ; Dementia ; Drug Therapy* ; Galantamine ; Ginkgo biloba ; Humans ; Korea ; Memantine ; N-Methylaspartate ; Vitamins

Hachinski coined the term 'multi-infarct dementia', which now changed to 'vascular demntia', and used the Hachiski Ischemia Score (HIS) to differentiate multi-infarct dementia from Alzheimer's disease since 1974. The past two decades has seen a renewed interest in vascular dementia. New classification systems like DSM-IV, ICD-10, NINDS-AIREN and ADDTC have been developed to improve the reliability of the diagnosis, and there have been advances in diagnostic methodology, such as neuroimaging and neuropsychological assessment. Diagnostic criteria for vascular dementia remain to be validated by carefully designed, systematic, clinicopathologic study. Once such criteria are validated, meaningful study of subgroups of vascular dementia can be explored. Until the relationship between vascular dementia and Alzheimer's disease is better defined, the nosology for vascular dementia may be defined best as dementia associated with stroke. Various aspects of clinical manefestation of vascular dementia were discussed and presented as tables.
Alzheimer Disease ; Classification ; Dementia ; Dementia, Multi-Infarct ; Dementia, Vascular ; Diagnosis* ; Diagnostic and Statistical Manual of Mental Disorders ; International Classification of Diseases ; Ischemia ; Neuroimaging ; Numismatics ; Stroke

OBJECTIVE: The aims of this study were to determine the factor structure of the BEHAVE-AD, Korean version, and to identify the cross-cultural validity of the observed factors . DESIGN: Cross-sectional study of geriatric patients evaluated at a mental hospital for the elderly. SAMPLE: One hundred and twelve consecutive patients diagnosed with Alzheimer's disease (AD) according to NINCDS-ADRDA diagnostic criteria (52 probable AD and 60 possible AD). RESULTS: Principal component analysis with Varimax rotation resulted in a five-factor solution that accounted for 50.0% of the common variance. The five factors included behavioral dyscontrol (wandering, purposeless activity, inappropriate activity, verbal aggressiveness, physical threats/ violence), anxiety (agitation, anxiety of upcoming events, other anxiety, fear of being left alone and other phobia), delusions (delusion of theft, delusion one's house is not one's home, delusion of infidelity, suspiciousness/paranoia, other delusion), hallucination (visual hallucination, auditory hallucination), depression (delusion of abandonment, tearfulness, depressed mood). CONCLUSION: The results of this study suggest that the BEHAVE-AD measures a wide range of behavioral pathology that can be empirically represented by five independent symptom clusters among AD patients admitted in a mental hospital for the Korean elderly. Cross-cultural persepctive may be necessary to interpret factor structure of this study compared to other studies from Western countries.
Aged ; Alzheimer Disease* ; Anxiety ; Cross-Sectional Studies ; Delusions ; Dementia ; Depression ; Hallucinations ; Hospitals, Psychiatric ; Humans ; Inpatients* ; Pathology* ; Principal Component Analysis ; Psychotic Disorders ; Theft

OBJECTIVE: Aims to observe temporal change in dementia prevalence, identify factors related to regional diversity of dementia subtype and propose explanatory hypothesis. METHOD: Studies qualifying selection criteria were chosen after PubMedline search, to identify prevalence of all dementia, Alzheimer's disease(AD) and vascular dementia(VaD) and to compare those analytically with related data. RESULT: 1) There has been temporal change of dementia prevalence in Far-eastern countries;more prevalent VaD(before year 1989), mutually contradictory reports(1990-1994)-more prevalent VaD in Japan, more prevalent AD in Korea and China-, more prevalent AD(after 1995). 2) Dementia prevalence in Africa seems relatively low and AD is more prevalent than VaD. 3) Reports from India are mutually contradictory;more prevalent VaD, more prevalent AD. 4) Reports from America and Europe have been consistent that AD is more prevalent as previously reported. CONCLUSION: Author' hypothesis is as follows. It may be hard to find dementia case in a society until average life expectancy reaches to the threshold age of dementia. Once it is over the threshold age, incidence of dementia may upsurge in a short period. High incidence-high mortality society may last for a while. With the efforts to control risk factors of dementia and improve medical services, incidence and mortality of dementia may gradually decline to reach low incidence-low mortality society at the end. The transition from high incidence-high mortality society to low incidence-low mortality society may develop in various ways according to social health policies and efforts to control risk factors of dementia and improve medical services. The reason why dementia case was not found in Nigeria is because average life expectancy in Nigeria was not reached to the threshold age of dementia. The reasons why VaD is less prevalent than AD in Far-eastern countries are mainly due to low incidence of VaD in Japan, but mainly due to high mortality of VaD in Korea and China. Namely, Japan is closer to the low incidence-low mortality society than Korea and China.
Africa ; Alzheimer Disease* ; Americas ; China ; Dementia* ; Dementia, Vascular* ; Europe ; Health Policy ; Incidence ; India ; Japan ; Korea ; Life Expectancy ; Mortality ; Nigeria ; Patient Selection ; Prevalence ; Risk Factors

BACKGROUND: Recent therapeutic advances to delay the progression of dementia have renewed calls to improve early detection and management of individuals with dementia. A new computerized neuropsychological interview and clinical examination, the Cognitive Assessment and Reference Diagnosis System (CARDS) was developed to incorporate in a single instrument all the information required to make an accurate clinical diagnosis of dementia, its subtype, depression and delirium, to present reference diagnoses just after completion of tests, and to detect early dementia. This study aims to verify the diagnostic capability of the CARDS. METHODS: The CARDS was administered to 56 dementia patients (38 Alzheimer's disease, 18 vascular dementia) as well as 40 nondemented subjects. To evaluate the sensitivity and specificity of the CARDS, we compared the CARDS diagnosis with the clinician's diagnosis on dementia, Alzheimer's disease, vascular dementia and depression. To test diagnostic capability of the CARDS in the diagnosis of early dementia, we compared mean scores of total and subscales in the CARDS of GDS stage 3 group with those of GDS stage 4 group. RESULTS: The CARDS demonstrated high levels of sensitivity and specificity in the diagnosis of dementia, AD, VaD and depression. Mean CARDS scores for total and 3 subscales (amnesia, aphasia, agnosia) in GDS stage 3 group were significantly different from those of GDS stage 4 group (p<0.001). CONCLUSION: We demonstrated that CARDS is valid instrument not only for dementia diagnosis but also for detection of early dementia.
Alzheimer Disease ; Aphasia ; Delirium ; Dementia ; Dementia, Vascular ; Depression ; Diagnosis* ; Humans ; Sensitivity and Specificity