The concept of vascular dementia is not still established. Its pathogenesis is not completely understood, either. It may be different among the subtypes, e.g., ischemic, hemorrhaginc, or Binswanger's disease. In this article epidemiology of vascular dementia was reviewed, based on the important findings regarding to prevalence, ethnic difference in prevalence, incidence, risk factors, and natural history and survival. We have to wait for more elegant concept of and better understanding of vascular dementia.
Cerebrovascular Disorders ; Dementia, Vascular* ; Epidemiology* ; Incidence ; Natural History ; Prevalence ; Risk Factors

The contents of educational goals and objectives of 32 Korean medical schools, that were listed in the Korean Medical Education Directory for 1994-1995, were analysed to help developing new educationa l goals and objectives. Regarding the professions in which the graduates of medical schools can be engaged, all of the 32 school were aiming at the medical doctor. 34.4% at the medical scientist, 28.1% at the medical educator, and 15.6% at the health administrator. Only 37.5% of the medical schools stated that their educational objective is training the primary physician and 50% of the schools did not specify the level of their graduates as a physician. The proportion of schools which stated that the medical student should learn in three domains of educational objectives, i.e. medical knowledge,clinical skills and attitude were 18.8% and 56.3% of the schools descirbed learning just in two domains of medical knowledge and skills which may reflect underating the importance of attitude. The proportions of knowledge and skills which may reflect underating the importance of attitude. The proportions of schools that stated aquiring the ability of holistic management of patients and self-learning/life long study in their educational objectives were 28.1% and 62.5%, respectively. The proportion of schools that emphasized on the medical ethics and morality was 93.8% and on cultivating human nature was 71.9%. These reflect that a high quality of ethics and morality was 93.8% and on cultivating human nature was 71.9%. These reflect that a high quality of ethics and human nature is required to the medical doctor. The universal and ultimate goal of human society and universities, such as democratic educational ideology, Korean educational ideology, prosperity of human society, promotion of human welfare, and improvement of public health, were included in the educational goals in 43.8% of the schools. As the primary goal of medical schools is the producing primary physicians, it is suggested to include the affective domain(attitude), cultivation of the capacity of self-learning and ability of holistic management of patients in the educational objectives of medical shools.
Administrative Personnel ; Education, Medical ; Ethics ; Ethics, Medical ; Human Characteristics ; Humans ; Learning ; Morals ; Public Health ; Schools, Medical* ; Students, Medical

Etiological classification of a syndrome is most warranted. However, it is very difficult in the case of dementia because many research activities are still being made about the cause of degenerative dementias. In the current paper, clinical aspects and pathological findings were also con-sidered in the etiological classification. Prevalence and annual incidence of dementia are 5-15% and 1.5-2.0% in the elderly over 65, respectively. Old age, female sex, genetic background, lower education, ethnicity or geographical difference, and head trauma seem to be risk factors for developing dementia. Urinary and fecal incontinece, extrapyramidal symptoms, primitive reflexes, psychotic symptoms, and cognitive decline seem to adversely affect on the mortality, while social class, age at onset, depressive symptoms, aggressive behavior, wandering, increased appetite, increased sexual behaviors, and early diagnosis do not.
Aged ; Appetite ; Classification* ; Craniocerebral Trauma ; Dementia* ; Depression ; Early Diagnosis ; Education ; Epidemiology* ; Female ; Humans ; Incidence ; Mortality ; Prevalence ; Reflex ; Risk Factors ; Sexual Behavior ; Social Class ; Wandering Behavior

OBJECTIVE: The authors investigated effects of gender, age and education on the MMSEK performances in a non-demented elderly rural population. METHODS: The MMSEK was administered to 617 non-demented elderly people aged 65 or more in a rural area. The effects on the total and subtest MMSEK scores of gender, age and education were analyzed by Student t-test, Pearson's correlation, oneway analysis of variance, analysis of covariance and stepwise multiple regression. RESULTS: The three independent variables showed significant influence on the total score, orientation in time, orientation in place, attention/calculation, language function and comprehension & judgement of the MMSEK. The three variables could account for 40.0% of the variance of the total MMSEK score. Of the MMSEK subtests, memory registration and memory recall were resistant to the variables. MMSEK scores of the female, the older people and the undereducated were even less. CONCLUSION: Prevalence of dementia seems not to influence on the variance of total MMSEK score in a population in which its prevalence is about 10%. Gender, age and education have significant effects on orientation in time, orientation in place, attention/calculation, language function and comprehension & judgement, while not on memory registration and memory recall. Female sex, old age and undereducation are thought to be risk factors for development of dementia.
Aged* ; Cognition ; Comprehension ; Dementia ; Education* ; Female ; Humans ; Memory ; Prevalence ; Risk Factors ; Rural Population*

Research articles are rapidly increasing in number of publications in the regular journals on geriatric psychiatry and it's allied fields since 1989. However, they were mainly on dementia, depression, epidemiology and neurocognitive functions. Widening of research areas, refinement of study methodology and multidisciplinary approach based on clinical data are needed. And of importance is submission to the popular foreign scientific journals listed in medical indexes, including the Current Contents, Excerpta Medica, Index Medicus, Medline, Psychological Abstracts, Science Citation Index, and Social Science Citation Index. In the case of home journals, a meticulous peer review system of manuscripts could improve the quality of research activities and of publications. All these activities would help us open a new horizon in the research into mental health problems in Korea.
Dementia ; Depression ; Epidemiology ; Geriatric Psychiatry ; Korea ; MEDLINE ; Mental Health ; Peer Review ; Social Sciences

OBJECTIVES: This study was conducted to delineate the long-term natural change of cognitive functions in aged community residents, using the Korean version of the mini-mental state examination (MMSEK) METHODS: The first MMSEK was administered to as the screening test for identification of dementia between January and December, 1990 in a total of 702 persons. They were residents of a Myun area, Pohang, Kyungpook Province and 65 or more as of December 31. 1990. The MMSEK was repeated from November, 1995 to June, 1996, using the Cognitive Impairment Diagnosing Instrument and was successful in 440. RESULTS: The 6-year mean(+/-SD) decline of the total MMSEK score was 1.52+/-3.45 and 6.42%. Of the subtests, memory registration showed no significant decline while comprehension/judgement improved significantly. The decline was most prominent in attention/calculation and memory recall, and then language, orientation in time and orientation in place in order. Change of the total score was not related to sex, education and the first total score. Decline of language function was more severe in the educated than in the noneducated-illiterate. Performances of all subtests declined significantly with aging and improvement of the comprehension/judgement was less prominent in the group aged 75 or more. Relations of the change with the first total score were inconsistent among the subtests. The stepwise multiple regression analysis revealed that age, the first total score and education were the variables significantly affecting the decline of MMSEK score. However, they could account for only 16.4% of the variance of decline of the total MMSEK score. CONCLUSIONS:Decline of the cognitive function was small during the 6-year period, and the change pattern was not homogenous among the subtests. Age, the first total MMSEK score and education were idenrified as significant, but not so important, factors accounting for the variance of the cognitive decline.
Aged* ; Aging ; Cognition ; Dementia ; Education ; Follow-Up Studies* ; Gyeongsangbuk-do ; Humans ; Mass Screening ; Memory

OBJECTIVES: To study of the effects of gender, age and education on the MMSEK performances in the elderly. METHOD: The MMSEK was administered to a total of 702 persons aged 65 or more in a rural area. The effects on the total and subtest MMSEK scores of the 3 independent variables were analyzed by Student t-test, Pearson's correlation, oneway analysis of variance, analysis of covariance, and stepwise multiple regression. RESULTS: The total and all subtest scores of MMSEK were found to be affected by age. All subtest, except memory registration and memory recall, scores were affected by education and sex. 39.6% of the variance of total MMSEK score could be accounted for by the 3 variables. CONCLUSIONS: 40% of the variance of the total MMSEK score could be accounted for by age, gender and education while the remaing 60% is assumed to be affected by other variables than age, sex, and education. Memory registration and memory recall seems to be resistant to sex and education effect, but sensitive to aging.
Aged* ; Aging ; Cognition ; Education* ; Humans ; Memory ; Rural Population*

OBJECTIVES: To investigate the relationship between cognitive functions and death in the elderly. METHOD: The MMSEK was administered to a community elderly population aged 65 or more. The initial MMSEK score and age were compared between the 6-yr survivors and 6-yr decedents. Relative risks of death were calculated in terms of sex, age, and educational level. RESULTS: The decedents were older and poorer in MMSEK performances except for orientation in place. The relative risk of death was 1.08 in the persons with questionable cognitive impairment and 1.94 in the persons with definite impairment. It was 1.13 in the illiterates and 1.26 in the educated. CONCLUSIONS:In the elderly the prospective survival and death may be related to severe cognitive decline, male sex, and old age, but not to mild cognitive decline, educational level, and remote memory.
Aged* ; Cognition ; Humans ; Male ; Memory, Long-Term ; Survivors

OBJECTIVE: Elucidation of questionable dementia of the Alzheimer type(QDAT) is important far accurate estimation of prevalence and incidence of dementia of the Alzheimer type, understanding of its natural history and evaluation of treatment strategies for dementia of the Alzheimer type. Subject and METHODS: Performances neuropsychological tests were compared between non-demented controls and 14 elderly people in a community diagnosed as having questionable senile dementia of the Alzheimer type. They lived in a rural community and their sex, age and education were controlled. RESULTS: The two groups were not significantly different comprehension and digit span of the Wechsler Memory Scale. Performances on arithmetic, similarity and block design were significantly lower in QDAT subjects. Scores on associate learning of the Wechsler Memory Stale and immediate and delayed recalls of logical memory were lower in QDAT subjects with statistical significance. performance on the semantic verbal fluency tended to the lower for the QDAT subjects. CONCLUSION: These findings suggest that QDAT may be early dementia of the Alzheimer type.
Aged* ; Aging ; Alzheimer Disease ; Cognition ; Comprehension ; Dementia* ; Education ; Humans ; Incidence ; Learning ; Logic ; Memory ; Natural History ; Neuropsychological Tests ; Prevalence ; Rural Population ; Semantics

Cognitive function and its related issues were studied for 10 years in 766 elderly people aged 65 or more as of December, 1990 in Jookjang Myun, Pohang, Kyungpook Province. The major findings on prevalence of dementia, nature of questionable dementia, early cognitive symptoms of Alzheimer's disease, the meaning of a screening test for cognitive impairment, reliability of dementia diagnosis, variables affecting cognitive functions, relation of cognitive dysfunction to survival, and natural course of cognitive functions were summarized in this review.
Aged* ; Alzheimer Disease ; Cognition ; Dementia* ; Diagnosis ; Epidemiology* ; Gyeongsangbuk-do* ; Humans ; Mass Screening ; Neurobehavioral Manifestations ; Prevalence