OBJECTIVES: Seoul-Activities of Daily Living(S-ADL) was developed to assess elderly person's basic activities of daily living. This study aims to develop standardized ADL assessment scale and confirm the reliability and validity of the S-ADL. METHODS: It was participated in 336 controls and 145 patients diagnosed Alzheimer's disease. RESULTS: In controls, it was statistically significant to age, but not sex, education, region and presence of spouse. Also, reliability and validity were statistically significant. Principal axis factoring analysis revealed three factors that accounted for 66.67% of the total variance(1.self-care/hygiene, 2.ambulation, 3.toileting). According to each CDR stage, there were significant difference, except for CDR 0.5 and CDR 1 suggesting early dementia. Particularly, it was remarkable for functional impairment in CDR 2 and CDR 3 suggesting moderate to severe dementia. The order of the loss of function was (1) self-care/hygiene, (2) toileting, and (3) ambulation. CONCLUSIONS: Our study showed that the S-ADL could be a very reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-ADL would be useful in assessing daily function of moderate to severe AD.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Education ; Humans ; Reproducibility of Results* ; Spouses ; Walking

OBJECTIVES: The purpose of this study was to examine the determinants of care burden of caregivers in patients with dementia. METHODS: 128 dementia patients and patients' caregivers participated in this study. Care burden using the BI ; cognition using the K-MMSE ; dementia severity using the CDR ; activities of daily living using the S-ADL and the S-IADL ; behaviour problems using NPI were measured. RESULTS: The results showed that care burden was related significantly with the K-MMSE, the CDR, the S-ADL, the SIADL and the NPI total score. Of the behavior problems, agitation/aggression, anxiety, disinhibition, irritability, and aberrant behavior correlated positively with care burden of caregivers. Regression analysis indicated that agitation/aggression, anxiety, the CDR contributed to care burden. CONCLUSION: Agitation/aggression, anxiety and dementia severity contributed to care burden of caregivers. The identified determinants of care burden and the stress of caregivers suggest areas of therapeutic intervention to reduce caregiver's burden so that the institutionalization can be delayed.
Activities of Daily Living ; Anxiety ; Caregivers* ; Cognition ; Dementia* ; Humans ; Institutionalization

This study was conducted to examine the reliability, validity and clinical utility of the Severe Impairment Battery (SIB) for a Korean population. 69 dementia patients with Clinical Dementia Rating (CDR) stages 2 or 3 were participated in this study. The SIB, Korean version-Mini Mental State Examination (K-MMSE), CDR, and Seoul-Activities of Daily Living (S-ADL) were administered. The validity of the SIB was confirmed by evaluating the correlation coefficients between the SIB and K-MMSE, CDR, S-ADL, which were found to be significant. Cronbach's alpha for the total SIB score and each subscale score showed high significance, and the item-total correlation for each subscale was also acceptable. The test-retest correlation for the total SIB score and subscale scores were significant, except for the praxis and orienting to name. The total SIB score and subscale scores were examined according to CDR. The results suggest that the SIB can differentiate the poor performances of severely impaired dementia patients. On the basis of the receiver operating characteristic (ROC), it can be concluded that the SIB is able to accurately discriminate between CDR 2 and 3 patients. The results of this study suggest that the SIB is a reliable and valid instrument for evaluating severe dementia patients in Korean population.
Severity of Illness Index ; Reproducibility of Results ; ROC Curve ; *Neuropsychological Tests ; Male ; Korea ; Humans ; Female ; Dementia/*diagnosis ; Cognition Disorders/diagnosis ; Cognition ; Aged ; Activities of Daily Living

Objectives : We developed the instrument to assess the quality of life(QOL) for demented patients, 'Geriatric Quality of Life-Dementia(GQOL-D)'. The purpose of this study was to standardize the GQOL-D and to introduce administration results in Korean demented patients. METHODS: The normal subjects were 340 elderly people, aged over 55 years old, who were physically and cognitively normal. And the patient group was consisted of 69 demented patients. RESULTS: Both in normal group and in patient group, the internal consistency, Cronbach's = 0.87, 0.90, respectively, and item-total correlation was acceptable. And the test-retest reliability revealed the stability across time by r=0.86, 0.77, respectively. Criterion validity was found to be a high correlation between each itemand overall QOL' item, and adequate correlations between the GQOL-D and scales assessing cognition, psychological wellbeing, behavior and activities of daily living convinced convergent validity. In the result of factor analysis, 2 factors with a variance percentage of 37.7% were extracted. The mean score and standard deviation of items of the GQOL-D for two groups and differences in items such as memory, recreation/leisure, self esteem, general health, and mobility between groups were presented. CONCLUSION: It was confirmed that there is no difficulty for old people to carry out the GQOL-D. As it was suggested that there is enough room for intervening in dementia patients' emotional and behavioral difficulties, the GQOL-D will be useful in research and clinical practice for the patients with dementia.
Activities of Daily Living ; Aged ; Cognition ; Dementia ; Humans ; Memory ; Middle Aged ; Quality of Life* ; Self Concept ; Weights and Measures

OBJECTIVES: We aimed to provide standard data of the individual tests in 7MS that could generalized for Korean elderly according to age and education. We also evaluated diagnostic efficacy of each test in 7MS. METHODS: Data on demographic characteristics of 311 normals were gathered for comparison. We also assessed two differences between normal and dementia group in individual tests of 7MS. RESULTS: All individual tests of 7MS showed significant differences in sex, age, and education, except for ECR. But there were no significant differences in sex controlling age and education. As a result of ROC curve, the ability of the ECR test to discriminate between AD and normal subject appeared superior. The scores of the individual tests of 7MS among CDR 0.5 and 1 group and normal group were compared. It was also found that the ECR test stands out among 7MS tests. CONCLUSION: The 7MS, particularly ECR, had the highest sensitivity and specificity for diagnosis of AD as well as early dementia. It suggests that the individual tests of 7MS are useful to predict early dementia, without using the complex logistic regression equation.
Aged ; Dementia ; Diagnosis ; Education ; Humans ; Logistic Models ; Mass Screening ; ROC Curve ; Sensitivity and Specificity

OBJECTIVES: Seoul-Instrumental Activities of Daily Living (S-IADL) was developed to assess elderly person's instrumental everyday activities. This study aims to develop standardized IADL assessment scale and to confirm the reliability and validity of the S-IADL. METHODS: The 336 controls were included in standardization study. Reliability and validity of S-IADL were tested by 72 Alzheimer's disease patients and 72 controls matched to age, sex, and education. We also conducted Receiver Operating Characteristics curve for sensitivity and specificity of S-IADL. RESULTS: Because of positively skewed distribution of S-IADL, standardization data were presented using 1SD and 2SD value. Internal consistency, test-retest reliability, and interrater reliability were statistically significant. Principal axis factoring analysis revealed two factors that accounted for 59.95% of the total variance, and second factor was items sensitive to sex (3.preparing food/cooking, 4.household chores). S-IADL was correlated significantly with other standardized cognitive measures, demonstrating good convergent validity. With a cut-off point of 8, the S-IADL had a sensitivity of 83.3% and specificity of 93.1% in the diagnosis of dementia. Also, with a 2SD standardized data, sensitivity was 81.9% and specificity was 93.1%. CONCLUSION: Our study showed that the S-IADL could be a reliable and valid tool for the assessment of functional disabilities of Korean dementia patients. Particularly, S-IADL had higher sensitivity and specificity than other IADL instruments, suggesting that it is useful to early detection of dementia.
Activities of Daily Living ; Aged ; Alzheimer Disease ; Axis, Cervical Vertebra ; Dementia ; Diagnosis ; Education ; Humans ; Reproducibility of Results* ; ROC Curve ; Sensitivity and Specificity

PURPOSE: Pretransplant peripheral vascular examination in renal transplant recipient is not common even though the uremic status is a risk factor of developing atherosclerosis. Since that kind of atherosclerotic stenosis is inadequate for renal artery anastomosis, surgeons should perform certain procedures in that area. Until now, we have no written report about the results of renal transplant recipient who have been done endarterectomy at anastomosing iliac artery. The aim of this paper is to review the results of renal allograft recepient whose anastomosed iliac artery is endarterectomized at the time of transplantation. METHODS: Among 161 living donor renal allografts which were performed between January 1993 through June 1998, 21 allografts needed recipient iliac artery endarterectomy before vascular anastomosis. Their graft survivals, serial changes of blood pressure, serum creatinine level, and ultrasonic measure of renal arterial diameter and peak systolic velocity with their wave patterns were compared between endarterectomy group and non-endarterectomy group (control group). Mean age of endarterectomy group was older than control group (45.4 vs 32.9). Endarterectomy was done at internal iliac artery in 18 patients and both common and external iliac arteries in 3 patients. RESULTS: One and 3 year graft survivals showed higher in endarterectomy group than control group (90.9% vs 82.3%). Uncontrolled hypertension of endarterectomy group was 6.3%, 11.5%, 27.3% in 12, 24, 36 months and that of control group was 18.9%, 23.6%, 25.1%, but there was no statistical significance between groups. Serial changes of serum creatinine level of endarterectomy group was maintained low until the end of 3 years compare to control group (1.2 0.9 mg/ml vs 1.9 1.1). There was no difference between groups in peak systolic velocity and wave pattern proximal and distal to the anastomotic site of renal artery, and also no difference in measured arterial diameter and resistance index. CONCLUSION: Endarterectomy of recipient iliac artery before transplant renal vascular anastomosis show no adverse effect on recipient blood pressure, renal allograft function, graft survival and renal artery restenosis at least up to 3 years after graft.
Allografts* ; Atherosclerosis ; Blood Pressure ; Constriction, Pathologic ; Creatinine ; Endarterectomy* ; Graft Survival ; Humans ; Hypertension ; Iliac Artery ; Living Donors ; Renal Artery ; Risk Factors ; Transplantation ; Transplants ; Ultrasonics

PURPOSE: To evaluate the accuracy and availability of Multidetector-Row Computed Tomography (MDCT) and Color Doppler Sonography as a method for making an early diagnosis of DVT after joint arthroplasty. MATERIALS AND METHODS: A total of 71 cases (63 patients) were selected. 32 cases (32 patients) underwent a THRA and 39 cases (31 patients) underwent a TKRA between April 2004 to August 2004. All cases underwent both Color Doppler Sonography and MDCT, before and after surgery. No prophylactic medications for DVT were given. Patients who previously had DVT or pulmonary embolism or a medication history of anticoagulation therapy were excluded. RESULTS: DVT was found by MDCT in 33 cases (46.5%) and by Color Doppler Sonography in 15 cases (21.1%). In the 33 cases of DVT diagnosed by MDCT, 24 cases developed in the calf vein, among them, only 4 cases were positive and remaining 20 were negative in Color Doppler Sonography. In the 15 cases of DVT diagnosed by Color Doppler Sonography, 13 cases were positive and only 2 cases were negative in MDCT. CONCLUSION: MDCT is effective in diagnosing DVT after joint arthroplasty in terms of the objectivity, efficacy and accuracy.
Arthroplasty* ; Early Diagnosis ; Humans ; Joints* ; Multidetector Computed Tomography ; Pulmonary Embolism ; Veins ; Venous Thrombosis*