BACKGROUND AND PURPOSE: Cognitive training refers to a series of standardized tasks with inherent challenges that target specific cognitive domains. Positive outcome of cognitive training in persons with Alzheimer's disease has been reported. In this study, the objective was to design sets of cognitive training program, “Gipum-seo” which is combined cognitive training, consists of different levels of difficulty using predesigned paper-and-pencil exercises. Also, to evaluate the effects of the cognitive training on patients' with early stage of Alzheimer's disease. METHODS: The subjects for this study were forty participants who were diagnosed with early stage of Alzheimer's dementia. To test the efficacy of paper-based cognitive training programs to cognition, all patients were randomly grouped to either an intervention group (n=20) or a control group (n=20). The intervention group regularly received 24 sessions of paper-based cognitive training over a 12-week period. Neuropsychological examinations were conducted before and after this training period. RESULTS: After the 12 weeks, the intervention group showed a significant change in Korean version of the Mini-Mental State Examination (25.90±3.8), compared to the control group (23.7±2.8) (p=0.042). The training group also showed a significant improvement in language, attention and executive function, as compared with controls. CONCLUSIONS: Paper-based cognitive training might have beneficial effects on the general cognitive functions in the early stage of Alzheimer's dementia.
Alzheimer Disease ; Cognition ; Cognitive Therapy ; Dementia ; Education ; Executive Function ; Exercise ; Humans ; Neurocognitive Disorders ; Neuropsychological Tests

Patients with mild cognitive impairment (MCI) are at increased risk of developing dementia and Alzheimer's disease (AD). Currently, no disease-modifying or preventive drugs for AD are available. Non-pharmacological interventions, including cognitive intervention and physical exercise, could assist in the prevention and treatment of AD. Cognitive interventions can improve cognition and prevent dementia, and promote cognitive reserve and plasticity. As there are few standardized intervention programs for the treatment of MCI, development and effective study of cognitive interventions are needed. Psychiatrists should have a great interest in this kind of non-pharmacological interventions regarding neurocognitive disorders.
Alzheimer Disease ; Cognition ; Cognitive Reserve ; Dementia ; Exercise ; Humans ; Mild Cognitive Impairment ; Neurocognitive Disorders ; Plastics ; Psychiatry

PURPOSE: Obtaining brain tissue is critical to definite diagnosis and to furthering understanding of neurodegenerative diseases. The present authors have maintained the National Neuropathology Reference and Diagnostic Laboratories for Dementia in South Korea since 2016. We have built a nationwide brain bank network and are collecting brain tissues from patients with neurodegenerative diseases. We are aiming to facilitate analyses of clinic-pathological and image-pathological correlations of neurodegenerative disease and to broaden understanding thereof. MATERIALS AND METHODS: We recruited participants through two routes: from memory clinics and the community. As a baseline evaluation, clinical interviews, a neurological examination, laboratory tests, neuropsychological tests, and MRI were undertaken. Some patients also underwent amyloid PET. RESULTS: We recruited 105 participants, 70 from clinics and 35 from the community. Among them, 11 died and were autopsied. The clinical diagnoses of the autopsied patients included four with Alzheimer's disease (AD), two with subcortical vascular dementia, two with non-fluent variant primary progressive aphasia, one with leukoencephalopathy, one with frontotemporal dementia (FTD), and one with Creutzfeldt-Jakob disease (CJD). Five patients underwent amyloid PET: two with AD, one with mixed dementia, one with FTD, and one with CJD. CONCLUSION: The clinical and neuropathological information to be obtained from this cohort in the future will provide a deeper understanding of the neuropathological mechanisms of cognitive impairment in Asia, especially Korea.
Alzheimer Disease ; Amyloid ; Aphasia, Primary Progressive ; Asia ; Brain* ; Cognition Disorders ; Cohort Studies ; Creutzfeldt-Jakob Syndrome ; Dementia ; Dementia, Vascular ; Diagnosis ; Frontotemporal Dementia ; Humans ; Korea* ; Leukoencephalopathies ; Magnetic Resonance Imaging ; Memory ; Neurodegenerative Diseases ; Neurologic Examination ; Neuropathology ; Neuropsychological Tests

OBJECTIVES: The purpose of present study was to investigate the effect, safety and tolerability of risperdal sachet(oral solution) with lorazepam tablet versus intramuscular haloperidol and lorazepam injection for management of acute psychotic symptom in the elderly with organic mental disorder. METHODS: Total 37 patients who have dementia, medical or physical diseases, associated with acute psychotic symptom were randomly assigned to oral treatment with 1mg of risperdal sachet(oral solution) plus 1mg of lorazepam(N=17) or to intramuscular treatment with 2.5mg of haloperidol plus 2mg of lorazepam(N=20). The change of CGI scores was used for the evaluation of efficacy. RESULTS: Mean score improvements at 15, 30, 60, and 120 minutes after treatment were statistically significant at each time point in both groups(p<0.001) and were similar in both groups(p=0.189). CONCLUSION: A single oral dose of risperdal sachet(oral solution) plus lorazepam was as effective and tolerable as parenterally administered haloperidol plus lorazepam for the rapid control of acute psychotic symptom in the elderly with organic mental disorder.
Aged* ; Delirium ; Neurocognitive Disorders* ; Dementia ; Haloperidol* ; Humans ; Lorazepam*

Dementias can be calssified into cortical, subcortical, cortical-subcortical and multifocal ones based on the major pathological distribution within the brain. The literatures of recent knowledge about clinical features of other dementias than Alzheimer's and vascular ones, which were most frequently experienced by many clinicians were reviewed. That is, cortical dementias such as Pick's disease, frontal lobe type dementia and non-Alzheimer's type lobar atrophy including fronto-temporal dementia, progressive dysphasia, fronto-temporal dementia with motor neuron disease, and alcohol-related dementia were reviewed. Subcortical dementias such as dementias accompanying Parkinson's disease, Huntington's disease and progressive supranuclear palsy, and cortical-subcortical dementias such as Lewy body dementiaq and cortical-basal degeneration were also reviewed. As multifocal dementias, prion dementias including KUru, Creutzfeldt-Jakob disease, fatal familial insomnia and Gerstmann-Strussler-Sheinker syndrone, and AIDS dementia were also reviewed.
Aphasia ; Atrophy ; Brain ; Creutzfeldt-Jakob Syndrome ; Dementia* ; Frontal Lobe ; Frontotemporal Dementia ; Huntington Disease ; Insomnia, Fatal Familial ; Kuru ; Lewy Bodies ; Lewy Body Disease ; Motor Neuron Disease ; Parkinson Disease ; Pick Disease of the Brain ; Supranuclear Palsy, Progressive

Levetiracetam is a new antiepileptic drug that is used widely in Korea. It has reported behavioral side effects, most notably irritability, agitation, and aggressive behavior. However, these behavioral side effects are often not considered by prescribers and psychiatrists. We report a 64-year-old male with a cerebral astrocytoma who was referred to the department of psychiatry for increased aggression and irritability. The severity of symptoms did not fluctuate over a 24-hour period, and there was no evidence of depression (Clinical Global Impression of depression severity score: 2). The scores of scales for delirium and cognitive function did not support the possible diagnosis of delirium or dementia [Korean Mini-Mental State Examination (K-MMSE): 25; Korean version of the Delirium Rating Scale-Revised-98: 5]. The severity of aggression was very high in the trait questions of the Korean adaptation of the State-Trait Anger Expression Inventory (STAXI-K: 34). After ruling out dementia, delirium, depression, and an organic mental disorder, we thought that the aggression and irritability might be related to levetiracetam, and recommended discontinuing it without treating the symptoms. After discontinuing the levetiracetam, the patient and caregiver reported a dramatic improvement in the aggression and irritability within 3 days, and the score on the STAXI-K decreased to 10. Twenty-eight weeks follow up after consultation, the STAXI-K was 10, and K-MMSE was increased to 26. We considered a final diagnosis of other substance (levetiracetam)-related disorder not otherwise specified because of the temporal relationship between the use of levetiracetam, occurrence of the symptoms, and improvement on withdrawing the drug. The behavioral side effects of levetiracetam should be considered, especially in patients who develop behavioral changes while taking the drug.
Aggression ; Anger ; Astrocytoma ; Caregivers ; Delirium ; Neurocognitive Disorders ; Dementia ; Depression ; Dihydroergotamine ; Follow-Up Studies ; Humans ; Korea ; Male ; Piracetam ; Psychiatry ; Weights and Measures

Vascular dementia is one of the few remediable causes of dementia among the eldery. Prevention of the disease can be best achieved by primary or secondary prevention of controllable risk factors for strokes. Therefore, early and accurate diagnosis of vascular cognitive impairment prior to the dementia stage is essential to the prevention and treatment of vascular dementia. Pharmacological and non-pharmacological methods for prevention of vascular dementia are listed in this article. Recent epidemiologic data, suggesting a direct correlation between vascular risk factors and Alzheimer type dementia, emphasized the importance of controlling vascular risk factors in the prevention of dementia. Treatment strategies for patients diagnosed as vascular dementia are also discussed. Several clinical trials for symptomatic improvement of vascular dementia are ongoing and their success can be a hope to patients with vascular dementia.
Alzheimer Disease ; Cognition Disorders ; Dementia ; Dementia, Vascular* ; Diagnosis ; Hope ; Humans ; Risk Factors ; Secondary Prevention ; Stroke

Vascular dementia (VaD) subtypes include multi-infarct dementia, subcortical ischemic vascular dementia, strategic-infarct dementia, etc. Poststroke dementia may be related to preexisting cognitive level, and the frequency increased with aging, lower educational level and accompanied vascular risk factors. Vascular cognitive impairment (VCI) forms a spectrum that includes VaD, mixed Alzheimer's disease (AD) with a vascular component, and VCI without dementia. The concept of VCI will improve the early diagnoses and secondary prevention and treatment of VaD, and promote the further research on vascular component in neurodegenrative disorders.
Cognition ; Cognition Disorders ; classification ; diagnosis ; etiology ; Dementia, Multi-Infarct ; classification ; diagnosis ; Dementia, Vascular ; classification ; diagnosis ; Humans

No abstract available.
Alzheimer Disease* ; Creutzfeldt-Jakob Syndrome*

Psychosis in patients with dementia contributes substantially to patient morbidity and caregiver distress. The concept of psychosis of Alzheimer's disease (AD) and other types of dementia is developed with respect to prevalence, incidence, clinical characteristics, clinical course, and potential response to treatment. This article provides an overview of concept of psychosis in dementia. Published prevalence estimates of psychosis in patients with AD range from 10 to 73% within clinical populations. There is a continuing persistence of psychotic symptomatology among people with AD;most patients with psychosis continue to fulfill criteria for psychosis of dementia over at least 3 months, and over a half may have psychotic symptoms persist over a year. Among people with AD who have no psychotic symptoms there appears to be an annualized incidence of psychosis of about 20% in outpatients, and a much higher rate in nursing home patients. Frontal hypometabolism and greater frontal neuropsycological deficits occur in AD patients with psychosis in comparison to those without. There is some evidence that psychotic symptoms improve modestly with antipsychotic medication treatment, although optimal treatment guidelines have been elusive. The characteristics of psychosis in Parkinson's disease, Lewy body dementia, frontotemporal dementia and vascular dementia were also reviewed. Conclusively, further research to support the validity of a syndrome of psychosis in various types of dementia, as well as AD is needed.
Alzheimer Disease ; Caregivers ; Dementia ; Dementia, Vascular ; Frontotemporal Dementia ; Humans ; Incidence ; Lewy Body Disease ; Nursing Homes ; Outpatients ; Parkinson Disease ; Prevalence ; Psychotic Disorders