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The Behavior Pathology in Alzheimer's Disease Rating Scale, Korean Version (BEHAVE-AD-K): Factor Structure among Alzheimer's Disease Inpatients.

Guk Hee SUH ; Jong Han PARK

Journal of Korean Geriatric Psychiatry.2001;5(1):86-95.

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

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Analysis of the Risk Factors and Psychotropics' Role in the Falls of the Dementic Elderlies in a Nursing Home.

Sae Hoon CHUNG ; Kyung Hyung JHO ; Young Min SHIN

Journal of Korean Geriatric Psychiatry.2001;5(1):76-85.

OBJECTIVE: This study examines the risk factors of the falls of the dementic elderlies in the nursing home. Especially we investigated how the psychotropics affect them in the aspect of the falling tendency. METHODS: We investigated the falls of the 262 patients living in the Seoul JungGae Nursing Home for six month since March 1 1999. Among these we recruited 182 patients whom the exclusion criteria was applied to, and then we measured the relative risks of risk factors known from the previous studies. RESULTS: The incidence rate of falls is 40.1/100person year. The relative risk of gender, age, disease of central nervous system, chronic illness, cognitive function, antipsychotics, antidepressants and anxiolytics had no significance (p>0.05). BADL, mobility, mood stabilizers were related with the falls significantly, and the relative risks were 0.904 (95%CI 0.840-0.973), 1.744 (95%CI 1.064-2.858), 4.683 (95%CI 1.412-15.532) relatively. CONCLUSIONS: The average rate of falling was 40.1/100person year showing less frequent accidents than that of other foreign studies, which was assumed the large number the care-givers and sitting life style on the floor helped preventing the elderlis' falling. Although The gender, age, disease of central nervous system, chronic illness, cognitive function, antipsychotics, antidepressants and anxiolytics did not influence the rate of the falling tendendy of the elderlies, the mobility and impaired activity of daily living increased the rate of their falling. The elderlies taking psychotropics more fell than others not taking pills. The imbalance between the mobile potency and imposed real activity causes the falls. When the psychotropics affect negatively on the mobility, it increases the falling rate of the elderlies. On the other hands, when these affect positively, these prevent elderlies falling.
Anti-Anxiety Agents ; Antidepressive Agents ; Antipsychotic Agents ; Central Nervous System ; Chronic Disease ; Dementia ; Hand ; Humans ; Incidence ; Life Style ; Nursing Homes* ; Nursing* ; Risk Factors* ; Seoul

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Comparison of Cognitive Disorders in Dementia, Major Depressive Disorder and Alcohol Dependence Using the 7 Minute Screening Battery.

Jin Sook CHEON ; Han Cheol YOON ; Byoung Hoon OH

Journal of Korean Geriatric Psychiatry.2001;5(1):67-75.

OBJECTIVES: 'The 7 Minute Screen' was reported so sensitive to discriminate mild dementia. The test results were not influenced by the education, age and sex. Furthermore, the examiners needed no professional training. The tests covered the cognitive areas such as memory, oritention to time, verbal fluency and visuospatial or visuoconstructional abilities. The aims of this study were to evaluate the efficiency of 'The 7 Minute Screen' to discriminate differences between illnesses, and to analyze the factors affecting the test results. METHODS: 'The 7 Minute Screen' and the Mini-Mental State Examination (MMSE) were obtained from 36 inpatients with dementia of the Alzheimer's type (N=8), vascular dementia (N=8), Major depressive disorders (N=10) and alcohol dependence (N=10). The test battery was consisted of the Benton Temporal Orientation, the Enhanced Cued Recall, the Clock Drawing and the Category Fluency. RESULTS: 1) On the Benton Temporal Orientation, the highest mean scores were obtained in vascular dementia. On the memory, the lowest mean scores were obtained in vascular dementia, especially on the Uncued Recall in the dementia of the Alzheimer's type, and on the Cued Recall in vascular dementia. On the Clock Drawing, the lowest mean scores were obtained in the dementia of the Alzheimer's type. On the Category Fluency, the lowest mean scores were obtained in the dementia of the Alzheimer's type. 2) There was no statistically significant difference between 4 illness groups on the Benton Temporal Orientation. While there were no differences between 4 illness groups on total scores of memory and the Cued Recall, on the Uncued Recall showed significant difference between alcohol dependence and other illness groups (p<0.05). On the Clock Drawing, there was no significant difference between 4 illness groups. On the Category Fluency, there was significant difference between alcohol dependence and dementia of the Alzheimer's type and vascular dementia (p<0.001), and major depressive disorders (p<0.01). 3) In the dementia of the Alzheimer's type, the test scores of the Clocking Drawing were correlated positively with the education level (gamma=0.740, p<0.05), and negatively on the sex (gamma=-0.902, p<0.005), while in major depressive disorders, there was negative correlation between the Cued Recall and the age (gamma=-0.725, p<0.05). Otherwise, there were no significant correlation between the scores of individual tests with age, sex and educational level in vascular dementia and alcohol dependence. CONCLUSIONS: 'The 7 Minute Screen' seemed to be more superior to find out mild cognitive deficit than the Mini-Mental State Examination as well as it might be useful to discriminate differences between illnesses. However, some individual test results of a kind of illnesses could be influenced by the education level, age and sex.
Alcoholism* ; Dementia* ; Dementia, Vascular ; Depressive Disorder, Major* ; Education ; Humans ; Inpatients ; Mass Screening* ; Memory

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Temporal Lobe Volume in Geriatric Depressive Patients: A Magnetic Resonance Imaging Study.

Chang Hyun KIM ; Young Kuk YUN ; Sung Hwan CHOI

Journal of Korean Geriatric Psychiatry.2001;5(1):58-66.

OBJECTIVE: The purpose of this study was to measure and compare temporal lobe volumes of geriatric depressive patients and normal controls. Temporal lobe volume was measured with computerized volumetric technique using brain MRI films. METHOD: We studied 15 patients of 50 years or older with major depressive disorder (MDD) and 14 normal control subjects, measured temporal lobe volumes and cerebral volumes of both groups using semi-automated imaging analysis program from brain MRI films. A statistical analysis was done to compare right and left volumes in both groups and to compare right and left volumes in each group. The comparison of right and left volumes between early-onset MDD group and late-onset one and correlation with duration of illness of MDD group were taken too. RESULTS: There was no difference in right and left temporal volumes between MDD group and normal control (right p=.760, left p=.219) but there was statistically significant difference between right and left volume in normal controls who have larger right temporal lobe volume than left temporal lobe volume (p=.002) compared to MDD patients who have no difference between right and left temporal lobe volume (p=.644). In MDD patients, there were no difference between early-onset MDD group and late-onset one and no correlation of volume with duration of illness. CONCLUSION: This study aiming at identifying the structural change of brain in geriatric depressive patients did not reveal any difference of temporal lobe volume between MDD patients and normal controls, and between right and left temporal lobe in geriatric MDD patients. The loss of laterality in patients was partially identical with the previous results of other studies, so it needs further following studies which have larger size of subjcets with various implicated variables and more fine brain structures.
Brain ; Depressive Disorder, Major ; Humans ; Magnetic Resonance Imaging* ; Temporal Lobe*

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Reliability and Analysis of Symptom Category Scores of the Behavior Pathology in Alzheimer's Disease Rating Scale, Korean Version(BEHAVE-AD-K).

Guk Hee SUH ; Hyun Gyun SON ; Hyongju SHIN ; In Myoung KIM ; Sangeui HONG ; Jonghan PARK ; Ihn Geun CHOI ; Sang Kook KIM ; Byeong Kil YEON

Journal of Korean Geriatric Psychiatry.2001;5(1):50-57.

OBJECTIVE: The aims of this study were to (1) validate the inter-rater reliability of the BEHAVE-AD, Korean version, to (2) analyze the quantitative relationship between severity of Alzheimer's disease (AD) and mean scores on each of the BEHAVE-AD categories and mean total BEHAVE-AD score. DESIGN: Cross-sectional study of geriatric patients with AD evaluated at a mental hospital for the elderly. SAMPLE: Fifty-two consecutive patients diagnosed with probable Alzheimer's disease (AD) according to NINCDS-ADRDA diagnostic criteria. RESULTS: In reliability study, significant correlations were obtained for all BEHAVE-AD symptoms category scores and for mean total BEHAVE-AD scores. Analysis of BEHAVE-AD scores as a function of disease severity demonstrated a non-linear relationship between severity of behavioral symptoms and the global and cognitive advance of AD. Score analysis of the BEHAVE-AD indicates that these behavioral disturbances become most severe in the moderate and moderately severe stages of AD. CONCLUSION: All the results proved the cross-cultural validity and reliability of the BEHAVE-AD, Korean version. Furthermore, these results have implications for the methodology of pharmacological trials of putative cognitive enhancer compounds in AD.
Aged ; Alzheimer Disease* ; Behavioral Symptoms ; Cross-Sectional Studies ; Dementia ; Hospitals, Psychiatric ; Humans ; Pathology* ; Psychotic Disorders ; Reproducibility of Results

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Significance of Non-Alzheimer Dementia.

Jonghan PARK

Journal of Korean Geriatric Psychiatry.2001;5(1):47-49.

Most of the research activities on dementias have been and are focused on Alzheimer's disease. With regard to the treatment possibility and the cause and pathogenesis of cognitive impairment, however, non-Alzheimer dementias are also very important. We should extend our efforts to other dementing diseases than Alzheimer's disease.
Alzheimer Disease ; Cognition ; Dementia*

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Clinical Characteristics of Dementia with Lewy Bodies.

Jin Sook CHEON ; Edmond CHIU

Journal of Korean Geriatric Psychiatry.2001;5(1):36-46.

The dementia with Lewy bodies which was common next to the Alzheimer's dementia had been oftenly misdiagnozed as vascular dementia. The pathologic diagnosis of dementia with Lewy bodies was increasing with the development of immunocytochemical techniques, and it also drew much interest recently. The clinical criteria included core symptoms such as fluctuation of cognitive function, well-formed visual hallucination and extrapyramidal symptoms. For the pathologic criteria, presence of brainstem or cortical Lewy bodies were essential, besides of other pathology. However, it was difficult to obtain satisfactory consensus between investigators about the clinical and pathologic criteria of the dementia with Lewy bodies. There were several reports which suggested good response to the cholinesterase inhibitors.
Brain Stem ; Cholinesterase Inhibitors ; Consensus ; Dementia* ; Dementia, Vascular ; Diagnosis ; Hallucinations ; Humans ; Lewy Bodies* ; Pathology ; Research Personnel

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Cognitive Enhancers in AAMI.

Guk Hee SUH

Journal of Korean Geriatric Psychiatry.2001;5(1):25-35.

No abstract available.
Nootropic Agents*

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Neurobiology of Age-Associated Memory Impairment.

Seung Hyun KIM ; Kyung Ho SHIN

Journal of Korean Geriatric Psychiatry.2001;5(1):17-24.

The diagnostic concept of age-associated memory impairment (AAMI) suggests that clinically recognized memory dysfunction could be a feature of normal aging. Although the memory impairment associated with aging is well recognized, underlying neurobiological mechanisms of cognitive decline remain unclear. There are a number of age-related structural and physiological changes in the brain that could have implications for cognitive decline in the elderly. The impact of these age-related changes in the brain on cognition has been studied using postmortem neurochemical, neuropathological findings or neuroimaging techniques. The available evidence from studies in aged and demented humans suggested that cognitive deficits related to aging might involve concomitant alterations of various neurochemical systems in several brain regions such as the striatum, the hippocampus or the cortex. It also seems that these alterations occur in a complex way which affects dopaminergic, glutamaterigc and serotonergic neurotnasmission in addition to the loss of cholinergic neurons in the basal forebrain, However, data collected to explain the mechanism of AAMI are still limited, the definite interpretation of these findings must await futher studies.
Aged ; Aging ; Brain ; Cholinergic Neurons ; Cognition ; Dopamine ; Glutamic Acid ; Hippocampus ; Humans ; Memory* ; Neurobiology* ; Neuroimaging ; Prosencephalon

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Epidemiology of Age-Associated Memory Impairment.

Byeong Kil YEON ; Seong Gon RYU

Journal of Korean Geriatric Psychiatry.2001;5(1):12-16.

It has been widely known that the elderly suffer very mild cognitive impairment including memory function that cannot satisfy the criteria of dementia. Koivisti and Hannien et al reported that the prevalences of age-associated memory impairment and age-associated cognitive decline were 38.6% and 26.6%, respectively. The prevalence rate of male was more than that of female and the prevalence rate was increased in younger elderly. The risk factors of age-related cognitive decline were age and myocardiac infarction whereas education and smoking decreased the risk of age-related cognitive decline. The small portion of age-associated memory impairment progressed toward dementia but the most of them were nonprogressive. The probability of progression toward dementia could be predicted by detailed neurocognitive function test. The further epidemiologic studies will reveal the nature of age-associated memory impairment.
Aged ; Dementia ; Education ; Epidemiologic Studies ; Epidemiology* ; Female ; Humans ; Infarction ; Male ; Memory* ; Mild Cognitive Impairment ; Prevalence ; Risk Factors ; Smoke ; Smoking

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