1.Clinical Practice Guidelines for Dementia: Recommendations for Cholinesterase Inhibitors and Memantine
Yeshin KIM ; Dong Woo KANG ; Geon Ha KIM ; Ko Woon KIM ; Hee-Jin KIM ; Seunghee NA ; Kee Hyung PARK ; Young Ho PARK ; Gihwan BYEON ; Jeewon SUH ; Joon Hyun SHIN ; YongSoo SHIM ; YoungSoon YANG ; Yoo Hyun UM ; Seong-il OH ; Sheng-Min WANG ; Bora YOON ; Sun Min LEE ; Juyoun LEE ; Jin San LEE ; Jae-Sung LIM ; Young Hee JUNG ; Juhee CHIN ; Hyemin JANG ; Miyoung CHOI ; Yun Jeong HONG ; Hak Young RHEE ; Jae-Won JANG ;
Dementia and Neurocognitive Disorders 2025;24(1):1-23
Background:
and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia.
Methods:
Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.
Results:
Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects.
Conclusions
This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.
2.Clinical Practice Guidelines for Dementia: Recommendations for Cholinesterase Inhibitors and Memantine
Yeshin KIM ; Dong Woo KANG ; Geon Ha KIM ; Ko Woon KIM ; Hee-Jin KIM ; Seunghee NA ; Kee Hyung PARK ; Young Ho PARK ; Gihwan BYEON ; Jeewon SUH ; Joon Hyun SHIN ; YongSoo SHIM ; YoungSoon YANG ; Yoo Hyun UM ; Seong-il OH ; Sheng-Min WANG ; Bora YOON ; Sun Min LEE ; Juyoun LEE ; Jin San LEE ; Jae-Sung LIM ; Young Hee JUNG ; Juhee CHIN ; Hyemin JANG ; Miyoung CHOI ; Yun Jeong HONG ; Hak Young RHEE ; Jae-Won JANG ;
Dementia and Neurocognitive Disorders 2025;24(1):1-23
Background:
and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia.
Methods:
Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.
Results:
Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects.
Conclusions
This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.
3.Clinical Practice Guidelines for Dementia: Recommendations for Cholinesterase Inhibitors and Memantine
Yeshin KIM ; Dong Woo KANG ; Geon Ha KIM ; Ko Woon KIM ; Hee-Jin KIM ; Seunghee NA ; Kee Hyung PARK ; Young Ho PARK ; Gihwan BYEON ; Jeewon SUH ; Joon Hyun SHIN ; YongSoo SHIM ; YoungSoon YANG ; Yoo Hyun UM ; Seong-il OH ; Sheng-Min WANG ; Bora YOON ; Sun Min LEE ; Juyoun LEE ; Jin San LEE ; Jae-Sung LIM ; Young Hee JUNG ; Juhee CHIN ; Hyemin JANG ; Miyoung CHOI ; Yun Jeong HONG ; Hak Young RHEE ; Jae-Won JANG ;
Dementia and Neurocognitive Disorders 2025;24(1):1-23
Background:
and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia.
Methods:
Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.
Results:
Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects.
Conclusions
This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.
4.Clinical Practice Guidelines for Dementia: Recommendations for Cholinesterase Inhibitors and Memantine
Yeshin KIM ; Dong Woo KANG ; Geon Ha KIM ; Ko Woon KIM ; Hee-Jin KIM ; Seunghee NA ; Kee Hyung PARK ; Young Ho PARK ; Gihwan BYEON ; Jeewon SUH ; Joon Hyun SHIN ; YongSoo SHIM ; YoungSoon YANG ; Yoo Hyun UM ; Seong-il OH ; Sheng-Min WANG ; Bora YOON ; Sun Min LEE ; Juyoun LEE ; Jin San LEE ; Jae-Sung LIM ; Young Hee JUNG ; Juhee CHIN ; Hyemin JANG ; Miyoung CHOI ; Yun Jeong HONG ; Hak Young RHEE ; Jae-Won JANG ;
Dementia and Neurocognitive Disorders 2025;24(1):1-23
Background:
and Purpose: This clinical practice guideline provides evidence-based recommendations for treatment of dementia, focusing on cholinesterase inhibitors and N-methyl-D-aspartate (NMDA) receptor antagonists for Alzheimer’s disease (AD) and other types of dementia.
Methods:
Using the Population, Intervention, Comparison, Outcomes (PICO) framework, we developed key clinical questions and conducted systematic literature reviews. A multidisciplinary panel of experts, organized by the Korean Dementia Association, evaluated randomized controlled trials and observational studies. Recommendations were graded for evidence quality and strength using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.
Results:
Three main recommendations are presented: (1) For AD, cholinesterase inhibitors (donepezil, rivastigmine, galantamine) are strongly recommended for improving cognition and daily function based on moderate evidence; (2) Cholinesterase inhibitors are conditionally recommended for vascular dementia and Parkinson’s disease dementia, with a strong recommendation for Lewy body dementia; (3) For moderate to severe AD, NMDA receptor antagonist (memantine) is strongly recommended, demonstrating significant cognitive and functional improvements. Both drug classes showed favorable safety profiles with manageable side effects.
Conclusions
This guideline offers standardized, evidence-based pharmacologic recommendations for dementia management, with specific guidance on cholinesterase inhibitors and NMDA receptor antagonists. It aims to support clinical decision-making and improve patient outcomes in dementia care. Further updates will address emerging treatments, including amyloid-targeting therapies, to reflect advances in dementia management.
5.Impact of Electronic Prescription System Modification for Appropriate Blood Component Utilization
Soo Eung PARK ; Jin Kyung LEE ; Young Jun HONG ; Ae-Chin OH ; Heyjin KIM
Korean Journal of Blood Transfusion 2024;35(3):178-186
Background:
Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components.
Methods:
The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification.
Results:
This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001).
Conclusion
Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.
6.Impact of Electronic Prescription System Modification for Appropriate Blood Component Utilization
Soo Eung PARK ; Jin Kyung LEE ; Young Jun HONG ; Ae-Chin OH ; Heyjin KIM
Korean Journal of Blood Transfusion 2024;35(3):178-186
Background:
Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components.
Methods:
The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification.
Results:
This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001).
Conclusion
Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.
7.The glutamate-serine-glycine index as a biomarker to monitor the effects of bariatric surgery on non-alcoholic fatty liver disease
Nichole Yue Ting Tan ; Elizabeth Shumbayawonda ; Lionel Tim-Ee Cheng ; Albert Su Chong Low ; Chin Hong Lim ; Alvin Kim Hock Eng ; Weng Hoong Chan ; Phong Ching Lee ; Mei Fang Tay ; Jason Pik Eu Chang ; Yong Mong Bee ; George Boon Bee Goh ; Jianhong Ching ; Kee Voon Chua ; Sharon Hong Yu Han ; Jean-Paul Kovalik ; Hong Chang Tan
Journal of the ASEAN Federation of Endocrine Societies 2024;39(2):54-60
Objective:
Bariatric surgery effectively treats non-alcoholic fatty liver disease (NAFLD). The glutamate-serine-glycine (GSG) index has emerged as a non-invasive diagnostic marker for NAFLD, but its ability to monitor treatment response remains unclear. This study investigates the GSG index's ability to monitor NAFLD's response to bariatric surgery.
Methodology:
Ten NAFLD participants were studied at baseline and 6 months post-bariatric surgery. Blood samples were collected for serum biomarkers and metabolomic profiling. Hepatic steatosis [proton density fat fraction (PDFF)] and fibroinflammation (cT1) were quantified with multiparametric magnetic resonance imaging (mpMRI), and hepatic stiffness with magnetic resonance elastography (MRE). Amino acids and acylcarnitines were measured with mass spectrometry. Statistical analyses included paired Student’s t-test, Wilcoxon-signed rank test, and Pearson’s correlation.
Results:
Eight participants provided complete data. At baseline, all had hepatic steatosis (BMI 39.3 ± 5.6 kg/m2, PDFF ≥ 5%). Post-surgery reductions in PDFF (from 12.4 ± 6.7% to 6.2 ± 2.8%, p = 0.013) and cT1 (from 823.3 ± 85.4ms to 757.5 ± 41.6ms, p = 0.039) were significant, along with the GSG index (from 0.272 ± 0.03 to 0.157 ± 0.05, p = 0.001).
Conclusion
The GSG index can potentially be developed as a marker for monitoring the response of patients with NAFLD to bariatric surgery.
Non-alcoholic Fatty Liver Disease
;
Amino Acids
;
Metabolomics
8.Impact of Electronic Prescription System Modification for Appropriate Blood Component Utilization
Soo Eung PARK ; Jin Kyung LEE ; Young Jun HONG ; Ae-Chin OH ; Heyjin KIM
Korean Journal of Blood Transfusion 2024;35(3):178-186
Background:
Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components.
Methods:
The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification.
Results:
This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001).
Conclusion
Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.
9.Impact of Electronic Prescription System Modification for Appropriate Blood Component Utilization
Soo Eung PARK ; Jin Kyung LEE ; Young Jun HONG ; Ae-Chin OH ; Heyjin KIM
Korean Journal of Blood Transfusion 2024;35(3):178-186
Background:
Transfusion reactions are major considerations in transfusions. Appropriate transfusion practices are essential to minimize the risk of transfusion reactions, such as using irradiated and leukoreduced blood components for indicated patients. This study examined the effectiveness of an electronic prescription system modification in promoting the appropriate use of these blood components.
Methods:
The blood component prescription data from seven years (Jan 2016∼Dec 2022) were analyzed retrospectively. The proportion of irradiated units was calculated for each half-year. Each transfusion was categorized by cancer diagnosis, blood component type, and visit type. Statistical comparisons were performed to assess the changes in the use of irradiated blood units and leukoreduced red cell components before and after the system modification.
Results:
This study analyzed 33,701 blood component prescriptions. The average number of irradiated units per prescription increased significantly from 0.21 to 0.77 after system modification. All patient groups, excluding transfusion in the operating room, showed a significant increase in irradiated unit use (P≤0.001). In addition, the percentage of leukoreduced red cell components increased significantly after the intervention (P<0.001).
Conclusion
Modification of the electronic prescription system was effective in promoting the appropriate use of irradiated blood components among clinicians. This intervention can reduce transfusion reactions and improve patient outcomes by ensuring the correct selection of blood components for the indicated patients.
10.The Usefulness of 18 F-FDG PET to Differentiate Subtypes of Dementia:The Systematic Review and Meta-Analysis
Seunghee NA ; Dong Woo KANG ; Geon Ha KIM ; Ko Woon KIM ; Yeshin KIM ; Hee-Jin KIM ; Kee Hyung PARK ; Young Ho PARK ; Gihwan BYEON ; Jeewon SUH ; Joon Hyun SHIN ; YongSoo SHIM ; YoungSoon YANG ; Yoo Hyun UM ; Seong-il OH ; Sheng-Min WANG ; Bora YOON ; Hai-Jeon YOON ; Sun Min LEE ; Juyoun LEE ; Jin San LEE ; Hak Young RHEE ; Jae-Sung LIM ; Young Hee JUNG ; Juhee CHIN ; Yun Jeong HONG ; Hyemin JANG ; Hongyoon CHOI ; Miyoung CHOI ; Jae-Won JANG ; On behalf of Korean Dementia Association
Dementia and Neurocognitive Disorders 2024;23(1):54-66
Background:
and Purpose: Dementia subtypes, including Alzheimer’s dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18 F-Fluorodeoxyglucose Positron Emission Tomography ( 18 F-FDG PET) in differentiating these subtypes for precise treatment and management.
Methods:
A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18 F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the goldstandard clinical diagnosis for dementia subtypes.
Results:
From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88–0.98) and specificity was 0.84 (95% CI, 0.70–0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70–0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80–0.91) and the specificity was 0.88 (95% CI, 0.80–0.91). The studies mostly used case-control designs with visual and quantitative assessments.
Conclusions
18 F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.


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