Alzheimer's disease (AD) is characterized by decreased neuronal activity and atrophy, while hyperactivity of neurons seems to make them resistant to aging and neurodegeneration, a phenomenon which we have paraphrased as 'use it or lose it'. Our hypothesis proposes that (1) during their functioning, neurons are damaged; (2) accumulation of damage that is not repaired is the basis of aging; (3) the vulnerability to AD is determined by the genetic background and the balance between the amount of damage and the efficiency of repair, and (4) by stimulating the brain, repair mechanisms are stimulated and cognitive reserve is increased, resulting in a decreased rate of aging and risk for AD. Environmental stimulating factors such as bilingualism/multilingualism, education, occupation, musical experience, physical exercise, and leisure activities have been reported to reduce the risk of dementia and decrease the rate of cognitive decline, although methodological problems are present.
Animals ; Brain ; pathology ; physiopathology ; Dementia ; genetics ; pathology ; physiopathology ; prevention & control ; Humans ; Models, Neurological

Korea is becoming an aged society at an alarmingly fast rate, which suggests that dementia care may become a major public health problem in Korea. At this point in time, the new policy of national responsibility for dementia care is a well-timed strategy, but it should be assessed based on a careful consideration of several aspects. We must promote a model of dementia care in which all members of society jointly participate. We need to improve the volunteer system in dementia care, and to make various cultural spaces for patients suffering from dementia and their family members. We need to balance financial resources and benefits in cost-reduction plans for dementia treatment. We should implement a careful quality control system for dementia care and educational programs for public dementia care hospitals and nationwide regional dementia centers. These care systems should also incorporate a health policy aiming at primary prevention to reduce the prevalence of dementia in the future. Improving the new policy of national responsibility for dementia care using detailed analyses and systematic approaches will lead to a successful dementia welfare policy.
Dementia ; Health Policy ; Humans ; Korea ; Prevalence ; Primary Prevention ; Public Health ; Quality Control ; Volunteers

The Ministry of Science and ICT and the Ministry of Health and Welfare of the Republic of Korea have organized the first National Committee for Dementia Research, to which all domestic experts in the field have been invited as they endeavor to achieve ‘national dementia liability’, which is one of the core national agenda items of the current Korean government. To make this initiative sustainable and bring dementia under control, we should not focus only on providing care and economic support to the family of patients with dementia. Instead, a large-scale, long-term research and development (R&D) strategy for dementia prevention, diagnosis, and therapy is warranted. This R&D project comprises several parts: 1) elucidation of the etiology and prevention of dementia, 2) innovative diagnostics for dementia, 3) tailored therapies for dementia, and 4) tangible and effective care for dementia. Given the fact that dementia is a very heterogeneous condition involving multiple pathogenic factors and typically having a chronic disease course, comprehensive and integrated approaches across various disciplines should be explored for primary, secondary, and tertiary prevention of this disease. With the success of this R&D project, the national dementia liability system will gain momentum and come into its own. Integrated efforts in terms of both policyrelated and scientific initiatives would allow us to take a step closer to realizing our shared goal of living in a world of dementia carefree.
Alzheimer Disease ; Chronic Disease ; Dementia ; Diagnosis ; Humans ; Republic of Korea ; Tertiary Prevention

Dementia is one of the biggest global public health challenges facing our generation today. By 2030, Korea is projected to have the highest life expectancy in the world. The government's new plans regarding national responsibility for dementia care are well-timed strategies for patients and family members suffering from dementia and should be welcomed. The newly designed national dementia strategy of Korea may set new standards for dementia welfare policies. However, these plans should be modified after careful consideration of following aspects: financial sustainability, issues related with long-term care systems for other critical diseases, and instantaneous nationwide implementation without a period of trial-and-error learning. More gradual and steady policy initiatives is preferred. Through consensus we should strategically develop the optimal quality control system for dementia care and education program for training physicians, dementia-care professionals, and workers to be deployed in both specialized 72 public dementia care hospitals and nationwide 252 regional dementia centers. In addition, these care plans should also include health policy aiming the primary prevention to reduce future dementia prevalence while creating dementia-friendly communities and emphasizing clinical and basic research for dementia. Modifying the current plans for the Korean national dementia strategy using stepwise, well-integrated, and systematic approaches will lead to successful dementia welfare policy.
Consensus ; Dementia* ; Education ; Health Policy ; Humans ; Korea ; Learning ; Life Expectancy ; Long-Term Care ; Prevalence ; Primary Prevention ; Public Health ; Quality Control

Hypertension is the most important potentially reversible risk factor for stroke in all age groups; high blood pressure (BP) is also associated with increased risk of recurrent stroke in patients who have already had an ischemic or hemorrhagic event. Twenty-four hour ambulatory BP monitoring (ABPM) has become an important tool for improving the diagnosis and management of hypertension, and is increasingly used to assess patients with hypertension. Nevertheless, although ABPM devices are increasingly used for assessment of hypertension, their value in the chronic management of hypertension in patients with stroke has not been systematically studied. In fact, among large-scale randomized trials for secondary stroke prevention, only the Morbidity and Mortality After Stroke, Eprosartan Compared With Nitrendipine for Secondary Prevention trial included 24-hour ABPM. ABPM has demonstrated chronic disruption of the circadian rhythm of BP after acute phase of stroke and has shown higher sensitivity compared to office BP in evaluating the effectiveness of antihypertensive treatment among stroke survivors. High 24-hour BP is an independent predictor for cerebrovascular events, brain microbleeds, and subsequent development of dementia. Nevertheless, although stroke care guidelines endorse the importance of hypertension management, the specific role of ABPM among stroke survivors after the acute phase of disease has not been established. Further studies are needed to clarify whether routine application of ABPM among these patients should be recommended.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Brain ; Circadian Rhythm ; Dementia ; Diagnosis ; Humans ; Hypertension* ; Mortality ; Nitrendipine ; Risk Factors ; Secondary Prevention ; Stroke* ; Survivors

Hypertension is the most important potentially reversible risk factor for stroke in all age groups; high blood pressure (BP) is also associated with increased risk of recurrent stroke in patients who have already had an ischemic or hemorrhagic event. Twenty-four hour ambulatory BP monitoring (ABPM) has become an important tool for improving the diagnosis and management of hypertension, and is increasingly used to assess patients with hypertension. Nevertheless, although ABPM devices are increasingly used for assessment of hypertension, their value in the chronic management of hypertension in patients with stroke has not been systematically studied. In fact, among large-scale randomized trials for secondary stroke prevention, only the Morbidity and Mortality After Stroke, Eprosartan Compared With Nitrendipine for Secondary Prevention trial included 24-hour ABPM. ABPM has demonstrated chronic disruption of the circadian rhythm of BP after acute phase of stroke and has shown higher sensitivity compared to office BP in evaluating the effectiveness of antihypertensive treatment among stroke survivors. High 24-hour BP is an independent predictor for cerebrovascular events, brain microbleeds, and subsequent development of dementia. Nevertheless, although stroke care guidelines endorse the importance of hypertension management, the specific role of ABPM among stroke survivors after the acute phase of disease has not been established. Further studies are needed to clarify whether routine application of ABPM among these patients should be recommended.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Brain ; Circadian Rhythm ; Dementia ; Diagnosis ; Humans ; Hypertension* ; Mortality ; Nitrendipine ; Risk Factors ; Secondary Prevention ; Stroke* ; Survivors

To make clear of the absorbed components of Tianzhusan (TZS) and its possible mechanism in preventing vascular dementia (VD), the rats' models of VD were prepared by a permanent ligation of the bilateral common carotid arteries. After 60 days, rats were administrated with TZS for 0.1 g x kg(-1), and the volume is 0.02 mL x g(-1). After 3 days, the medicated serum was prepared and detected by UPLC, and then we predicted the possible chemical structure of the absorbed components of TZS. According to the absorbed components, the potential targets of TZS were found by ligand profiling of Discovery Studio 3.5. All of these target genes were submitted to DAVID onine for gene set enrichment analysis (GSEA). The 5 absorbed components of TZS have been predicted, and four of them have been identified as parishin B, parishin C, parishin, pennogenin-3-O-alpha-L-rhamnopyranosy-(1-->2)-beta-D-glucoside. Through reverse finding targets, we got 861 pharmacophore models and 9 pathways from KEGG, BIOCARTA after document verification. These results showed that the efficacy mechanism of TZS on VD perhaps were be related with these absorbed components and pathways. If the traditional herbs could be proved effective by efficacy tests, the serum pharmacochemistry, computer-aided drug design, system biology and other technologies can be used in the next experiments, which will be beneficial to fast discovery of material basis and mechanisms of traditional medicine coming form ethnic minorities.
Animals ; Dementia, Vascular ; prevention & control ; Drug Discovery ; Drugs, Chinese Herbal ; therapeutic use ; Gastrodia ; chemistry ; Male ; Medicine, Chinese Traditional ; Rats ; Rats, Sprague-Dawley ; Spectrometry, Mass, Electrospray Ionization ; Trillium ; chemistry

With the rapid aging of the population in Korea, the number of older people with dementia is projected to increase, forecasting an epidemic of dementia. Recent trends in dementia in several western countries, however, depict a gradual decline in prevalence and incidence. This decrease has been attributed to an improvement in education and living environments, engagement in healthy behaviors, and reduction in the prevalence of vascular risk factors. In Korea, however, trends in modifiable risk factors do not favor an optimistic outlook due to the continuous increase in the prevalence of hypertension, diabetes mellitus, and obesity. Given these observations, there is much to be gained through the promotion of healthy lifestyles. Moreover, public health resources need to be directed toward the provision of health promotion and preventive services, control and management of vascular risk factors, and improvement in the standard of living. Nationwide initiatives to develop and implement policies and strategies to protect cognitive health throughout the lifespan should be considered a public health priority.
Cost of Illness ; Dementia/economics/*epidemiology/prevention & control ; Developed Countries ; Diabetes Mellitus/epidemiology ; Health Behavior ; Humans ; Hypertension/epidemiology ; Obesity/epidemiology ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors

Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole or adjunct treatment in mental disorders. This review summarizes studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment. Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups. Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes. Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.
Anxiety Disorders/prevention & control/therapy ; Databases, Factual ; Dementia/prevention & control/therapy ; Eating Disorders/prevention & control/therapy ; *Exercise ; Humans ; Mental Disorders/prevention & control/*therapy ; Mood Disorders/prevention & control/therapy ; Motor Activity ; Obsessive-Compulsive Disorder/prevention & control/therapy ; Schizophrenia/prevention & control/therapy ; Substance-Related Disorders/prevention & control/therapy

PURPOSE: This study was done to examine actor and partner effect of dementia knowledge, self-efficacy and depression on dementia preventive behavior in elderly couples. METHODS: Participants were 115 couples aged 60 years or over who met eligibility criteria. All measures were self-administered. Data were analyzed using SPSS 18.0 and AMOS 18.0 program. RESULTS: Dementia knowledge in elderly couples showed actor and partner effect on dementia preventive behavior. Self-efficacy in the wife did not have direct effects on dementia preventive behavior, but showed indirect effects through dementia knowledge. Self-efficacy in the husband showed direct effects on dementia preventive behavior and indirect effects through dementia knowledge. Wife's depression had direct actor effect on dementia preventive behavior and indirect effect through self-efficacy and dementia knowledge. Husband's depression did not have direct actor effect on dementia preventive behavior, but indirect effect through self-efficacy and dementia knowledge. Effect size of wives' dementia knowledge, self-efficacy and depression on dementia preventive behavior was larger than that of husbands'. Dementia preventive behavior, dementia knowledge and depression had a mutual effect. CONCLUSION: Results indicate that to promote dementia preventive activity in elderly couples, programs should be conducted for both of the couple, but focused differently for wife and husband.
Aged ; Aged, 80 and over ; Dementia/*prevention & control ; *Depression ; Female ; Humans ; Knowledge ; Male ; Middle Aged ; Questionnaires ; *Self Efficacy ; Spouses/*psychology