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.

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.

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.

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.

Background: and Purpose: We aimed to develop the diagnostic matrix of the Seoul Cognitive Status Test (SCST) and compare its performance with traditional paper-and-pencil neuropsychological tests, including the Seoul Neuropsychological Screening Battery-II (SNSB-II) and the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K). Methods: We recruited 197 participants from the head-to-head SCST-SNSB cohort, and 204 participants from the head-to-head SCST-CERAD cohort. They underwent either SNSB-II or CERAD-K, in addition to SCST. The diagnostic matrix was developed by combining cognitive function, determined by neuropsychological tests, and activities of daily living (ADL), determined by Instrumental-ADL scales. Results: The diagnostic agreement between the SCST and the SNSB-II was 83.9% (weighted kappa=0.87). The agreement between the SCST and the CERAD-K was 84.3% (weighted kappa=0.88). In the SCST-SNSB cohort, all differences in SCST scores between the cognitively unimpaired (CU), mild cognitive impairment (MCI), and dementia diagnosed with the SNSB-II were significant in all cognitive domains (all p<0.01), except for the executive domain between CU and MCI (p=0.145). In the SCST-CERAD cohort, all differences in SCST scores between the 3 groups diagnosed with the CERAD-K were significant in all cognitive domains (all p<0.01), except for the language and visuospatial domains between MCI and dementia (p=0.169 and p=0.778, respectively). Conclusions Our findings suggest that the tablet-based SCST may be another option to traditional paper-and-pencil neuropsychological tests, especially in situations where time and space are relatively limited, and neuropsychological testing specialists are not available.

Background: and Purpose Episodic ataxia type 2 (EA2) is characterized by recurrent vertigo and ataxia due to mutations in CACNA1A that encodes the α 1A-subunit of the P/Q-type voltage-gated calcium channel. This study aimed to determine intellectual function in EA2. Methods: During 2019–2023, 13 patients (6 males, age range=10–52 years, median age=29 years) with a genetically confirmed diagnosis of EA2 had their intellectual function evaluated using the Korean versions of the Wechsler Intelligence Scales (version IV) for adults or children in 3 referral-based university hospitals in South Korea. Results: The full-scale intelligence quotients (FSIQs) among the 13 patients were below the average (90–109) in 11, low average (80–89) in 5 (38.5%), borderline (70–79) in 1 (7.7%), and indicated intellectual disability (≤69) in 5 (38.5%). These patterns of cognitive impairments were observed in all four of the following subtests: verbal comprehension, perceptual reasoning, working memory, and processing speed. The FSIQ was not correlated with the ages at onset for vertigo and ataxia (Pearson correlation: p=0.40). Conclusions Patients with EA2 may have hidden intellectual disabilities even without a history of epilepsy or administration of antiepileptic drugs, and should be considered for genetic counseling and therapeutic interventions. Given the availability of medication to control episodic vertigo and ataxia, early diagnosis and management are important in preventing irreversible brain dysfunction in EA2.

Background: and Purpose: We aimed to develop the diagnostic matrix of the Seoul Cognitive Status Test (SCST) and compare its performance with traditional paper-and-pencil neuropsychological tests, including the Seoul Neuropsychological Screening Battery-II (SNSB-II) and the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K). Methods: We recruited 197 participants from the head-to-head SCST-SNSB cohort, and 204 participants from the head-to-head SCST-CERAD cohort. They underwent either SNSB-II or CERAD-K, in addition to SCST. The diagnostic matrix was developed by combining cognitive function, determined by neuropsychological tests, and activities of daily living (ADL), determined by Instrumental-ADL scales. Results: The diagnostic agreement between the SCST and the SNSB-II was 83.9% (weighted kappa=0.87). The agreement between the SCST and the CERAD-K was 84.3% (weighted kappa=0.88). In the SCST-SNSB cohort, all differences in SCST scores between the cognitively unimpaired (CU), mild cognitive impairment (MCI), and dementia diagnosed with the SNSB-II were significant in all cognitive domains (all p<0.01), except for the executive domain between CU and MCI (p=0.145). In the SCST-CERAD cohort, all differences in SCST scores between the 3 groups diagnosed with the CERAD-K were significant in all cognitive domains (all p<0.01), except for the language and visuospatial domains between MCI and dementia (p=0.169 and p=0.778, respectively). Conclusions Our findings suggest that the tablet-based SCST may be another option to traditional paper-and-pencil neuropsychological tests, especially in situations where time and space are relatively limited, and neuropsychological testing specialists are not available.

Background: and Purpose: We aimed to develop the diagnostic matrix of the Seoul Cognitive Status Test (SCST) and compare its performance with traditional paper-and-pencil neuropsychological tests, including the Seoul Neuropsychological Screening Battery-II (SNSB-II) and the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K). Methods: We recruited 197 participants from the head-to-head SCST-SNSB cohort, and 204 participants from the head-to-head SCST-CERAD cohort. They underwent either SNSB-II or CERAD-K, in addition to SCST. The diagnostic matrix was developed by combining cognitive function, determined by neuropsychological tests, and activities of daily living (ADL), determined by Instrumental-ADL scales. Results: The diagnostic agreement between the SCST and the SNSB-II was 83.9% (weighted kappa=0.87). The agreement between the SCST and the CERAD-K was 84.3% (weighted kappa=0.88). In the SCST-SNSB cohort, all differences in SCST scores between the cognitively unimpaired (CU), mild cognitive impairment (MCI), and dementia diagnosed with the SNSB-II were significant in all cognitive domains (all p<0.01), except for the executive domain between CU and MCI (p=0.145). In the SCST-CERAD cohort, all differences in SCST scores between the 3 groups diagnosed with the CERAD-K were significant in all cognitive domains (all p<0.01), except for the language and visuospatial domains between MCI and dementia (p=0.169 and p=0.778, respectively). Conclusions Our findings suggest that the tablet-based SCST may be another option to traditional paper-and-pencil neuropsychological tests, especially in situations where time and space are relatively limited, and neuropsychological testing specialists are not available.

Background: and Purpose Episodic ataxia type 2 (EA2) is characterized by recurrent vertigo and ataxia due to mutations in CACNA1A that encodes the α 1A-subunit of the P/Q-type voltage-gated calcium channel. This study aimed to determine intellectual function in EA2. Methods: During 2019–2023, 13 patients (6 males, age range=10–52 years, median age=29 years) with a genetically confirmed diagnosis of EA2 had their intellectual function evaluated using the Korean versions of the Wechsler Intelligence Scales (version IV) for adults or children in 3 referral-based university hospitals in South Korea. Results: The full-scale intelligence quotients (FSIQs) among the 13 patients were below the average (90–109) in 11, low average (80–89) in 5 (38.5%), borderline (70–79) in 1 (7.7%), and indicated intellectual disability (≤69) in 5 (38.5%). These patterns of cognitive impairments were observed in all four of the following subtests: verbal comprehension, perceptual reasoning, working memory, and processing speed. The FSIQ was not correlated with the ages at onset for vertigo and ataxia (Pearson correlation: p=0.40). Conclusions Patients with EA2 may have hidden intellectual disabilities even without a history of epilepsy or administration of antiepileptic drugs, and should be considered for genetic counseling and therapeutic interventions. Given the availability of medication to control episodic vertigo and ataxia, early diagnosis and management are important in preventing irreversible brain dysfunction in EA2.

Background: and Purpose: We aimed to develop the diagnostic matrix of the Seoul Cognitive Status Test (SCST) and compare its performance with traditional paper-and-pencil neuropsychological tests, including the Seoul Neuropsychological Screening Battery-II (SNSB-II) and the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K). Methods: We recruited 197 participants from the head-to-head SCST-SNSB cohort, and 204 participants from the head-to-head SCST-CERAD cohort. They underwent either SNSB-II or CERAD-K, in addition to SCST. The diagnostic matrix was developed by combining cognitive function, determined by neuropsychological tests, and activities of daily living (ADL), determined by Instrumental-ADL scales. Results: The diagnostic agreement between the SCST and the SNSB-II was 83.9% (weighted kappa=0.87). The agreement between the SCST and the CERAD-K was 84.3% (weighted kappa=0.88). In the SCST-SNSB cohort, all differences in SCST scores between the cognitively unimpaired (CU), mild cognitive impairment (MCI), and dementia diagnosed with the SNSB-II were significant in all cognitive domains (all p<0.01), except for the executive domain between CU and MCI (p=0.145). In the SCST-CERAD cohort, all differences in SCST scores between the 3 groups diagnosed with the CERAD-K were significant in all cognitive domains (all p<0.01), except for the language and visuospatial domains between MCI and dementia (p=0.169 and p=0.778, respectively). Conclusions Our findings suggest that the tablet-based SCST may be another option to traditional paper-and-pencil neuropsychological tests, especially in situations where time and space are relatively limited, and neuropsychological testing specialists are not available.