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.The Effects of Generalized Anxiety Disorder 7-Item Scale on Health Behavior among Korean Adults: The 8th Korea National Health and Nutrition Examination Survey (2021)
Ahrang CHO ; Yoo Jin UM ; Jung Jin CHO ; Yo Hwan YEO ; Hwa Nee SUH
Korean Journal of Family Practice 2024;14(2):75-81
Background:
Anxiety disorder is one of the most common mental illnesses in primary care. It is associated with increased reliance on medical care, comorbidities, and poor quality of life. This study is intended to evaluate the relationship between scores on the Generalized Anxiety Disorder 7-item (GAD-7) scale and adult health behavior based on the 2021 Korea National Health and Nutrition Examination Survey (KNHANES 2021).
Methods:
The study selected 5,191 Korean adults, who completed the survey and evaluation according to KNHANES 2021. To determine the effect of the GAD-7 scale on outpatient visits, underweight, obesity, smoking, drinking, and physical activity, a multiple logistic regression analysis was performed. Additionally, subgroup analysis was performed by dividing the sexes.
Results:
Among the study subjects, people in the mild, moderate, and severe anxiety groups numbered 560, 141, and 95, respectively. The odds ratio (OR) of the probability of outpatient visits within two weeks increased (mild: OR, 1.79; 95% confidence intervals [CI], 1.46–2.19; moderate: OR, 1.78; 95% CI, 1.16–2.74; severe: OR, 1.76; 95% CI, 1.09–2.85) compared to the normal group. The risk of smoking and drinking increased in the moderate group (OR, 2.10; 95% CI, 1.24–3.58; OR, 1.70; 95% CI, 1.15–2.52). In the subgroup analysis, the probability of outpatient visits increased among both sexes, and the risk of smoking increased among females.
Conclusion
Among Korean adults, the probability of outpatient visits and the risk of smoking and drinking increased in the anxiety group compared to the normal group.
6.Association between Handgrip Strength, Obstructive Sleep Apnea (STOP-bang score), and Lung Function in Adults Aged over 40 Years: The 8th Korea National Health and Nutrition Examination Survey (2019)
Hwa Nee SUH ; Yo Hwan YEO ; Jung Jin CHO ; Yoo Jin UM ; Ahrang CHO
Korean Journal of Family Practice 2024;14(2):82-89
Background:
Decreased handgrip strength (HGS) reflects overall muscle mass reduction, which can reduce respiratory muscle strength and impair lung function. Obstructive sleep apnea (OSA) has also been reported to cause muscle catabolism and lung damage. This study aimed to investigate the relationship between HGS and lung function by exploring the effect modifiers, including OSA.
Methods:
Data from the 8th Korea National Health and Nutrition Examination Survey was used in this study. A total of 3,207 adults aged >40 years were included. The association between HGS and lung function was determined using correlation analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using complex sample logistic regression analysis to determine the association between lung function (restrictive or obstructive pattern) according to HGS groups stratified by sex and OSA risk.
Results:
In total, 1,264 males and 1,479 females had normal HGS. In males, the low HGS group had lower forced vital capacity (FVC, L), FVC (%, predicted), forced exploratory volume in one second (FEV 1), FEV 1 (%, predicted), and FEV 1/FVC, than the normal HGS group. The risk of having restrictive pattern of lung function was higher in males with low HGS (adjusted OR, 2.77; 95% CI, 1.22–6.30). The association between low HGS and decreased lung function was stronger in males (P interaction of sex: 0.022 for obstructive pattern and 0.008 for restrictive pattern). However, there was no significant effect modification by OSA risk.
Conclusion
Males with a low HGS showed a higher risk of restrictive pattern of decreased pulmonary function.
7.The Effects of Generalized Anxiety Disorder 7-Item Scale on Health Behavior among Korean Adults: The 8th Korea National Health and Nutrition Examination Survey (2021)
Ahrang CHO ; Yoo Jin UM ; Jung Jin CHO ; Yo Hwan YEO ; Hwa Nee SUH
Korean Journal of Family Practice 2024;14(2):75-81
Background:
Anxiety disorder is one of the most common mental illnesses in primary care. It is associated with increased reliance on medical care, comorbidities, and poor quality of life. This study is intended to evaluate the relationship between scores on the Generalized Anxiety Disorder 7-item (GAD-7) scale and adult health behavior based on the 2021 Korea National Health and Nutrition Examination Survey (KNHANES 2021).
Methods:
The study selected 5,191 Korean adults, who completed the survey and evaluation according to KNHANES 2021. To determine the effect of the GAD-7 scale on outpatient visits, underweight, obesity, smoking, drinking, and physical activity, a multiple logistic regression analysis was performed. Additionally, subgroup analysis was performed by dividing the sexes.
Results:
Among the study subjects, people in the mild, moderate, and severe anxiety groups numbered 560, 141, and 95, respectively. The odds ratio (OR) of the probability of outpatient visits within two weeks increased (mild: OR, 1.79; 95% confidence intervals [CI], 1.46–2.19; moderate: OR, 1.78; 95% CI, 1.16–2.74; severe: OR, 1.76; 95% CI, 1.09–2.85) compared to the normal group. The risk of smoking and drinking increased in the moderate group (OR, 2.10; 95% CI, 1.24–3.58; OR, 1.70; 95% CI, 1.15–2.52). In the subgroup analysis, the probability of outpatient visits increased among both sexes, and the risk of smoking increased among females.
Conclusion
Among Korean adults, the probability of outpatient visits and the risk of smoking and drinking increased in the anxiety group compared to the normal group.
8.Association between Handgrip Strength, Obstructive Sleep Apnea (STOP-bang score), and Lung Function in Adults Aged over 40 Years: The 8th Korea National Health and Nutrition Examination Survey (2019)
Hwa Nee SUH ; Yo Hwan YEO ; Jung Jin CHO ; Yoo Jin UM ; Ahrang CHO
Korean Journal of Family Practice 2024;14(2):82-89
Background:
Decreased handgrip strength (HGS) reflects overall muscle mass reduction, which can reduce respiratory muscle strength and impair lung function. Obstructive sleep apnea (OSA) has also been reported to cause muscle catabolism and lung damage. This study aimed to investigate the relationship between HGS and lung function by exploring the effect modifiers, including OSA.
Methods:
Data from the 8th Korea National Health and Nutrition Examination Survey was used in this study. A total of 3,207 adults aged >40 years were included. The association between HGS and lung function was determined using correlation analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using complex sample logistic regression analysis to determine the association between lung function (restrictive or obstructive pattern) according to HGS groups stratified by sex and OSA risk.
Results:
In total, 1,264 males and 1,479 females had normal HGS. In males, the low HGS group had lower forced vital capacity (FVC, L), FVC (%, predicted), forced exploratory volume in one second (FEV 1), FEV 1 (%, predicted), and FEV 1/FVC, than the normal HGS group. The risk of having restrictive pattern of lung function was higher in males with low HGS (adjusted OR, 2.77; 95% CI, 1.22–6.30). The association between low HGS and decreased lung function was stronger in males (P interaction of sex: 0.022 for obstructive pattern and 0.008 for restrictive pattern). However, there was no significant effect modification by OSA risk.
Conclusion
Males with a low HGS showed a higher risk of restrictive pattern of decreased pulmonary function.
9.The Effects of Generalized Anxiety Disorder 7-Item Scale on Health Behavior among Korean Adults: The 8th Korea National Health and Nutrition Examination Survey (2021)
Ahrang CHO ; Yoo Jin UM ; Jung Jin CHO ; Yo Hwan YEO ; Hwa Nee SUH
Korean Journal of Family Practice 2024;14(2):75-81
Background:
Anxiety disorder is one of the most common mental illnesses in primary care. It is associated with increased reliance on medical care, comorbidities, and poor quality of life. This study is intended to evaluate the relationship between scores on the Generalized Anxiety Disorder 7-item (GAD-7) scale and adult health behavior based on the 2021 Korea National Health and Nutrition Examination Survey (KNHANES 2021).
Methods:
The study selected 5,191 Korean adults, who completed the survey and evaluation according to KNHANES 2021. To determine the effect of the GAD-7 scale on outpatient visits, underweight, obesity, smoking, drinking, and physical activity, a multiple logistic regression analysis was performed. Additionally, subgroup analysis was performed by dividing the sexes.
Results:
Among the study subjects, people in the mild, moderate, and severe anxiety groups numbered 560, 141, and 95, respectively. The odds ratio (OR) of the probability of outpatient visits within two weeks increased (mild: OR, 1.79; 95% confidence intervals [CI], 1.46–2.19; moderate: OR, 1.78; 95% CI, 1.16–2.74; severe: OR, 1.76; 95% CI, 1.09–2.85) compared to the normal group. The risk of smoking and drinking increased in the moderate group (OR, 2.10; 95% CI, 1.24–3.58; OR, 1.70; 95% CI, 1.15–2.52). In the subgroup analysis, the probability of outpatient visits increased among both sexes, and the risk of smoking increased among females.
Conclusion
Among Korean adults, the probability of outpatient visits and the risk of smoking and drinking increased in the anxiety group compared to the normal group.
10.Association between Handgrip Strength, Obstructive Sleep Apnea (STOP-bang score), and Lung Function in Adults Aged over 40 Years: The 8th Korea National Health and Nutrition Examination Survey (2019)
Hwa Nee SUH ; Yo Hwan YEO ; Jung Jin CHO ; Yoo Jin UM ; Ahrang CHO
Korean Journal of Family Practice 2024;14(2):82-89
Background:
Decreased handgrip strength (HGS) reflects overall muscle mass reduction, which can reduce respiratory muscle strength and impair lung function. Obstructive sleep apnea (OSA) has also been reported to cause muscle catabolism and lung damage. This study aimed to investigate the relationship between HGS and lung function by exploring the effect modifiers, including OSA.
Methods:
Data from the 8th Korea National Health and Nutrition Examination Survey was used in this study. A total of 3,207 adults aged >40 years were included. The association between HGS and lung function was determined using correlation analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using complex sample logistic regression analysis to determine the association between lung function (restrictive or obstructive pattern) according to HGS groups stratified by sex and OSA risk.
Results:
In total, 1,264 males and 1,479 females had normal HGS. In males, the low HGS group had lower forced vital capacity (FVC, L), FVC (%, predicted), forced exploratory volume in one second (FEV 1), FEV 1 (%, predicted), and FEV 1/FVC, than the normal HGS group. The risk of having restrictive pattern of lung function was higher in males with low HGS (adjusted OR, 2.77; 95% CI, 1.22–6.30). The association between low HGS and decreased lung function was stronger in males (P interaction of sex: 0.022 for obstructive pattern and 0.008 for restrictive pattern). However, there was no significant effect modification by OSA risk.
Conclusion
Males with a low HGS showed a higher risk of restrictive pattern of decreased pulmonary function.

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