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.Association between Smoking and Symptoms of Late-Onset Hypogonadism in Korean Men
Seon Su JANG ; Yoon Jeong CHO ; Hana MOON ; Hyun Ji KIM ; Geon Ho LEE ; Yun-A KIM
Korean Journal of Family Practice 2024;14(1):11-18
Background:
Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men.
Methods:
Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels.
Results:
There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups.
Conclusion
These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.
6.Association between Smoking and Symptoms of Late-Onset Hypogonadism in Korean Men
Seon Su JANG ; Yoon Jeong CHO ; Hana MOON ; Hyun Ji KIM ; Geon Ho LEE ; Yun-A KIM
Korean Journal of Family Practice 2024;14(1):11-18
Background:
Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men.
Methods:
Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels.
Results:
There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups.
Conclusion
These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.
7.Lecanemab: Appropriate Use Recommendations by Korean Dementia Association
Kee Hyung PARK ; Geon Ha KIM ; Chi-Hun KIM ; Seong-Ho KOH ; So Young MOON ; Young Ho PARK ; Sang Won SEO ; Bora YOON ; Jae-Sung LIM ; Byeong C. KIM ; Hee-Jin KIM ; Hae Ri NA ; YongSoo SHIM ; YoungSoon YANG ; Chan-Nyoung LEE ; Hak Young RHEE ; San JUNG ; Jee Hyang JEONG ; Hojin CHOI ; Dong Won YANG ; Seong Hye CHOI
Dementia and Neurocognitive Disorders 2024;23(4):165-187
Lecanemab (product name Leqembi ® ) is an anti-amyloid monoclonal antibody treatment approved for use in Korea for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease. The Korean Dementia Association has created recommendations for the appropriate use of lecanemab to assist clinicians. These recommendations include selecting patients for administration, necessary pre-administration tests and preparations,administration methods, monitoring for amyloid related imaging abnormalities (ARIA), and communication with patients and caregivers. Lecanemab is recommended for patients with MCI or mild dementia who confirmed positive amyloid biomarkers, and should not be administered to patients with severe hypersensitivity to lecanemab or those unable to undergo magnetic resonance imaging (MRI) evaluation. To predict the risk of ARIA before administration, apolipoprotein E genotyping is conducted, and regular brain MRI evaluations are recommended to monitor for ARIA during treatment. The most common adverse reactions are infusion-related reactions, which require appropriate management upon occurrence. Additional caution is needed when co-administering with anticoagulants or tissue plasminogen activator due to the risk of macrohemorrhage. Clinicians should consider the efficacy and necessary conditions for administration, as well as the safety of lecanemab, to make a comprehensive decision regarding its use.
8.Lecanemab: Appropriate Use Recommendations by Korean Dementia Association
Kee Hyung PARK ; Geon Ha KIM ; Chi-Hun KIM ; Seong-Ho KOH ; So Young MOON ; Young Ho PARK ; Sang Won SEO ; Bora YOON ; Jae-Sung LIM ; Byeong C. KIM ; Hee-Jin KIM ; Hae Ri NA ; YongSoo SHIM ; YoungSoon YANG ; Chan-Nyoung LEE ; Hak Young RHEE ; San JUNG ; Jee Hyang JEONG ; Hojin CHOI ; Dong Won YANG ; Seong Hye CHOI
Dementia and Neurocognitive Disorders 2024;23(4):165-187
Lecanemab (product name Leqembi ® ) is an anti-amyloid monoclonal antibody treatment approved for use in Korea for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease. The Korean Dementia Association has created recommendations for the appropriate use of lecanemab to assist clinicians. These recommendations include selecting patients for administration, necessary pre-administration tests and preparations,administration methods, monitoring for amyloid related imaging abnormalities (ARIA), and communication with patients and caregivers. Lecanemab is recommended for patients with MCI or mild dementia who confirmed positive amyloid biomarkers, and should not be administered to patients with severe hypersensitivity to lecanemab or those unable to undergo magnetic resonance imaging (MRI) evaluation. To predict the risk of ARIA before administration, apolipoprotein E genotyping is conducted, and regular brain MRI evaluations are recommended to monitor for ARIA during treatment. The most common adverse reactions are infusion-related reactions, which require appropriate management upon occurrence. Additional caution is needed when co-administering with anticoagulants or tissue plasminogen activator due to the risk of macrohemorrhage. Clinicians should consider the efficacy and necessary conditions for administration, as well as the safety of lecanemab, to make a comprehensive decision regarding its use.
9.Lecanemab: Appropriate Use Recommendations by Korean Dementia Association
Kee Hyung PARK ; Geon Ha KIM ; Chi-Hun KIM ; Seong-Ho KOH ; So Young MOON ; Young Ho PARK ; Sang Won SEO ; Bora YOON ; Jae-Sung LIM ; Byeong C. KIM ; Hee-Jin KIM ; Hae Ri NA ; YongSoo SHIM ; YoungSoon YANG ; Chan-Nyoung LEE ; Hak Young RHEE ; San JUNG ; Jee Hyang JEONG ; Hojin CHOI ; Dong Won YANG ; Seong Hye CHOI
Dementia and Neurocognitive Disorders 2024;23(4):165-187
Lecanemab (product name Leqembi ® ) is an anti-amyloid monoclonal antibody treatment approved for use in Korea for patients with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease. The Korean Dementia Association has created recommendations for the appropriate use of lecanemab to assist clinicians. These recommendations include selecting patients for administration, necessary pre-administration tests and preparations,administration methods, monitoring for amyloid related imaging abnormalities (ARIA), and communication with patients and caregivers. Lecanemab is recommended for patients with MCI or mild dementia who confirmed positive amyloid biomarkers, and should not be administered to patients with severe hypersensitivity to lecanemab or those unable to undergo magnetic resonance imaging (MRI) evaluation. To predict the risk of ARIA before administration, apolipoprotein E genotyping is conducted, and regular brain MRI evaluations are recommended to monitor for ARIA during treatment. The most common adverse reactions are infusion-related reactions, which require appropriate management upon occurrence. Additional caution is needed when co-administering with anticoagulants or tissue plasminogen activator due to the risk of macrohemorrhage. Clinicians should consider the efficacy and necessary conditions for administration, as well as the safety of lecanemab, to make a comprehensive decision regarding its use.
10.Association between Smoking and Symptoms of Late-Onset Hypogonadism in Korean Men
Seon Su JANG ; Yoon Jeong CHO ; Hana MOON ; Hyun Ji KIM ; Geon Ho LEE ; Yun-A KIM
Korean Journal of Family Practice 2024;14(1):11-18
Background:
Late-onset hypogonadism (LOH) is associated with reduced testosterone levels and an increase in various physical, mental, and emotional changes in men with age. Several lifestyle factors, including smoking, are reported to be related to LOH; however, very few studies have sufficiently investigated the relationships between smoking and the symptoms of LOH. This study aimed to use the Androgen Deficiency in Aging Males (ADAM) questionnaire to assess the associations between smoking and LOH symptoms in Korean men.
Methods:
Men who underwent medical check-ups and transrectal ultrasonography at a university hospital between January 1, 2018 and March 31, 2021 (n=793) were included in this study. Multiple logistic regression was used to assess the risk of LOH symptoms among non-smokers, exsmokers, and current smokers, with adjustments for age, body mass index, alcohol consumption, and exercise and education levels.
Results:
There were significant correlations between LOH symptoms, as assessed using the ADAM questionnaire, and smoking status. The results of the multivariate logistic regression analysis adjusted for confounding factors indicated that the risk of LOH symptoms was higher in the ex-smokers (odds ratio, 2.446; 95% confidential interval, 1.511–3.962) and current smokers (odds ratio, 6.664; 95% confidential interval, 3.485–12.74) groups.
Conclusion
These results indicate a positive correlation between smoking and LOH symptoms in Korean men. Nevertheless, large-scale studies are required to further validate these findings.

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