연령 연관 기억 손상의 역학

연병길(Byeong Kil Yeon),류성곤(Seong Gon Ryu) 대한노인정신의학회 2001 노인정신의학 Vol.5 No.1

It has been widely known that the elderly suffer very mild cognitive impairment including memory function that cannot satisfy the criteria of dementia. Koivisti and Hannien et al reported that the prevalences of age-associated memory impairment and age-associated cognitive decline were 38.6% and 26.6%, respectively. The prevalence rate of male was more than that of female and the prevalence rate was increased in younger elderly. The risk factors of age-related cognitive decline were age and myocardiac infarction whereas education and smoking decreased the risk of age-related cognitive decline. The small portion of age-associated memory impairment progressed toward dementia but the most of them were nonprogressive. The probability of progression toward dementia could be predicted by detailed neurocognitive function test. The further epidemiologic studies will reveal the nature of age-associated memory impairment.

정상 노인 및 노인 치매 환자와 우울증 환자의 삶의 질 비교

연병길(Byeong Kil Yeon),서국희(Guk Hee Suh),류성곤(Seong Gon Ryu),임종우(Jong-Woo Lim),방현숙(Hyeon Soog Bang),신지용(Jee Yong Shin),한창환(Chang Hwan Han) 대한노인정신의학회 1999 노인정신의학 Vol.3 No.2

The elderly people are often afflicted with chronic illnesses of which depression and dementia comprise substantial proportion. The authors tried to figure out the impact of depression and dementia on the quality of life of elderly. 1,300 community residents over 65 years of age were selected by random sampling. Using Geriatric Mental State-Automated Geriatric Examination for Computer Assisted Taxonomy, the authors selected 3 groups of subjects, namely dementia group (N=113), depression group (N=157), normal control group (N=289). The 3 groups of subjects were examined with General Health Questionnaire 12-Quality of Life, Geriatric Depression Scale, Mini-Mental State Exam-K, and Physical Self-Maintenance Scale. The results were compared between groups and the correlations of each scales were examined. The quality of life was lower in the older, female, lower educational groups. The quality of life was significantly lower in dementia group and depression group than in normal elderly group. The subjective quality of life of depressed elderly got lower with increasing severity of depression. Demented elderly had low quality of life but no correlation was found between subjective quality of life and severity of depression. The score of Mini-Mental State Exam-K was found to have significant correlation with the quality of life in demented group. The quality of life of normal elderly and those with dementia had significant correlation with Physical Self-Maintenance Scale. Conclusively, the quality of life was decreased in both normal elderly group and dementia group. The severity of depressive symptoms were correlated with the decrease of quality of life in depression group, whereas the degree of cognitive impairment had significant correlation with quality of life in dementia group. Therefore, the subjective quality of life must be considered in the treatment of the depression and dementia, and further study about the relation between psychopathology and the various aspects of living and the quality of life in the elderly is needed.

노인의 신경인지기능검사

연병길(Byeong Kil Yeon) 대한노인정신의학회 1998 노인정신의학 Vol.2 No.2

The decline of cognitive functions uses to follow the increase in incidence of various organic mental disorders and systemic diseases, and administration of drugs with increasing age. The assessments of cognitive functions are needed to discriminate normal aging from other cognitive disorders and to differentiate the organic mental disorders. We have to be cautious to interpret the test results of elderly patients who are easily fatigue and frequently have sensory disturbances. There are two basic approaches to assess cognitive function of the elderly patients. One is to use standardized test batteries and another is to use several tests that are relevant to diagnostic purposes. Many assessment tools of cognitive functions have been developed and used clinically but there are a few available standardized test in Korea. It is eagerly needed to develope standardized tests that are pertinent our culture.

국가정신보건전달체계내 치매의 위상

연병길(Byeong Kil Yeon),류성곤(Sung-Gon Ryu) 대한사회정신의학회 2001 사회정신의학 Vol.6 No.1

우리나라도 고령화 사회에 접어들면서 치매가 사회적 문제로 제기되고 있다. 그동안에서 연구된 여러 역학조사를 종합하면 치매의 유병율은 노인 인구의 8.3%로 279천명의 치매 노인이 있다고 추계된다. 정부는 1996년 치매 노인 10년 대책을 발표한 이후 치매전문요양병원, 노인전문요양시설, 재가 노인복지시설. 재가노인복지시설 등을 확충하고자 노력해 왔다. 그러나 아직도 이러한 시설들이 치매 노인의 수에 비하여 매우 부족하며 주로 생활보호대상자를 대상으로 하고 있다. 정부의 치매에 대한 정책은 시설 위주로 치매 환자를 위한 효과적인 프로그램 개발은 이루어지지 못하고 있다. 또한 치매 환자를 등록하고 종합관리하며 치매 관련 기관을 유기적으로 연결시켜 치료 전달 시스템을 확립할 수 있는 중심기관의 필요하다. 그리고 치매 전문인력의 양성과 의료보험제도의 개선이 치매 환자의 효과적인 치료를 위하여 반드시 필요하다. Dementia is raising many social issues as Korean society becomes aging society. According to epidemiological studies the prevalence of dementia is 8.3% of the aged population and it is calculated that 279,000 of elderly suffers from dementia at present. Since announced“10 year-policy toward dementia”, Korean government has tried to increase the number of special care facilities for dementic patient, special facilities for elderly and facilities providing at-home welfare services . But these facilities are insufficient for dementic patients and centered to the indigent elderly. Still it has not been developed efficient and effective programs for dementic patients. It is suggested that a new national institution has to be established to register and manage dementic patients, to establish health care delivery system organizing special facilities for dementia patients. It is also presented the necessities of training experts for dementia patients and the improvement of insurance system.

노인 자살의 조기 발견과 예방

연병길(Byeong Kil Yeon),류성곤(Seong Gon Ryu) 대한노인정신의학회 2001 노인정신의학 Vol.5 No.2

Older persons are at higher risk for suicide than any other age groups and elderly suicide is a critical public health problem. Attempted suicide in elderly is very lethal, therefor it's management must be accompanied by prevention. Though, there are few reports about risk factors in elderly suicide, and significant differences in the data between western and eastern world. So, there should be researches about risk factors influenced by peculiar cultural and re-gional circumstances, and these make it possible to detect elderly suicide early by education and community efforts.

한국의 물의 상징성에 관한 소고 - 치료적 기능을 중심으로 -

연병길(Byeong Kil Yeon) 한국분석심리학회 1990 心性硏究 Vol.5 No.1

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치매환자가족의 지지프로그램 효과 평가

연병길 ( Byeong Kil Yeon ),윤선경 ( Seonkyung Yun ),윤혜진 ( Hyejin Yoon ) 한국장기요양학회 2019 장기요양연구 Vol.7 No.2

본 연구는 치매환자 가족의 부양스트레스를 경감시키기 위한 가족지원 프로그램인 ‘휴식공간’과 ‘Savvy 돌봄제공자 프로그램(Savvy Caregiver Program: SCP)’을 적용하여 효과를 비교하고자 수행하였다. I 지역에 거주하며 치매환자를 직접 돌보고 있는 가족조호자 86명을 모집하였으나 평가 미시행, 중도 탈락 등의 이유로 61명이 프로그램을 완료하였다. 본 센터에서 개발한 ‘휴식공간’과 미국의 조호자 프로그램인 ‘SCP’는 주 1회 2시간 씩, 총 8주간 시행했으며 프로그램의 효과성을 검증하기 위해 부양부담(Burden Interview), 우울감(CES-D), 삶의 질(EQ-5D), 사회적지지(MOS), 회복력(BRS), 자기효능감(CSE)을 측정하였다. 중재제공 결과 ‘휴식공간’ 프로그램에 참여한 집단은 부양부담과 우울감이 유의하게 감소하였고, ‘SCP’에 참여한 집단은 회복력이 유의하게 향상되었다. 또한 두 집단 간 중재방법에 따른 효과 차이를 비교한 결과, ‘휴식공간’ 프로그램에 참여한 집단이 ‘SCP’에 참여한 집단보다 우울감(CES-D)이 유의하게 감소하였다. 본 연구결과에 따라 국내에서 개발된 치매환자 가족지원 프로그램 운영 시 가족조호자의 부양부담과 우울감 감소뿐만 아니라 삶의 질, 회복력, 자기효능감 등을 향상시키기 위해 ‘휴식공간’ 프로그램 매뉴얼을 개정할 필요가 있으며, 추후 개정된 프로그램을 확대 운영하고 효과를 재확인할 필요가 있다. The purpose of this study was to compare the effects of 'Hyu-Sig-Gong-Gan' and 'Savvy Caregiver Program(SCP)', which are family support program to reduce the stress of family caregivers of the elderly with dementia. We recruited 86 family caregivers who lived in Inchoen and were taking care of the elderly with dementia, but 61 participants completed the program. 'Hyu-Sig-Gong-Gan' program was developed by the research team and the 'SCP' was developed in USA. Two programs were conducted once a week for two hours, for total a eight weeks. To evaluate the effects of the program, the caregiving burden, depression, quality of life, social support, resilience, and self-efficacy were measured. As the result of the intervention, the group who participated in the 'Hyu-Sig-Gong-Gan' had significantly reduced caregiving burden and depression and the group who participated in the 'SCP' significantly improved resilience. In addition, the group who participated in the 'Hyu-Sig-Gong-Gan' had significantly lower depression than group who participated in the 'SCP'. Therefore, it is necessary to revise the 'Huy-Sig-Gong-Gan' program to improve the quality of life, resilience, and self-efficacy as well as to reduce the caregiving burden and depressive symptoms. In future, there is a need to expand the revised program and reconfirm its effectiveness.

기억력과 정신질환

홍경수,연병길,Hong, Kyung Sue,Yeon, Byeong Kil 대한생물정신의학회 1997 생물정신의학 Vol.4 No.1

Disturbances in memory are the most common problem in patients with an organic mental syndrome. Other patients with significant psychiatric disorders also often have difficulty with memory. So it is very important in the clinical practice of psychiatry to understand the biological and neurocognitive mechanisms of memory proessing, and to develop the assessment tools with which memory function can be evaluated reliably and validly. Moreover, memory researches provide an important viewpoint from which we can understand the pathophysiological mechanisms of major neuropsychiatric illnesses. This article focuses on our understanding of memory functions in clinical and neurobiological aspects. The relevant material will be presented in four parts : 1) terminologies needed in defining major stages of various types of memory processing : 2) neurochemical and neuroanatomical basis of memory processing : 3) brief bed-side screening tests and more comprehensive neuropsychological tests for the evaluation of memory function : 4) the characteristics of memory dysfunction in several major psychiatric illnesses.

양성 및 음성 정신분열병 환자의 언어성 및 시각적 기억력에 관한 연구

우병탁(Byeong Tak Woo),연병길(Byeong Kil Yeon),한창환(Chang Hwan Han),신지용(Jee Yong Shin) 한국정신병리진단분류학회 1998 精神病理學 Vol.7 No.1

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노인요양보장제도의 요양 대상 평가 도구의 타당도에 관한 연구

홍나래(Na Rei Hong),연병길(Byeong Kil Yeon),김현철(Hyun Cheol Kim),류성곤(Sung Gon Ryu),정갑희(Gab Hee Chung),한창환(Chang Hwan Han) 대한노인정신의학회 2005 노인정신의학 Vol.9 No.2

Objectives : For the further development of the Korean Long-Term Care System, we analyzed the validity of the assessment tools of cognitive impairment and behavioral problems for the Korean Long-Term Care System. Methods : We investigated 326 elderly people who were residing in Onyang 4-dong and Dogo-myun, Asan-si, Chungcheongnamdo. Our research team visited their residence and performed the assessment tools for the Korean Long-Term Care System and Korean version of the Mini-Mental State Examination (MMSE-K), Neuropsychiatric Inventory-Questionnaire (NPI-Q) and Seoul-Instrumental Activities of Daily Living (S-IADL). Results : The correlation between the cognitive function tests and MMSE-K (r=0.579, p<0.001) and that between the behavioral problem tests and NPI-Q (r=0.688, p<0.001) were not as good as we expected. Moreover, if the items of the behavioral problem tests were decreased to 10 items as the government wanted, we got much lower correlation coefficiency. The cognitive function tests could not detect early cognitive deterioration in dementia. Conclusion : The assessment tools of cognitive impairment and behavioral problems for the Korean Long-Term Care System need modifications to promote validity.