The Gender- and Age-dependency of the Risk for Alzheimer s Disease Conferred by Apolipoprotein E Polymorphism in Koreans

JinHyeong Jhoo,KiWoong Kim,YoungJu Suh,DongYoung Lee,JongChul Youn,JungHie Lee,JongInn Woo 대한신경정신의학회 2004 PSYCHIATRY INVESTIGATION Vol.1 No.1

Objectives-The aim of this study is to examine the impact of the apolipoprotein E (APOE) polymorphism on the risk of Alzheimer s disease (AD) in Koreans. Materials and Methods-We determined the APOE genotype of 303 probable AD patients and 1,052 non-demented normal controls, and compared their genotypic and allelic frequencies. Then, we determined the odds ratios for AD of the APOE polymorphism in the subjects, stratified by age and gender. Results-The APOE 4 allele was more prevalent in the AD patients than in the controls (P<0.0001). The APOE 4 allele increased the risk of AD in a dose-dependent manner; the odds ratios for AD of the APOE 4-heterozygous and the APOE 4-homozygous subjects were 3.9 (95% CI=2.8-5.3) and 15.6 (95% CI=6.6-36.7), respectively. The APOE 4-conferred AD risk was also dependent on the age and gender of the subjects; the odds ratios for AD were highest in the subjects aged 75-79 years and higher in the women than in the men. Conclusions-The APOE 4 allele is a significant genetic risk factor for AD and confers the AD risk in a dose-, age- and genderdependent manner in Koreans.

A Normative Study of the Disability Assessment for Dementia in Community-Dwelling Elderly Koreans

JinHyeong Jhoo,YeonKyung Chi,HyoJung Choi,JiWon Han,TaeHui Kim,JungJae Lee,SeokBum Lee,JoonHyuk Park,JongChul Youn,JeongLan Kim,SeungHo Ryu,DongYoung Lee,Ki Woong Kim 대한신경정신의학회 2014 PSYCHIATRY INVESTIGATION Vol.11 No.4

Objective-We investigated demographic influences on Korean version of Disability Assessment for Dementia (DAD-K) performance and developed normative data for DAD-K. Methods-The DAD-K was administered to 2362 normal controls (NCs), 296 patients with mild cognitive impairment (MCI) and 293 patients with Alzheimer’s disease (AD). MANOVA and ROC curve analysis were used to compare DAD-K performance and the diagnostic accuracy of DAD-K, respectively. The demographic influence on DAD-K scores was analyzed by multiple linear regression and ANOVA. Normative DAD-K data were calculated using natural logarithmic transformation. Results-All DAD-K scores were significantly different among groups (p<0.001). Post hoc analysis showed that instrumental activities of daily living (IADL), executive function and DAD-K total scores began to decline significantly in the very mild stage of AD, whereas the basic activities of daily living (BADL) scores began to decline in the mild stage of AD. The area under the ROC curve differentiating MCI or AD from NC was 0.737 and that differentiating AD from MCI or NC was 0.911. IADL and planning and organization scores were influenced by age and education and performance and DAD-K total scores were influenced by education. Conclusion-The demographic influences on DAD-K scores are not conspicuous and are mainly limited to the IADL and planning and organization scores. Unitary or minimally stratified norms for a specific population were developed for DAD-K application. Our results suggest that the DAD-K is useful for differentiating NC or MCI from AD but not as powerful for differentiating NC from MCI.

국가 치매조기검진사업

주진형(JinHyeong Jhoo) 대한노인정신의학회 2007 노인정신의학 Vol.11 No.1

The rapid increase of the elderly and dementia patients has motivated psychiatrists and government officials in Korea to participate in dementia research, programs and projects more actively since the nineties. Korean association for geriatric psychiatry and Korean association for dementia were founded in 1994 and the ministry of health and welfare pronounced the 10 year project for dementia in 1995 and the dementia service program at the public health center was established by law in 1997. Several leading groups of psychiatrists have started the dementia registry and service programs with the public health centers based on local communities and their endeavor made the foundation for nationwide projects for early detection of dementia. The pilot project of registry and service for dementia has been performed with the participation of 16 hospitals and 21 public health centers in 2006. And in 2007 nationwide project for early detection of dementia has started with 60 hospitals and 85 public health centers throughout the country. This project might contribute to delay the development and progression of dementia and help to promote the quality of life in dementia patients and their families in Korea.

Dementia Incidence Rate Before and After Implementing the National Responsibility Policy for Dementia Care in Patients With Vascular Risk Factors in Korea

Byeon Gihwan,Kwon Sung Ok,Jhoo JinHyeong,Jang Jae-Won,Kim Yeshin 대한치매학회 2023 Dementia and Neurocognitive Disorders Vol.22 No.2

Background and Purpose: The National Responsibility Policy for Dementia Care was implemented in September 2017 in Korea. This study aimed to compare dementia incidence in Seoul and Gangwon-do before and after the implementation of this policy. Methods: We extracted insurance claim data from the Korean Health Insurance Review and Assessment Service for people diagnosed with diabetes, hypertension, or dyslipidemia for the first time in Seoul and Gangwon-do, Korea. We defined two enrollment groups based on the policy implementation date: 1) January 1, 2015 to December 31, 2016 (Index 1, pre-implementation), and 2) January 1, 2017 to December 31, 2018 (Index 2, post-implementation). Each group was followed up for 1 year from the time of enrollment. Then, we calculated hazard ratios to compare the incidence of dementia between the two groups, and between Seoul and Gangwon-do. Results: In Seoul, the incidence of dementia was significantly lower in Index 2 than in Index 1 (hazard ratio [HR], 0.926; 95% confidence interval [CI], 0.875–0.979). However, the incidence rate did not differ between the 2 groups (HR, 1.113; 95% CI, 0.966–1.281) in Gangwon-do. In Index 1, the incidence of dementia did not differ between Seoul and Gangwon-do (HR, 1.043; 95% CI, 0.941–1.156), but in Index 2, was significantly higher in Gangwon-do than in Seoul (HR, 1.240; 95% CI, 1.109–1.386). Conclusions: After implementing the National Responsibility Policy for Dementia Care, the dementia incidence rate decreased significantly in Seoul, consistent with other studies, but not in Gangwon-do.

Effects of social supports on burden in caregivers of people with dementia

Han, Ji Won,Jeong, Hyeon,Park, Jae Young,Kim, Tae Hui,Lee, Dong Young,Lee, Dong Woo,Ryu, Seung-Ho,Kim, Shin-Kyeom,Yoon, Jong Chul,Jhoo, JinHyeong,Kim, Jeong Lan,Lee, Seok Bum,Lee, Jung Jae,Kwak, Kyung Cambridge University Press 2014 INTERNATIONAL PSYCHOGERIATRICS - Vol.26 No.10

<B>ABSTRACT</B><B>Background:</B><P>Social support programs for dementia caregivers were widely used in order to reduce care burden. We investigated which types of social supports can reduce psychological and non-psychological burdens of dementia caregivers, and explored the mechanism of those social supports.</P><B>Methods:</B><P>We evaluated 731 community-dwelling dementia patients and their caregivers from the National Survey of Dementia Care in South Korea. We investigated the five types of social supports (emotional support, informational support, tangible support, positive social interaction, affectionate support) using the Medical Outcomes Study Social Support Survey in each caregiver. The mechanisms of specific types of social support on psychological/non-psychological burden were examined using path analysis.</P><B>Results:</B><P>Positive social interaction and affectionate support reduced psychological burden via direct and indirect paths. Tangible support reduced the non-psychological burden via direct and indirect paths. Informational support and emotional support were not helpful for reducing psychological or non-psychological burden. A maximum of 20% of psychological burden could be relieved by positive social interaction and 10.3% of that could be reduced by affectionate support. Tangible support was associated with a 15.1% maximal improvement in non-psychological burden.</P><B>Conclusions:</B><P>In order to reduce caregiver burden in dementia effectively, psychosocial interventions should be tailored to target type of caregiver burden.</P>