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        • KCI등재

          치매환자들의 운전실태: 노인성치매임상연구센터 연구

          최성혜,이지욱,김수정,최준용,권지원,윤병남,김종헌,윤보라,양영순,김상윤,정지향 대한치매학회 2014 Dementia and Neurocognitive Disorders Vol.13 No.4

          Background: There are few studies about driving and dementia in Korea. The purpose of this study is to investigate the real condition of automobile driving in patients with dementia and the characteristics of those who continue to drive after diagnosis of dementia. Methods: A total of 4,377 patients including 3,792 with Alzheimer’s disease and 585 with vascular dementia were recruited from multiple nationwide hospitals. Clinical evaluations and neuropsychological tests were done in them according to the protocol of the Clinical Research Center for Dementia of South Korea study. Caregivers replied which patients drove an automobile, gave up driving, or has never driven. The same evaluations of them were followed after one year. Results: There were 272 (6.2%) drivers, 321 (7.3%) ex-drivers, and 3,784 (86.5%) non-drivers with dementia. Drivers with dementia were younger and had higher Korean Mini-Mental State Examination (K-MMSE) (21.5±4.3 vs 19.8±5.1 vs 17.4±5.2, p<0.001) and lower Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) scores (4.08±2.15 vs 5.80±3.41 vs 5.83±3.39, p<0.001) compared with ex-drivers and non-drivers with dementia. The drivers and ex-drivers with dementia had higher educational level and a higher proportion of male compared with non-drivers with dementia (77.6% vs 80.1% vs 23.3%, p<0.001). About 54.6% of the drivers with dementia continued to drive at one year after diagnosis of dementia. They had higher K-MMSE (23.2±3.6 vs 20.8±4.5, p=0.003) and lower CDR-SB scores (3.30±1.47 vs 4.40±1.85, p=0.001) at baseline compared with those who quitted driving after baseline. Conclusions: Male patients who were relatively young and had high educational level and mild dementia had a tendency to drive an automobile at that time of diagnosis of dementia. About half of them continued to drive after diagnosis of dementia.

        • KCI등재
        • KCI등재
        • KCI등재후보

          기억의 신경심리학적 평가

          강연욱 대한치매학회 2004 Dementia and Neurocognitive Disorders Vol.3 No.2

          Based on the Squire's and the Tulving & Schacter's models about memory system, the neuropsychological evaluation of human memory for clinical purposes usually consists of 7 areas; Orientation, immediate memory, episodic memory, semantic memory, implicit memory, remote memory, and prospective memory. Numerous, seemingly disparate processes such as encoding and acquisition of information, retention and retrieval, rate of decay, and interference effect are assessed in both the verbal and nonverbal modalities for each area. Standardized tests that are normed, reliable, and valid tests as well as a more behavioral or functional measures provided by direct observation, self-reports, or interviews have been used for the evaluation. The majority of patients with memory impairments have other cognitive deficits as well. The poor performance on memory tests may be at least partly attributable to the deficits of other cognitive functions such as attention, information processing, and executive function. Therefore, a comprehensive cognitive assessment is recommended to examine the nature of memory disorders. A complicating factor in the memory assessment of older adults is that appropriate norms for the elderly group may not be available. More age- and cohort-specific norms for the elderly population are needed.

        • KCI등재

          Diffusion Tensor Imaging Changes Correlate with Clinical Progression in Vascular Mild Cognitive Impairment and Vascular Dementia of Subcortical Type

          유나영,윤병남,윤혜원,안종현,최준용,임명관,권훈기,박준성,이종민,최성혜 대한치매학회 2013 Dementia and Neurocognitive Disorders Vol.12 No.3

          Background: Cerebral small vessel disease (SVD) induces vascular cognitive impairment (VCI) such as subcortical vascular dementia (SVaD) and subcortical vascular mild cognitive impairment (svMCI). We compared MRI parameters between SVaD and svMCI and determined which MRI parameters best correlated with cognitive function and disability on cross-sectional and longitudinal analyses within them. Methods: Twenty-four patients with SVaD and twelve with svMCI were recruited. They underwent multimodal MRIs including fluid-attenuated inversion recovery lesion load, lacunar infarct number, and fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor imaging (DTI), neuropsychological testing, Sum of Boxes of Clinical Dementia Rating Scale (CDR-SB), Barthel Index, and the Korean version of a Geriatric Depression Scale (GDS-K). Seventeen patients were retested after 20 months for a brain MRI and clinical evaluation. Results: There were significant differences in average MD and peak height of MD histograms within normal-appearing brain tissue (NABT) between SVaD and svMCI patients. In the cross-sectional analysis, average MD within NABT significantly correlated with the composite neuropsychology score (r=-0.80, p<0.001), the composite executive function score (r=-0.67, p< 0.001), and the CDR-SB (r=0.54, p=0.001), and the Barthel Index correlated with peak heights of the MD histograms (r=0.37, p=0.03) in NABT. Changes of CDR-SB was associated with changes of average MD within WMH (r=0.57, p=0.02), and changes of GDS-K was associated with changes of WMH volume (r=0.51, p=0.04) on a longitudinal scale. Conclusions: DTI parameters in NABT correlated with cognitive impairment and disability in VCI associated with SVD. Clinical progression of SVD was associated with some increment of WML volume and ultrastructural changes in WMH.

        • KCI등재

          노인의 주관적 기억 장애의 특징 및 하위 유형

          진주희,오경자,서상원,신희영,나덕렬 대한치매학회 2010 Dementia and Neurocognitive Disorders Vol.9 No.4

          Background: Subjective memory impairment (SMI) refers to a condition where people complain about memory problem despite intact cognition. The aims of this study were to examine the specific characteristics of memory complaints using Multifactorial Memory Questionnaire (MMQ) and to investigate whether there were subgroups among the SMI subjects. Methods: A total of 252 subjects with SMI were recruited from a health promotion center. These subjects did not have previous history of dementia or cognitive impairment and performed normally on the Korean-Mini Mental State Examination (K-MMSE). A group of 196 individuals served as healthy controls (HC) recruited from the same center. Both SMI and HC groups underwent KMMSE, short version of Geriatric Depression Scale (S-GDS) and MMQ which consisted of 3 subscales: Memory contentment (MMQ-C), memory ability (MMQ-A) and memory strategy (MMQ-S). SMI were analyzed according to 3 subscales of MMQ. Results: SMI group showed the lower scores on the MMQ-C and MMQ-A and the higher scores on the S-GDS and MMQ-S than HC group, but no significant difference on K-MMSE scores between groups. Three clusters of SMI subjects were identified according to MMQ- A, MMQ-S and S-GDS. Cluster 1 contained subjects with lower memory contentment, more memory complaints and less use of memory strategy than HC. Cluster 2 subjects presented lower memory contentment, more memory complaints and more use of memory strategy. Subjects in cluster 3 showed prominent depression, severe discontentment about memory and memory complaints. Conclusions: Our results indicate that SMI group might be heterogeneous and could be divided into subgroups according to specific features of memory complaints. Furthermore we could suggest that memory questionnaire is useful to evaluate various features of SMI and some SMI subjects might be closely related with psychological problem such as depression.

        • KCI등재후보

          한글의 자소-음소 변환과 관련된 뇌 영역: 기능자기공명영상 연구

          김광기,이승환,김성훈 대한치매학회 2008 Dementia and Neurocognitive Disorders Vol.7 No.2

          Background: Hangeul is a phonographic script, and it is written with adequate arrangements of vowel(s) and consonant(s). This study used functional magnetic resonance imaging (fMRI) to show the brain areas involved in the grapheme-phoneme conversion system. Methods: Images were acquired using a 1.5T scanner from twelve right-handed normal participants (M:F= 10:2) while they performed two kinds of visual decision-making tasks. The mean age of the subjects was 27.6±3.1 years. In the first condition, two one-syllable words that had no meaning but could be read were displayed. In the second condition two arrangements of vowel(s) and consonant(s) that could not be read were displayed on a screen. Participants were asked to determine whether the two were the same or different. All participants responded by pushing buttons, and all reaction times and errors were recorded for every participant. Data analyses were performed based on a general linear model. Results: Areas showing greater activation under the second condition than under the first included the bilateral lateral occipital cortices and the right parietal cortex (FDR corrected p<0.05). However, none of the activated areas showed more significant activation under the first condition than under the second. Conclusions: These results suggest that the known grapheme-phoneme conversion system for Hangeul words might be located in both the posterior temporo-occipital and right parietal cortices.

        • KCI등재

          일개 종합병원 기억장애 클리닉을 방문한 환자들의 뇌영상 검사의 특성

          이준형,이수지,안진영,허재혁 대한치매학회 2012 Dementia and Neurocognitive Disorders Vol.11 No.4

          Background: With the ageing population, number of dementia patients is on the rise, as well as the public interest. The population who would visit memory disorder clinic will also grow. The diagnostic significance of brain MRI in dementia lies in idetifying hippocampal atrophy or ischemic lesions. However, patients visiting memory disorder clinic are mostly old-aged with multiple vascular risk factors, raising the risk of cerebrovascular abnormalities. The authors set out to evaluate the need for cerebrevascular imaging in patients who visited memory disorder clinic. Methods: The study recruited patients who visited the memory clinic in Seoul medical center between July 2011 and June 2012. Among those, patients who had taken the neuropsychiatric test and had both brain MRI and MRA taken were included for analysis. In brain MRI, severities of white matter hyperintensities and presence of cerebral infarction were assessed. In brain MRA, intra- and extra-cranial arterial stenosis and presence of aneurysm were noted. Results: A total of 173 patients was included, and 64 were men. The mean age was 71±9.4 years, and the mean education period was 7±5.2 years. In brain MRI, white matter hyperintensities were observed in 113 patients (65.3%), and cerebral infarction was present in 57 patients (32.9%). In brain MRA, 88 (50.9%) patients showed more than one stenotic segment in intracranial vessel or proximal ICA and 6 patients (3.5%) were diagnosed with unruptured aneurysm. Conclusions: The incidence of white matter hyperintensities or stenosis of cerebral vessels on magnetic resonance imaging is very high. Therefore, brain MRI and MRA should be included in diagnostic work up for dementia in patients who are old aged and have multiple vascular risk factors. It would provide clinicians with valuable information in making treatment decisions and prevention of future cerebrovascular accident.

        • KCI등재

          로고패닉 진행성실어증: 임상적, 신경 심리학적 연구

          김정은,강희진,백여정,최경규,정지향 대한치매학회 2011 Dementia and Neurocognitive Disorders Vol.10 No.2

          The logopenic variant of primary progressive aphasia (PPA-L), which has been known as the subtype of the primary progressive aphasia (PPA), prominently shows the decreases in speech speed and long sentence comprehension, while showing the relatively little damages in comprehension of single word or grammar. We report a patient who suffered from progressive aphasia diagnosed as PPA-L by clinical and neuropsychological analysis.

        • KCI등재후보

          Quetiapine: The Possibility of Quetiapine as a Cause of Neuroleptic Hypersensitivity in Dementia with Lewy Bodies

          Sang Joon An,Go Un Kim,Hyung Woo Shin,Jong-Ho Park,한현정,신동익 대한치매학회 2009 Dementia and Neurocognitive Disorders Vol.8 No.2

          The clinical manifestations of dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) overlap and differential diagnosis may be difficult. However, among the diagnostic criteria of DLB, severe neuroleptic sensitivity is strongly suggestive of DLB. We report a case of a 79-yr-old woman who developed with acute confusion state after low dose quetiapine medication.

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