The Validity of the Assessment Tools for the Korean Long-Term Care System

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.

Clinical Features of Elderly Patients Referred to Neuropsychiatric Department

OBJECTIVE: As the geriatric admission and geropsychiatric consultation increase, more study was needed about geropsychiatric consultation. This comparative study investigates the character of geropsychiatric consultation in general hospital. METHOD: We compared 22 young patients (25(age<45) with 55 elderly patients ((65) who are consulted to neuropsychiatry department for the first time for 3 months (2004. 1. 1-2004. 3. 31) in Kang-Dong Sacred Heart Hospital, Hallym University. Data on patterns of consultation, demography, psychiatric and physical illness were collected and analyzed. RESULT: 1) The rate of psychiatric consultations for elderly patients was 6.2%, and this rate was much higher than 1.9% of young patients. 2) There were no significant difference in referral department between the elderly group and the control group, and internal medicine was the most common referral department in both groups. 3) The main reasons of consultations were alcohol related problems and psychiatric follow up in order in control group, but sleep disturbance and disorientation in order in elderly group. 4) In elderly group, the most frequent psychiatric diagnoses made by consultants were organic brain disorder such as dementia and delirium, but in control group, they were functional psychiatric disorder such as alcohol related disorder and psychosis. 5) Psychotropic drug and follow-up consultation were two most frequent recommendations from consultants in both group. But recommendations for psychotherapy and psychosocial management were rare in both groups. 6) There were significant difference only in psychiatric transfer among compliance for psychiatric consultation between the elderly group and the control group. Compliance for recommendations were low in both groups. 7) In both group, only one follow up consultation was done. And OPD follow up after discharge was rare in both groups. CONCLUSION: Elderly patients need more psychiatric consultations than younger patients and has different characteristics in pattern of consultations. Further studies are warranted on geropsychiatric consultation in Korea.