Usefulness of Family-Report Screening Tests for Dementia

OBJECTIVES: The purpose of this study was to examine the usefulness of domestic family-report screening tests for dementia in an effort to lay the foundation for a standardization of self-report dementia screening tests. METHODS: The subjects in this study were 56 psychiatrists and neurologists etc. who were members of the Korean Geriatrics Society and Korean Association for Geriatric psychiatry and in charge of demented elderly people. RESULTS: Out of 56 respondents, 31 rated SDQ or a short form of SDQ as useful. 10 doctors replied that there was no need to put dementia screening tests for caregivers to use, and the reason was that those tests for caregivers lagged behind screening tests for patients in usefulness, or that no separate assessment through caregivers would be necessary if it's possible to evaluate patients themselves. CONCLUSION: There is little accurate information on the usefulness or results of family-report screening tests for dementia, and sustained research efforts should be dedicated to this field.

Usefulness of Brief Screening Tests for Early Detection of Dementia

There has been great progress in diagnosis of dementia. Diagnosis of dementia involves the early detection of a significant cognitive deficit from normal aging and differential diagnostic approach of the cause of the cognitive impairment. Although there is controversy whether screening tools are useful for early detection of dementia, many brief screening tests have been developed and widely used. The Mini-Mental State Examination (MMSE) is the brief instrument most commonly used to assess cognitive changes in dementia. The MMSE has limitations, but it has been translated into many languages with modest adjustments. It also has been translated and standardized into three Korean versions (MMSE-K, K-MMSE, MMSE-KC) and there are several studies comparing the diagnostic validities between Korean MMSE versions. All three versions have good validities for screening dementia. Other brief screening instruments that have been translated and standardized in Korean may have clinical utility in early diagnosis of dementia. In conclusion, use of screening instruments such as the MMSE, especially in high risk elderly group can be recommended to increase early detection of dementia.

Survey of Neuroimaging and Biological Screening Tests for Early Detection of Dementia

OBJECTIVES: The importance of obtaining an accurate and early diagnosis for dementia is now becoming recognized. Neuroimaging, hematologic tests, CSF and genetic markers to identify dementia have been sought for many years, with many candidates proposal. Several diagnostic tests now show utility in identifying patients with dementia. This study was performed to verify the guidelines on diagnostic evaluation of dementia in Korea. METHODS: The subjects in this study were 52 psychiatrists, neurologists, and family physicians who were members of the Korean Geriatrics Society, the Korean society of gerontology, the Korean gerontological society, and Korean Association for Geriatric psychiatry and in charge of demented elderly people. The questionnaire segment consists of neuroimaging, hematologic, CSF and genetic tests to evaluate of patients with dementia. RESULTS: A number of laboratory tests (including complete blood count with ESR, glucose, electrolyte, calcium, kidney and liver function test, thyroid function tests, vitamin B12 level, syphilis serology) and structural neuroimaging with either CT or MRI scan are recommanded as routine initial evaluation of patients with dementia. CSF and genetic tests is not recommended for routine use in the diagnostic evaluation of dementia. CONCLUSION: This survey supports the necessity of a hematologic and neuroimaging tests under most circumstances at the time of the initial dementia assessment. Further research is needed to improve the validity of clinical diagnosis of dementia, as well as determine the utility of various instruments of neuroimaging, biological testing in increasing diagnostic accuracy.

Usefulness of Comprehensive Neuropsychological Tests for Diagnosis of Dementia

OBJECTIVES: The rapid increase of elderly people with dementia poses a strategy for effective management of dementia. The recent progress in pharmacotherapy of dementia have overcome the past therapeutic nihilism, and gives the hope that dementia can be managed by early diagnosis and early intervention. Accordingly, the use of comprehensive neuropsychological test for early diagnosis is emphasized. METHODS: In this study, we tried to evaluate the necessity and the usefulness of comprehensive neuropsychological tests in the diagnosis of dementia, by reviewing the guidelines for dementia, the researches about comprehensive neuropsychological tests, and by asking the experts about the necessity and the usefulness of comprehensive neuropsychological tests. RESULTS: As a result we came to know that there are many tests which comprehensively covers the cognitive domains, and can be performed in relatively short time. The guidelines recommend that the use of comprehensive neuropsychological tests should be decided by the clinician. Many experts were the same opinion. CONCLUSION: There are many useful comprehensive neuropsychological tests, the use of which should be decided by the clinician.

The Reality of Services for Families with Demented Elderly People

OBJECTIVES: The purpose of this study was to look into caregivers who took care of their demented elderly family members in an effort to find out what types of services they actually called for and how to make a diagnosis of demented elderly people, provide treatment to them and make an intervention for their families at the same time. METHODS: The subjects in this study were 61 psychiatrists, neurologists and rehabilitation doctors who were in charge of demented elderly people, and they were members of the Korean Geriatrics Society and Korean Association for Geriatric Psychiatry. RESULTS: As for interest in helping caregivers for demented elderly people get rid of their stress, 45.9 percent (28 doctors) of the medical personnels investigated answered they tended to have lots of interest in that. To get them to dispel their stress, they conducted education (13 doctors), offered supportive treatment and encouragement (24 doctors) or provide mental treatment and encouragement (24 doctors) or provide mental treatment or medication if necessary (8 doctors). CONCLUSION: Medical intervention should be carried out to alleviate the behavioral and psychological symptoms of the elderly with dementia to help their caregivers not to be under pressure. Their stress should be managed in a systematic manner according to the dementia grade of patients they look after. A sort of one-stop service network should be built to lend assistance to main caregivers, and the government should set up a family support policy for them.

The Reality of Services for Families with Demented Elderly People

OBJECTIVES: The purpose of this study was to look into caregivers who took care of their demented elderly family members in an effort to find out what types of services they actually called for and how to make a diagnosis of demented elderly people, provide treatment to them and make an intervention for their families at the same time. METHODS: The subjects in this study were 61 psychiatrists, neurologists and rehabilitation doctors who were in charge of demented elderly people, and they were members of the Korean Geriatrics Society and Korean Association for Geriatric Psychiatry. RESULTS: As for interest in helping caregivers for demented elderly people get rid of their stress, 45.9 percent (28 doctors) of the medical personnels investigated answered they tended to have lots of interest in that. To get them to dispel their stress, they conducted education (13 doctors), offered supportive treatment and encouragement (24 doctors) or provide mental treatment and encouragement (24 doctors) or provide mental treatment or medication if necessary (8 doctors). CONCLUSION: Medical intervention should be carried out to alleviate the behavioral and psychological symptoms of the elderly with dementia to help their caregivers not to be under pressure. Their stress should be managed in a systematic manner according to the dementia grade of patients they look after. A sort of one-stop service network should be built to lend assistance to main caregivers, and the government should set up a family support policy for them.

A study on the factors associated with compliances of orthdontic patient / 대한치과교정학회지

In orthodontic field, although lots of new materials have been developed and many mechanics intro duced, we can face the case patient cooperation still remain a problem to solve. So, factors related to the compliance of 254 adolescent orthodontic patients using intraoral elastic or extraoral orthopedic appliances were under investigation. The study subjects were 11 to 18 years old and from 5 exclusive orthodontic clinics in seoul. The subjects were asked to fill a questionnaire and compliances were evaluated by their assigned orthodontics. The questionnaire was consisted of 63 questions, and they represent 13 factors-7 psychological & 6 nonpsychological fators. The collected data were analyzed using ANOVA test between the compliance group and the factors. 1. The compliances were evenly distributed in both sex and age groups. 2. As a whole, it was found that the Attitude towards appliances factor affected the degree of compliance. 3. Besides that, in younger(11-12) age group, Pain and discomfort associated with treatment factor was also found to be related to the degree of compliance. 4. On the contrary, in older(16-18) age group, the degree of compliance was influenced by the factor of Achievement motivation, Role expectation, parental relationship.