Development of Hybrid Model for Integrating Management of Geriatric Depression and Dementia in Urban Area

Background: Depressive symptoms and cognitive decline are the common neuropsychiatric symptoms among the old. Screening of the cognitive decline should be accompanied with the screening of depression because the geriatric depression is frequently comorbid with dementia. Methods: The members of the geriatric division working group of the Seoul Metropolitan mental health advisory committee had a monthly expert meeting from January to December 2005. We searched the cases of the local and international geriatric mental health services. After the presentation in the action plan review committee of the Seoul city, authors made revisions and modified the hybrid form of geriatric mental health management plan. Results: The purposes of this plan are (1) development of screening system of geriatric mental health problems, (2) development of local suicide alarm system of the old, (3) installation of depression management system and suicide prevention system, (4) development of screening system of cognitive decline for the early detection of dementia, (5) development and installation of mental health promotion system for the old, (6) development of effective, continuous, personalized management system for the dementia patients, (7) development of linking system of the hospital and the related institutions, (8) installation of the educational programs for the geriatric mental health workers and the care-givers. This model of integrative management system for the geriatric mental health will be developed, tested and then be spread to the local community according to the three stages. Conclusion: The hybrid model for the geriatric mental health may contribute to enhancement of the quality and cost-effectiveness of community geriatric mental health management system. Thus this model may (1) decrease the incidence of geriatric depression and dementia, and (2) decrease the hospital utility and admission rate of the depressed, suicidal old. Also, this newly conceptualized hybrid system would increase the quality of lives of the geriatric population.

A Study on Noise Induced Hearing Loss of Employees Working for Seoul Metropolitan Subway Cooperation

Although some employees working for Seoul Metropolitan Subway Cooperation are working at the noisy workplaces, they has been excluded from Special Periodic Health Examination Program. And some workers complained of hearing loss or tinnitus. So, this study was carried out to investigate the prevalence rate of Noise Induced Hearing Loss of employees(10,792) working for Seoul Metropolitan Subway Cooperation. The number of subjects were total 10,792 with 10,355 men and 437 women. A questionnaire survey, otological examination, Rinne test, pure tone audiometric tests were performed and through the first and second screening audiometric examination, 605 workers were selected after excluding employees with past otologic problems, recent exposure to high level noise, and under medications. and the results were as follow; 1. Among 10,792 workers, 4 workers(0.037%) diagnosed as NIHL and 601 workers(5.56%) as early NIHL. As workers grew older, the prevalence rate of NIHL and early NIHL became more rising. 2. The prevalence rate of NIHL and early NIHL was different between work site. After age adjustment, The prevalence rate of NIHL and early NIHL was 23.74% in Train repairmen{80dB(A)}, 3.1% in Station staffs{below 70dB(A)}, 2.53% in Train crew{below 70dB(A)}, 2.1% in Office workers. 3. The perception rate of necessities of ear plug in NIHL and early NIHL was below 55% and wearing rate of ear plug in NIHL and early NIHL was 1.1% In conclusion, some employees who was under working environment in Seoul Metropolitan Subway Cooperation should be monitored to prevent hearing impairment and would be needed health education.