Dementia In Korea Research Articles

Association Between Cohabitation Status and Sleep Quality in Families of Persons With Dementia in Korea: A Cross-sectional Study.

ObjectivesThe aim of this study was to identify the association between cohabitation status and sleep quality in family members of people with dementia (PwDs).MethodsData of 190 365 participants aged ≥19 years from the 2018 Korea Community Health Survey were analyzed. Participants were categorized according to their cohabitation status with PwDs. Multiple logistic regression and ordinal logistic regression analyses were performed to evaluate the relationship between the cohabitation status of PwDs’ relatives and sleep quality measured using the Pittsburgh Sleep Quality Index (PSQI) and PSQI subscales.ResultsCompared to participants without PwDs in their families, both cohabitation and non-cohabitation with PwDs were associated with poor sleep quality (cohabitation, male: odds ratio [OR],1.28; 95% confidence interval [CI], 1.08 to 1.52; female: OR, 1.40; 95% CI, 1.20 to 1.64; non-cohabitation, male: OR, 1.14; 95% CI, 1.05 to 1.24; female: OR, 1.23; 95% CI, 1.14 to 1.33). In a subgroup analysis, non-cohabiting family members showed the highest odds of experiencing poor sleep quality when the PwD lived alone (male: OR, 1.48; 95% CI, 1.14 to 1.91; female: OR, 1.58; 95% CI, 1.24 to 2.01). Cohabiting male and female participants had higher odds of poor subjective sleep quality and use of sleeping medications than non-cohabiting male and female participants, respectively.ConclusionsThe residence of PwDs and cohabitation status may contribute to poor sleep quality among PwDs’ family members. The circumstances faced by cohabiting and non-cohabiting family members should be considered when evaluating sleep quality in family members of PwDs, and appropriate interventions may be needed to improve sleep quality in both cohabiting and non-cohabiting family members.

Estimates of Long-Term Care Utilization and Lifetime Distribution of Medical Cost for Dementia in Korea

Estimates of Long-Term Care Utilization and Lifetime Distribution of Medical Cost for Dementia in Korea

A Meta-Analysis on the Effects of Group Therapy for the Elderly with Dementia in Korea

목적 : 본 연구는 치매 노인을 대상으로 한 그룹치료 연구들을 수집 분석하여 그룹치료의 특성과 중재 효과를 확인하고자 하였다. 연구방법 : 2009년부터 2019년까지 국내 데이터베이스를 통해 23편의 무작위 대조군 실험연구를 분석대상으로 선정하였고, Cochrane Library의 RevMan 5.4 프로그램을 사용하여 효과크기를 산출하였다. 연구결과 : 그룹치료의 효과크기(1.48)는 큰 효과크기를 나타내었고, 하위중재별 효과크기에서 미술치료(1.81)와 음악치료(1.19)는 큰 효과크기를, 작업치료(0.54)는 중간효과크기를 나타냈다. 효과변인 별 효과 크기는 우울(1.76), 삶의 질(1.53), 자아표현통합감(1.38), 인지기능(1.31) 순으로 큰 효과를 보였다. 결론 : 본 연구의 그룹치료 효과성을 토대로 작업치료의 임상 현장에서 복합중재를 적용한 그룹치료 연구가 활발하게 진행되어야 할 것으로 여겨진다.

Prevalence of Dementia in Korea Based on Hospital Utilization Data from 2008 to 2016.

PurposeDementia is an important health issue in Korea due to its associated medical costs. Our study aimed to estimate the prevalence of dementia in Korea by analyzing hospital utilization rates.Materials and MethodsWe examined National Health Insurance data from 2008 to 2016 and identified all dementia cases. Crude and ageand sex-standardized prevalence were calculated. A generalized linear mixed model was used to estimate prevalence ratios.ResultsWe identified 176746 and 530269 dementia cases in 2008 and 2016, respectively. Alzheimer's disease was the most common dementia subtype (65.4% and 86.1% in 2008 and 2016, respectively). Across all age groups, the prevalence of dementia increased consistently: the increase was prominent among patients ≥85 years of age. Among patients ≥65 years of age, crude prevalence was estimated at 31.3 and 72.2 per 1000 population in 2008 and 2016, respectively. Age- and sex-standardized prevalence increased from 31.3 to 62.0 per 1000 population between 2008 and 2016, respectively. The prevalence ratio for dementia in 2016 was 2.02 times (95% confidence interval, 2.01–2.03) higher than that in 2008. When adjusted for age, dementia was more prevalent among females. The most common comorbidity was hypertension, followed by diabetes and stroke.ConclusionOur results demonstrated that hospital utilization for dementia increased significantly from 2008 to 2016, reflecting a proportional increase in the prevalence of dementia. Korean healthcare policy must prioritize dementia treatment.

Analysis of Effect of Non-drug intervention on the Elderly with Dementia in Korea: Meta-Analysis

Analysis of Effect of Non-drug intervention on the Elderly with Dementia in Korea: Meta-Analysis

Association of limb length with cognitive decline in elderly

AbstractBackgroundThere are not many studies about the risk factors of dementia in Korea. Early life nutrition is very important for the body size of grown‐ups. This study investigated the associations of arm and leg length with cognitive decline in a community sample of elderly Korean.Method382 community residents aged 65 or over were clinically assessed for cognitive impairment. Arm length and leg length were measured. Neuropsychological tests, including Korean version of Mini‐mental state examination, Clinical Dementia Rating, and Geriatric Depression Scale were performed for all the participants.ResultBoth arm length and leg length were not associated with decreased cognitive function by correlation analysis. Correlation analysis with adjustment of age and education also did not show any significant correlation.ConclusionWe could not find any correlation between limb length and cognition in an elderly Korean community.

Development and feasibility testing of a person‐centered cognitive service manual to enhance community care for people with dementia in Korea

AbstractBackgroundIn order to improve the quality of life for persons with dementia and their families and to ensure the efficiency of national cost for managing dementia, there is a need to support them in their communities as long as possible. Therefore, person‐centered cognitive interventions for early detecting of dementia and delaying its progression in the community is an urgent priority at the international level. This study aimed to develop a person‐centered cognitive service manual for early dementia to use for national long‐term care agencies and test its feasibility.MethodsThis study was conducted from February to July, 2019. The theoretical rationale for the manual was developed through systematic review of previous guidelines and studies. The focus group interviews identified the needs and preferences of stakeholders. The manual consisted of assessment, intervention, and outcome based on six domains. Six domains were individuality, independence, psychological health, physical health, safety, and social support. The manual provides comprehensive needs assessment tools and algorithms to plan and provide individualized service plan. The feasibility study was conducted at 47 senior welfare centers in Korea.ResultsThis study found that the manual was effective for initial consultation (63.0%), comprehensive evaluation (50.0%), service planning (72.7%), service provision (78.3%), goal achievement evaluation (50.0%), and service termination (100.0%). However, service provider’s increased workloads and the time for completing the needs assessment were identified as barriers to apply the manual. In addition, service providers experienced lack of knowledge and skills in comprehensive evaluation (55.9%) and service planning (29.4%). The continuous educational support for manual application was suggested.ConclusionThe national manual of person‐centered cognitive service can be useful to provide the best community services to improve the quality dementia community care. Development and dissemination of ICT based care pathways into the long‐term care service system to support best practices through the manual can be suggested.

PIH12 COMPARISON OF THE POST-MARKET UTILIZATION PATTERNS OF ALZHEIMER'S DISEASE TREATMENTS BETWEEN SOUTH KOREA AND AUSTRALIA: TIME TO CONSIDER REASSESSMENT OF COST-EFFECTIVENESS

Korea has limited post-market review systems and over the past decade the spending of some pharmaceuticals has skyrocketed. Given donepezil has been the most consumed medicine and increased with the fast rate among the Korean elderly population, this study aimed to compare the post-market utilization of four Alzheimer’s Disease (AD) treatments with Australia, which has established well-organized post-market review systems. The nationwide pharmaceutical utilization of donepezil, galantamine, rivastigmine, and memantine were extracted from National Health Insurance claims data in Korea and Pharmaceutical Benefits Scheme data in Australia. The time trends of the spending, utilization, and unit cost of each treatment were examined on a monthly basis from 2008 to 2019. The spending of AD treatments in Korea has increased drastically, while it has dropped by more than half in Australia. Provided a similar or lower prevalence of AD between Korea and Australia, the population standardized utilization measured by a defined daily dose/1,000/day of AD treatments in Korea has shoot up, while that of Australia remains static. The unit costs of treatments are higher in Korea than in Australia. This study revealed that much more people with dementia in Korea are treated with AD treatments with higher prices of medications than in Australia. Without systems to re-assessment of the post-market utilization, the sustainability of public funding can be threatened as well as the ill health caused by inappropriate utilization of medicines. Korea needs a further post-market review on the cost-effectiveness and health outcomes.

Evaluating the Efficacy of Therapeutic Programs on Improving Cognitive Function and Depression among Older Adults Living with Dementia in Korea.

The purpose of this study was to evaluate the effect size of programs for enhancing cognition and alleviating depression in older adults with dementia. This study selected 45 cognition and 37 depression programs, which conducted pre- and post-tests and had a treatment group and a control group comprising older adults living in Korea. This study conducted a meta-regression analysis to examine the moderating effect of the program location, number of sessions, intervals, group activities, and curriculum on cognition and depression. Most programs improved cognitive function and lowered depression symptoms. The heterogeneity of the effect size was large. The effect size of the number of sessions on a cognitive function significantly increased with an increasing number of sessions. The effect size of the group activity program on cognitive function was higher. The effect of healthcare institutions on depression was lower compared to other locations. To make more effective interventions for cognition and depression, long-term and group activity programs following a comprehensive curriculum will be required. The programs of healthcare institutions are encouraged to accept the advantages of other institutions and apply them to improve the effects of the programs on depression. Future studies shall focus on establishing concrete measures to enable healthcare institutions to connect older adults with dementia with various other institutions that offer long-term group programs.

Effects of Cognitive Intervention Activities for the Elderly with Dementia in Korea: A Meta-Analysis

Effects of Cognitive Intervention Activities for the Elderly with Dementia in Korea: A Meta-Analysis

Living with/out Dementia in Contemporary South Korea.

While the debate on diagnostic disclosure is often based on the premise that knowing about one's condition (the diagnosis and its prognosis) is essential in securing the patient's autonomy, many people with dementia in Korea are not told directly about their diagnosis. This article concerns the laborious and ethically contentious post-diagnostic living undertaken by the families of people with dementia, which I call "living with/out dementia." This is a paradoxical form of living that has emerged through the increasing biomedicalization of dementia, the socialization of elder care, and an enduring fear of dependency in old age. Attending to how living with/out dementia comes to be initiated and maintained through efforts of care, I argue that nondisclosure entails a kind of ethical process through which dementia is un/done in the caregivers' struggle to truthfully engage with the person with dementia while actively hiding the diagnostic truth from him or her.

Development and reliability of the Korean version of the Feeding Abilities Assessment.

ObjectiveThe purpose of this study is to introduce a standardised assessment tool by verifying the reliability of the translated Korean version of the Feeding Abilities Assessment (K-FAA), which was developed to suit Korean culture.MethodsThe research subjects were 65 patients with dementia living in nursing homes. The K-FAA was completed by verifying the suitability of translation and reverse translation. The validity of the K-FAA was established through content validity, while its reliability was analysed based on internal consistency reliability for the items, test–retest reliability and inter-rater reliability.ResultsThe content validity index determined, based on the assessment of professors, occupational therapists, and nurses, was more than .70. Cronbach’s α was more than .929, showing good internal consistency. A test–retest reliability of .884 was derived using Pearson’s correlation coefficient (p < .01), and an inter-rater reliability of .800 was derived using the kappa coefficients; intraclass correlation coefficient was .897, which also indicated good reliability.ConclusionThe K-FAA was modified to fit the Korean domestic situation, and this assessment had high reliability. Therefore, K-FAA can evaluate the feeding ability of patients with dementia. Future studies should focus on providing evidence-based data to maintain or supplement the feeding ability of patients with dementia in Korea.

Differential associations between depression and cognitive function in MCI and AD: a cross-sectional study.

Despite the possibility that cognitive deficits associated with depression may have different patterns depending on the level of neurocognitive impairment, there remains no clear evidence of this. This study aimed to investigate the differential association between depression and cognitive function in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). A cross-sectional analysis was performed of data from 1,724 patients with MCI and 1,247 patients with AD from the Clinical Research Center for Dementia in Korea. Depression was assessed using the Korean form of the Geriatric Depression Scale, and cognition was measured using the Seoul Neuropsychological Screening Battery, which includes five domains (attention, language and related function, visuospatial function, memory, and frontal/executive function). Significant differences were found between the two groups (non-depressed vs. depressed) in visuospatial, memory, and executive function domains in the MCI group, as well as in the attention domain in the AD group. The association between depressive symptoms and cognitive function was significantly greater in patients with MCI than in those with AD. These associations were more pronounced in memory and executive function. Our findings suggest that the association between depression and decreased cognitive function is more pronounced in MCI than AD.

Nutritional status of Korean elderly with dementia in a long-term care facility in Hongseong.

BACKGROUND/OBJECTIVESThis study investigated nutritional status of the elderly with dementia in a care facility with the aim of improving the meal quality of the facility.SUBJECTS/METHODSData were collected from 30 dementia patients aged more than 65 years in a long-term care facility in Hongseong. The data were obtained from questionnaires and medical records. The food intake data was obtained using food photographs and the nutrient intakes were calculated using the CAN-Pro 5.0. The data were compared with the dietary reference intakes for Koreans (KDRIs). The nutrient density, diet quality such as nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ), as well as dietary diversity score (DDS) were evaluated. The data were analyzed using SPSS statistical programs.RESULTSThe average daily energy intakes for men and women were much lower than the estimated energy requirements of the KDRIs. The average intakes of energy and most nutrients in the general diet group were significantly higher than those of the other two groups. Significant differences in diet quality and diet diversity were observed according to the meal type groups. The NARs of some minerals (calcium, iron, and zinc) and vitamins (vitamin B6 and folic acid) were less than 0.5 in all study groups. The NARs of protein, iron and MAR of the general diet group were significantly higher than those of the liquid diet group. The DDS scores of meats, fruits and diary food group were very low in all meal type groups, meaning that the diet qualities of the study subjects were not appropriate in all meal type groups.CONCLUSIONSThe food intakes of the study groups showed some limitations by a direct comparison with KDRIs because of the very low physical activities of the study subjects. The diet quality and diet diversity indices suggest the need for improvements in the nutritional quality in all types of diet. Overall, new intervention strategies targeting facility residents with dementia in Korea are needed as soon as possible.

Decline in the Incidence of All-Cause and Alzheimer's Disease Dementia: a 12-Year-Later Rural Cohort Study in Korea.

BackgroundThere has been no study on the time trends of dementia incidence in Korea. We report the 5-year incidence and its correlates of all-cause and Alzheimer's disease (AD) dementia, and compared our results with those of a 12-year-prior cohort study conducted in the same area.MethodsA total of 751 community-dwelling older adults were followed up for a mean duration of 5.4 years. The age-, gender-, and educational attainment-specific incidence of all-cause and AD dementia were reported as cases per 1,000 person-years. We performed univariate and multivariate cox proportional hazard regression analyses to determine whether baseline sociodemographic, lifestyle, and clinical variables were associated with the risk of all-cause and AD dementia. A 12-year-prior cohort study was used for descriptive comparison to indicate the time trends of dementia incidence.ResultsThe incidence rates were 16.2 and 13.0 cases per 1,000 person-years for all-cause and AD dementia, respectively. The baseline diagnosis of mild cognitive impairment increased the 5-year incidence of all-cause dementia by more than 4-fold. Old age and low baseline global cognitive function were noted as risk factors for both all-cause and AD dementia.ConclusionUpon comparing the results with those from the earlier cohort study in Yeoncheon, the incidence of all-cause and AD dementia decreased by approximately 40% over 12 years; it has been mainly driven by the increase in the educational level of older adults. The declining time trends of incidence should be taken into account for estimating the future prevalence of dementia in Korea.

Day care vs home care: Effects on functional health outcomes among long-term care beneficiaries with dementia in Korea.

First, to compare changes in cognitive function, behavioral symptoms, and physical function for Korean Long-Term Care Insurance (LTCI) beneficiaries with dementia in day care (DC) and home care (HC) settings over 1year. Second, to examine the association between LTCI service type and the aforementioned health outcomes. A retrospective matched cohort study was conducted using the national data set of the National Health Insurance Service in Korea. We identified 7822 beneficiaries with dementia who received either DC or HC services consistently for 1year from 2008 to 2009. The propensity score matching method was used, yielding 416 participants in each group. Paired samples t-tests and logistic regression analyses were conducted. Baseline differences between the two groups are present. According to multiple regression models, DC, when compared with HC, was related to less deterioration in cognitive and physical function but was associated with less improved behavioral symptoms 1year after the LTCI enrollment. In the comparison between matched cohorts, DC, when compared with HC, was associated with less cognitive decline, less disability progression, and similar decrease in behavioral symptoms. Cognitive function and disability declined less in the DC group, compared with the HC group. Conversely, behavioral symptoms showed a similar decrease between the two groups after 1-year follow-up. Further research is necessary to examine key features of DC services that have helped delay functional deterioration and alleviate behavioral symptoms.

Prevalence and Risk Factors of Abusive Behaviors in the Caregivers of People with Dementia in Korea.

ObjectiveWe investigated the prevalence and risk factors of physically abusive behaviors (PhAB) and psychologically abusive behaviors (PsAB) towards people with dementia (PWD) in family caregivers, and compared their prevalences between East Asian and Western countries. MethodsWe estimated the prevalence and risk factors of PhAB and PsAB in 467 Korean pairs of community-dwelling PWD and their primary family caregivers. We evaluated abusive behaviors using the Modified Conflict Tactics Scale. In addition, we compared the prevalence of abusive behaviors between Asian and Western countries through a meta-analysis on 12 studies including the current one. ResultsMore than a half of the caregivers reported PsAB and about one out of seven caregivers admitted PhAB within past three months. PsAB and PhAB were slightly more prevalent in East Asian countries than in Western countries. Non-Alzheimer type and moderate to severe behavioral and psychological symptoms of dementia were associated with the risk of PhAB but not with the risk of PsAB. Severe care burden and low income were associated with the risk of PhAB and PsAB. ConclusionPhAB and PsAB were as prevalent in the family caregivers of PWD in Asian countries including Korea as in Western countries. Prevention strategies should be implemented according to the type of abusive behaviors.

Oral Care and Considerations for Dental Treatment in Dementia Patients

The number of patients with dementia in Korea is estimated to be 576,000 in 2013 and 648,000 in 2015, and 840,000 in 2020 and 2,710,000 in 2050. Therefore, it can be expected that the number of patients with dementia will increase among the elderly patients who are looking for dentistry. Dementia and oral hygiene are closely related, so the future role of the dentist is very important. In order to treat effectively the patients with cognitive disorders, we should consider effective communication methods with them. Xerostomia is another important factor affecting oral health of dementia patients. In establishing the dental treatment plan, the most appropriate treatment method should be selected considering the characteristics of individual dementia patients and all possible efforts should be made for successful treatment results.

치매노인에 대한 한국의 의료보장정책 분석

치매노인에 대한 한국의 의료보장정책 분석

Psychometric Validation of the Korean Version of the Camberwell Assessment of Need for the Elderly in Individuals with Dementia

PurposeThe prevalence of dementia has increased rapidly with an aging Korean population. Compared to those without dementia, individuals with dementia have more and complex needs. In this study, the Korean version of the Camberwell Assessment of Need for the Elderly (CANE-K) was evaluated to determine its suitability for individuals with dementia in Korea. MethodsThe CANE-K was developed following linguistic validation. The reliability of the measurement was examined with Cronbach α coefficient. The factor structure and construct validity were evaluated by performing exploratory factor analysis and confirmatory factor analyses. Pearson's correlation coefficients with related measures were used to ensure concurrent validity. ResultsFour factors extracted with exploratory factor analysis and confirmatory factor analyses validated the model structure (χ2 = 367.25, p < .001, goodness-of-fit index = .84, adjusted goodness-of-fit index = .80, root mean square error of approximation = .07, and comparative fit index = .83). Items on the CANE-K loaded on the four factors in a range between .40 and .80. The output of Pearson's correlation coefficient with cognitive impairment, behavioral problems, activities of daily living, and caregiver burden showed acceptable concurrent validity. ConclusionThe CANE-K showed a reasonable degree of reliability and validity. Therefore, it has good potential to appropriately measure the needs and unmet needs of those with dementia.