본문 바로가기
KERD
논문KCI 등재

알츠하이머 치매 환자에서의 병식과 신경정신행동과의 연관성 : A Clinical Research Center for Dementia of South Korea (CREDOS) Study

Association between Insight and Neuropsychiatric Symptoms in Alzheimer’s Dementia : A Clinical Research Center for Dementia of South Korea Study (CREDOS)

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류정신과학

초록

Objectives The aim of this study was to identify the association between insight and neuropsychiatric symptoms in patients with Alzheimer’s dementia (AD). Methods We examined 2607 patients with AD in the Clinical Research Center for Dementia of South Korea study and designed a cross-sectional study. Each patient underwent psychiatric,neurological, and medical examination, interview for caregivers, laboratory tests, neuropsychological tests, and brain MRI. Cognitive function was measured using the Korean version of the Mini-Mental State Examination, Global Deterioration Scale, and Clinical Dementia Rating. Behavioral and psychological symptoms were measured using the Korean version of the Neuropsychiatric Inventory. Daily Living was measured using the Barthel Index for daily living activities and Seoul-Instrumental Activities of Daily Living. Insight was classified according to ‘with insight’,‘partial insight’, and ‘without insight’ by interview with caregivers. Results Among the 2607 patients, 990 were included in the ‘with insight’ group, 1191 were included in the ‘Partial insight’ group, and the ‘without insight’ group included 426 patients. The ‘without insight’ group had a significantly higher aggression level than the ‘with insight’ group, but not the ‘partial insight’ group [odds ratio (OR)=1.46, 95% confidence interval (CI) : 1,14-1.88]. A significantly lower prevalence of depression was observed in the ‘Partial insight’ group and the ‘without insight’ group, compared to the ‘with insight’ group (OR=0.51, 95% CI : 0.43-0.61/OR=0.61, 95% CI : 0.48-0.78). The ‘partial insight’ group showed a lower anxiety level than the ‘with insight’ group (OR=0.63, 95% CI : 0.53-0.75). Conclusion Findings of this study confirmed that insight level was associated with aggression,depression, and anxiety in patients with Alzheimer’ dementia.

Abstract

Objectives The aim of this study was to identify the association between insight and neuropsychiatric symptoms in patients with Alzheimer’s dementia (AD). Methods We examined 2607 patients with AD in the Clinical Research Center for Dementia of South Korea study and designed a cross-sectional study. Each patient underwent psychiatric,neurological, and medical examination, interview for caregivers, laboratory tests, neuropsychological tests, and brain MRI. Cognitive function was measured using the Korean version of the Mini-Mental State Examination, Global Deterioration Scale, and Clinical Dementia Rating. Behavioral and psychological symptoms were measured using the Korean version of the Neuropsychiatric Inventory. Daily Living was measured using the Barthel Index for daily living activities and Seoul-Instrumental Activities of Daily Living. Insight was classified according to ‘with insight’,‘partial insight’, and ‘without insight’ by interview with caregivers. Results Among the 2607 patients, 990 were included in the ‘with insight’ group, 1191 were included in the ‘Partial insight’ group, and the ‘without insight’ group included 426 patients. The ‘without insight’ group had a significantly higher aggression level than the ‘with insight’ group, but not the ‘partial insight’ group [odds ratio (OR)=1.46, 95% confidence interval (CI) : 1,14-1.88]. A significantly lower prevalence of depression was observed in the ‘Partial insight’ group and the ‘without insight’ group, compared to the ‘with insight’ group (OR=0.51, 95% CI : 0.43-0.61/OR=0.61, 95% CI : 0.48-0.78). The ‘partial insight’ group showed a lower anxiety level than the ‘with insight’ group (OR=0.63, 95% CI : 0.53-0.75). Conclusion Findings of this study confirmed that insight level was associated with aggression,depression, and anxiety in patients with Alzheimer’ dementia.

참고문헌 (29)

  1. "한국 치매노인 4년 새 27% 급증… 10년 후 100만명 넘는다/Availablefrom" (2012)[URL]
  2. Taipa R, "Clinico-pathological correlations of the most common neurodegenerative dementias", Front Neurol, 3, pp.68~ (2012)
  3. Greenop KR, "Awareness of cognitive deficits in older adults with cognitive-impairment- no-dementia (CIND): comparison with informant report", Alzheimer Dis Assoc Disord, 25, pp.24~33 (2011)
  4. Trouillet R, "Unawareness of deficits in Alzheimer’s disease: a multidimentional approach", Psychol Neuropsychiatr Vieil, 1, pp.99~110 (2003)
  5. Cerejeira J, "Behavioral and psychological symptoms of dementia", Front Neurol, 3, pp.73~ (2012)
  6. Spalletta G, "Anosognosia and neuropsychiatric symptoms and disorders in mild Alzheimer disease and mild cognitive impairment", J Alzheimers Dis, 29, pp.761~772 (2012)
  7. Hannesdottir K, "Primary amemory impairment in patients with Alzheimer’s disease", Cortex, 43, pp.1020~1030 (2007)
  8. Kalbe E, "Anosognosia in very mild Alzheimer’s disease but not in mild cognitive impairment", Dement Geriatr Cogn Disord, 19, pp.349~356 (2005)
  9. Michon A, "Relation of anosognosia to frontal lobe dysfunction in Alzheimer’s disease", J Neurol Neurosurg Psychiatry, 57, pp.805~809 (1994)
  10. Starkstein SE, "Two domains of anosognosia in Alzheimer’s disease", J Neurol Neurosurg Psychiatry, 61, pp.485~490 (1996)
  11. Starkstein SE, "Anosognosia is a significant predictor of apathy in Alzheimer’s disease", J Neuropsychiatry Clin Neurosci, 22, pp.378~383 (2010)
  12. Harwood DG, "Impaired insight in Alzheimer disease: association with cognitive deficits, psychiatric symptoms, and behavioral disturbances", Neuropsychiatry Neuropsychol Behav Neurol, 13, pp.83~88 (2000)
  13. Migliorelli R, "Anosognosia in Alzheimer’s disease: a study of associated factors", J Neuropsychiatry Clin Neurosci, 7, pp.338~344 (1995)
  14. Vogel A, "Impaired awareness of deficits and neuropsychiatric symptoms in early Alzheimer’s disease: the Danish Alzheimer Intervention Study (DAISY)", J Neuropsychiatry Clin Neurosci, 22, pp.93~99 (2010)
  15. McKhann G, "Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease", Neurology, 34, pp.939~944 (1984)
  16. Moon SY, "Impact of white matter changes on activities of daily living in mild to moderate dementia", Eur Neurol, 65, pp.223~230 (2011)
  17. Reisberg B, "The Global Deterioration Scale for assessment of primary degenerative dementia", Am J Psychiatry, 139, pp.1136~1139 (1982)
  18. Kang Y, "A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients", J Korean Neurol Assoc, 15, pp.300~308 (1997)
  19. Morris JC, "The Clinical Dementia Rating (CDR): current version and scoring rules", Neurology, 43, pp.2412~2414 (1993)
  20. Mahoney FI, "Functional evaluation: the barthel index", Md State Med J, 14, pp.61~65 (1965)
  21. 구형모, "일상활동평가-복합(Seoul-Instrumental Activities of Daily Living ; S-IADL)의 신뢰도 및 타당도 연구", 신경정신의학, 43(2), pp.189~199 (2004), 대한신경정신의학회
  22. Choi SH, "The Korean version of the neuropsychiatric inventory: a scoring tool for neuropsychiatric disturbance in dementia patients", J Korean Med Sci, 15, pp.609~615 (2000)
  23. Grochmal-Bach B, "Aggressive and impulsive behaviors in Frontotemporal dementia and Alzheimer’s disease", Med Sci Monit, 15, pp.248~254 (2009)
  24. Lee HB, "Depression in Alzheimer’s disease: heterogeneity and related issues", Biol Psychiatry, 54, pp.353~362 (2003)
  25. Holtzer R, "Depressive symptoms in Alzheimer’s disease: natural course and temporal relation to function and cognitive status", J Am Geriatr Soc, 53, pp.2083~2089 (2005)
  26. Antoine C, "Awareness of deficits and anosognosia in Alzheimer’s disease", Encephale, 30, pp.570~577 (2004)
  27. Kashiwa Y, "Anosognosia in Alzheimer’s disease: association with patient characteristics, psychiatric symptoms and cognitive deficits", Psychiatry Clin Neurosci, 59, pp.697~704 (2005)
  28. Hynninen MJ, "The frequency and correlates of anxiety in patients with first-time diagnosed mild dementia", Int Psychogeriatr, 24, pp.1771~1778 (2012)
  29. Orrell M, "Psychosocial stress and anxiety in senile dementia", J Affect Disord, 39, pp.165~173 (1996)

관련 논문AI추천

알츠하이머 치매 환자에서 교육 수준과 우울증의 연관성 : CREDOS(Clinical Research Center for Dementia of South Korea) 연구의 결과강효신, 김도관, 김상윤, 김상하, 김성윤, 나덕렬, 명우재, 송지혜, 윤혜연, 이유진, 이재홍, 임신원, 최성혜, 최준배, 한설희대한노인정신의학회 · 노인정신의학2012 · 제16권 제1호알츠하이머 치매 환자에서의 인지영역별 기능과 병식과의 연관성 : A Clinical Research Center for Dementia of South Korea Study강효신, 김도관, 김상윤, 김상하, 김성윤, 김영돈, 나덕렬, 명우재, 윤혜연, 이재홍, 최성혜, 최준배, 한설희대한노인정신의학회 · 노인정신의학2014 · 제18권 제2호Risk Factors of Behavioral and Psychological Symptoms in Patients with Alzheimer Disease: The Clinical Research of Dementia of South Korea Study김도관, 명우재, Duk L. Na, Jae-Hong Lee, Jinyoung Shin, Jun Hyun Yoo, Sang Yun Kim, Seol-Heui Han, Seong Hye Choi, Seong Yoon Kim, Su Jeong Shin, Sunyoung Park대한가정의학회 · Korean Journal of Family Medicine2019 · 제40권 제1호기억성 경도인지장애 환자에서 알츠하이머병 치매로의 진행과 신경정신행동 증상신진, 박두흠, 유승호, 유재학, 하지현대한노인정신의학회 · 노인정신의학2017 · 제21권 제1호The Prevalence and Severity of Neuropsychiatric Symptoms in Alzheimer’s Disease and Subcortical Vascular Dementia : the CREDOS Study김도관, 김상윤, 김성윤, 나덕렬, 안호영, 이재홍, 이중선, 정찬승, 한설희대한노인정신의학회 · 노인정신의학2011 · 제15권 제2호Clinical Characteristics of Behavioral and Psychological Symptoms in Patients with Drug-naïve Alzheimer’s Disease곽순구, 곽용태, 양영순대한치매학회 · Dementia and Neurocognitive Disorders(대한치매학회지)2012 · 제11권 제3호

이 간행물의 다른 논문 (4건)