알츠하이머 치매 환자에서의 인지영역별 기능과 병식과의 연관성 : A Clinical Research Center for Dementia of South Korea Study
Association between Cognitive Subdomains and Insight in Alzheimer Disease : A Clinical Research Center for Dementia of South Korea Study
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective:The aim of this study was to investigate the association between cognitive subdomains and insight into one’s cognitive impairment in patients with Alzheimer disease (AD). Methods:We recruited 1,722 patients with AD from the Clinical Research of Dementia of South Korea study and designed a cross-sectional study. Each patient’s cognitive subdomain was assessed by using the Seoul Neuropsychological Screening Battery-Dementia version. Severity of dementia was evaluated by Korean version of Mini-Mental Status Examination (K-MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SB). Insight into one’s cognitive impairment was categorized as ‘with insight’ and ‘without insight’ through interview with patient’s caregivers. Results:Among the 1,722 patients with AD, 1,475 patients were included in the ‘with insight’ group and the remaining 247 patients were included in the ‘without insight’ group. Subjects in the ‘without insight’ group had lower K-MMSE and CDR-SB scores than those in the ‘with insight’ group. After controlling for demographic data and dementia severity, higher scores on both attention function (odds ratio=1.12, 95% confidence interval : 1.03-1.21) and frontal-executive function (odds ratio=1.03, 95% confidence interval : 1.01-1.05) significantly predicted the membership to ‘with insight’ group. Conclusion:In patients with AD, attention and frontal-executive function were associated with insight into one’s cognitive impairment.
Abstract
Objective:The aim of this study was to investigate the association between cognitive subdomains and insight into one’s cognitive impairment in patients with Alzheimer disease (AD). Methods:We recruited 1,722 patients with AD from the Clinical Research of Dementia of South Korea study and designed a cross-sectional study. Each patient’s cognitive subdomain was assessed by using the Seoul Neuropsychological Screening Battery-Dementia version. Severity of dementia was evaluated by Korean version of Mini-Mental Status Examination (K-MMSE) and Clinical Dementia Rating Sum of Boxes (CDR-SB). Insight into one’s cognitive impairment was categorized as ‘with insight’ and ‘without insight’ through interview with patient’s caregivers. Results:Among the 1,722 patients with AD, 1,475 patients were included in the ‘with insight’ group and the remaining 247 patients were included in the ‘without insight’ group. Subjects in the ‘without insight’ group had lower K-MMSE and CDR-SB scores than those in the ‘with insight’ group. After controlling for demographic data and dementia severity, higher scores on both attention function (odds ratio=1.12, 95% confidence interval : 1.03-1.21) and frontal-executive function (odds ratio=1.03, 95% confidence interval : 1.01-1.05) significantly predicted the membership to ‘with insight’ group. Conclusion:In patients with AD, attention and frontal-executive function were associated with insight into one’s cognitive impairment.
참고문헌 (24)
- Dementia: a public health priority, "World Health Organization", Geneva: World Health Organization, ~ (2012)
- Reitz C, "Epidemiology of Alzheimer disease. Nat Rev Neurol", Nat Rev Neurol, 7, pp.137~152 (2011)
- Kim SH, "Prevalence of dementia among the South Korean population", J Korean Diabetes, 13, pp.124~128 (2012)
- Thies W, "Alzheimer’s Association. 2013 Alzheimer’s disease facts and figures", Alzheimers Dement, 9, pp.208~245 (2013)
- Feher EP, "Anosognosia in Alzheimer’s disease", Cogn Behav Neurol, 4, pp.136~146 (1991)
- 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)
- Trouillet R, "Unawareness of deficits in Alzheimer’s disease: a multidimentional approach", Psychol Neuropsychiatr Vieil, 1, pp.99~110 (2003)
- McDaniel KD, "Relationship between level of insight and severity of dementia in Alzheimer disease. CERAD Clinical Investigators. Consortium to Establish a Registry for Alzheimer’s Disease", Alzheimer Dis Assoc Disord, 9, pp.101~104 (1995)
- Migliorelli R, "Anosognosia in Alzheimer’s disease: a study of associated factors", J Neuropsychiatry Clin Neurosci, 7, pp.338~344 (1995)
- McKhann G, "Clinical diagnosis of Alzheimer’s disease: report of the NI-NCDS-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)
- Choi J, "Association between functional impairment, depression, and extrapyramidal signs in neuroleptic-free patients with Alzheimer disease.", J Geriatr Psychiatry Neurol, 26, pp.144~150 (2013)
- Moon SY, "Impact of white matter changes on activities of daily living in mild to moderate dementia", Eur Neurol, 65, pp.223~230 (2011)
- 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)
- Morris JC., "The Clinical Dementia Rating (CDR): current version and scoring rules", Neurology, 43, pp.2412~2414 (1993)
- 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)
- 안현정, "Seoul Neuropsychological Screening Battery-Dementia Version (SNSB-D): A Useful Tool for Assessing and Monitoring Cognitive Impairments in Dementia Patients", Journal of Korean Medical Science, 25(7), pp.1071~1076 (2010), 대한의학회
- Michon A, "Relation of ano-sognosia to frontal lobe dysfunction in Alzheimer’s disease", J Neurol Neurosurg Psychiatry, 57, pp.805~809 (1994)
- Kashiwa Y, "Anosognosia in Alzheimer’s disease: association with patient characteristics, psychiatric symptoms and cognitive deficits", Psychiatry Clin Neurosci, 59, pp.697~704 (2005)
- Salmon E, "A comparison of unawareness in frontotemporal dementia and Alzheimer’s disease", J Neurol Neurosurg Psychiatry, 79, pp.176~179 (2008)
- Morris R, "Cognitive neuropsychology of Alzheimer’s disease" (2004), Oxford University Press
- Shuren JE, "Attention and anosognosia: the case of a jargonaphasic patient with unawareness of language deficit", Neurology, 45, pp.376~378 (1995)
- Willcutt EG, "Validity of the executive function theory of attention-deficit", hyperactivity disorder: a meta-analytic review, 2005, pp.57, 1336~1346
- Hannesdottir K, "Primary and secondary anosognosia for memory impairment in patients with Alzheimer’s disease", Cortex, 43, pp.1020~1030 (2007)
- Mountain GA, "Self-management for people with early dementia: An exploration of concepts and supporting evidence", Dementia, 5, pp.429~446 (2006)
