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Journal of the Korean Neurological Association 2005;23(1): 21-27.
알쯔하이머병 환자의 인지기능 변화 및 예후인자: 1년 추적
김태유, 김상윤* 홍태용† 성상민‡ 윤성민§ 이은아∥ 곽강호¶ 인연권
김해한솔병원 신경과, 서울대학교 의과대학 신경과학교실*, 부산화명한솔병원 신경과†, 부산의료원 신경과‡, 마산태봉병원 신경과§, 서울특별시립서대문병원 신경과∥, 부산동인노인병원 정신과¶, 가톨릭대학교 의과대학 방사선과학교실**
The Change of Cognitive Function and Prognostic Factor in Alzheimer's Disease: 1-Year Follow-up Study
Tae-You Kim
Department of Neurology, Gimhae Hansol Hospital, Gimhae; Department of Neurology, Seoul National University College of Medicine*, Seoul; Department of Neurology, Hwamyung Hansol Hospital†, Busan; Department of Neurology, Busan Medical Center‡, Busan; Department of Neurology, Taebong Hospital§, Masan; Department of Neurology, Seoul Metropolitan Seodaemun Hospital∥, Seoul; Department of Psychiatry, Busan Dongin Geriatric Hospital¶, Busan; Department of Radiology, Catholic University of Korea College of Medicine**, Suwon, Korea
Background: The rate of cognitive change and prognostic factor in Alzheimer's disease are important for clinical management, but little is known in Korea. We report a one year follow-up study of comprehensive evaluation including cognitive functions, behavioral and psychological symptoms of dementia (BPSD) and activity of daily living (A이).
Methods: 43 patients with Alzheimer's disease were enrolled. All subjects received the Korean version of Mini-Mental State Examination (K-MMSE), the Severe Dementia Scale (SDS), the extended version of Korean Clinical Dementia Rating Scale (CDR) and Sum of Box (CDR-SB), the Barthel index of Activity of Daily Living (B-ADL), the Korean Instrumental Activity of Daily Living (K-IADL) and the Korean version of the Neuropsychiatric Inventory (K-NPI). We retested each scale after 1 year and evaluated the changes.
Results: The mean change rates of K-MMSE, SDS, CDR, CDR-SB and B-ADL scores were 2.0±3.2 (-7~8) mean±SD (range), 3.5±4.9 (-7~14), -0.4±0.7 (-2~1), -0.8±4.4 (-10~9) and 1.5±3.7 (-7~9). The change of K-MMSE and B-ADLscore according to CDR were significantly different. The annual rates of changes of scores on K-MMSE, B-ADL and CDR were largest in CDR 1 group (K-MMSE: 4.0±2.7, B-ADL: 3.4±2.8, CDR: -1±0.7). The change rate of SDS was largest in CDR 4 (7.2±4.3). There were not any significant factors that affected the change of K-MMSE, SDS, B-ADL or CDR.
Conclusions: These results suggest that K-MMSE is sensitive to the early stage and SDS is sensitive to the later stage. The deterioration rate of cognitive function in Alzheimer's disease is large at middle stage. KeyWords:Alzheimer's disease, Dementia, Prognosis, Cognition, Longitudinal study