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Journal of the Korean Neurological Association 2006;24(4): 337-346.
알츠하이머병과 혈관성치매에서의 진행 정도에 따른 임상 양상의 차이
김태유, 김수영a 김응규b 김재우c 박경원c 성상민d 손태홍e 안경숙a 유봉구f 윤수진g 윤성민h 이상찬i 정해관j 최문성k 홍태용 부산?경남치매학회
김해한솔요양병원, 경성대학교 사회복지학과a, 인제대학교 의과대학 신경과학교실b, 동아대학교 의과대학 신경과학교실c, 부산의료원 신경과d, 신라대학교 가족학과e, 고신대학교 의과대학 신경과학교실f, 성균관대학교 의과대학 마산삼성병원 신경과g, 마산태봉병원 신
The Differences of Clinical Features between Alzheimer's Disease and Vascular Dementia According to Progression
Tae-You Kim
Department of Neurology, Gimhae Hansol Hospital, Gimhae; Department of Social Welfare, Kyung Sung Universitya, Busan; Department of Neurology, Inje University College of Medicineb, Busan; Department of Neurology, Dong-A University College of Medicinec, Busan; Department of Neurology, Busan Medical Centerd, Busan; Department of Family Stuides, Silla Universitye, Busan; Department of Neurology, Kosin University College of Medicinef, Busan; Department of Neurology, Sungkyunkwan University College of Medicine, Masan Samsung Hospitalg, Masan; Department of Neurology, Masan Taebong Hospitalh, Masan; Department of Neurology, Dong-eui Medical Centeri, Busan; Department of Social and Preventive Medicine, School of Medicine, Sungkyunkwan Universityj, Suwon; Department of Neurology, Maryknoll Hospitalk, Busan, Korea
Abstract
Background: The differences in clinical features are important when differentiating between Alzheimer's disease (AD) and vascular dementia (VD). There have been many studies comparing the severity of progression in both diseases. They have assessed individual symptoms but have not explained the differences and global change of progression comprehensively. We have evaluated the cognitive and non-cognitive functions at the same time and evaluated the differences between AD and VD.
Methods: One hundred and thirty-eight dementia patients from Busan·Gyeongnam Dementia Association outpatient clinics were analyzed. All of the patients underwent the Korean version of the Mini-Mental State Examination (K-MMSE), the expanded version of the Korean Clinical Dementia Rating Scale (CDR), the Korean version of the Neuropsychiatric Inventory (K-NPI), the scales for activity of daily living, and the Short form of the Samsung Dementia Questionnaire (S-SDQ).
Results: There were 93 patients with AD and 45 with VD. VD patients revealed more severe Barthel Index of Activity of Daily Living (B-ADL) deficits. AD patients had more severe memory and orientation deficiency in CDR 1 and CDR 2. VD patients revealed much faster decline of K-MMSE score between CDR 2 and CDR 3.
Conclusions: These results suggest that VD patients display more severe B-ADL difficulty, while AD patients display more severe memory difficulty and disorientation. B-ADL progresses in the earlier stages in VD and in he later stages in AD. Global cognitive dysfunction progression is the opposite: in the earlier stages in AD and in the later stages in VD.KeyWords:Alzheimer's disease, Vascular dementia, Comprehensive, Difference