Dementia Response Technology Development Strategy through PEST-SWOT Analysis

Yu, Tae Gyu The Institute of Internet 2020 International journal of advanced smart convergenc Vol.9 No.1

The number of dementia patients in Korea is expected to increase to 3.30 million in 2050, and the cost of dementia management will increase sharply to KRW 106.5 trillion of GDP. In August 2017, the Moon Jae-in government announced the 'Dementia National Responsibility System' through a five-year plan for government operation and expanded the Dementia Peace Center nationwide. However, for this, strategic dementia-related technology development strategies should be established and given the role of government and the role of the private sector. Therefore, in order to derive the corresponding strategy, this study developed the government's 'dementia' response technology development strategy through the situation analysis from the political, economic, social, and technological perspective and the environmental (PEST) analysis of the strengths, weaknesses, opportunities, and threats (SWOT). As a result, the direction of technology development in the dementia-related medical device market is expected to become a trend of developing dementia self-measurement by developing low-cost and high-efficiency diagnostic technology products. It has been shown that the development of various products for consumers should begin. As a result, the dementia market approach strategy should be premised, the related technical support and legal restrictions should be minimized, and the education of related experts should be strengthened to solve the government's development of dementia technology and the social problems of dementia. In addition, by developing joint projects with major companies around the world and actively participating in the technology platform, it is important to naturally build up skills accumulation for the development of dementia technology and competence skills of dementia technology experts in the long term.

농촌형 치매 안심마을 사업이 지역주민의 치매 인식도, 인지기능, 우울감에 미치는 영향 :

한명일(Myeong-Il Han),김경민(Gyung-Min Kim),오지영(Ji-Young Oh),박미경(Mi-kyeong Park),강남인(Nam-In Kang),김재원(Jae-Won Kim) 대한노인정신의학회 2018 노인정신의학 Vol.22 No.1

Objective:According to the 3rd Korean National Dementia Plan, the dementia-friendly community initiative was launched. The aim of this study was to evaluate the effects of a rural dementia-friendly village project on the participants. Methods:Jeollabukdo Provincial Dementia Center designated Sosu-maeul, located in Buan-gun Jeollabuk-do, as a rural dementia-friendly village. We conducted dementia partnership education, youth-elder matching activity, and cognitive enhancing program. The efficacy of this project was evaluated by the changes in dementia awareness, cognitive function, and depressive symptoms. We used dementia awareness questionnaire, Mini-Mental Status Examination for Dementia Screening (MMSE-DS), and Korean version of Short form of Geriatric Depression Scale (SGDS-K). Results:This study was carried out with 24 residents in this community. There was no significant change in dementia awareness score between pre- and post-intervention (p=0.25). MMSE-DS score was significantly increased from 24.5 to 25.5 (p<0.001) and SGDS-K score was statistically improved from 3.5 to 2.5 (p=0.04) after interventions. Conclusion:We Jeollabukdo Provincial Dementia Center carried out a pilot study of a rural dementia-friendly village project. This project led to improvements on cognitive functions and depressive symptoms in the participants. But the improvement of dementia awareness was not achieved. More direct and experiencing interventions for people with dementia are necessary to improve dementia awareness.

Dementia is Associated with an Increased Risk of Hip Fractures: A Nationwide Analysis in Korea

전재현,박정훈,오충근,정재경,송정윤,김성헌,이승환,장재원,김영주 대한신경과학회 2019 Journal of Clinical Neurology Vol.15 No.2

Background and Purpose Dementia has been reported to be associated with an increased risk of hip fracture, but few case–control studies have been performed to actually confirm this. This study investigated the association between dementia and hip fracture by comparing the risk of hip fracture between subjects with and without dementia. Methods We examined a population-based matched cohort from the National Health Insurance Service–Senior Cohort data set that covers approximately half a million recipients of medical insurance in South Korea. Subjects with new clinically verified dementia during 2003–2007 were included, and five subjects without dementia were matched for age, sex, and index year to each subject with dementia as the controls. The risk of hip fracture for dementia was evaluated up to 2015 using Cox regression analysis. Results During the 12-year follow-up period, 284 subjects with dementia (10.66%) and 603 subjects without dementia (4.53%) experienced hip fractures. Dementia was independently associated with a higher risk of hip fracture [hazard ratio (HR)=2.840, 95% CI=2.449–3.293] and the adjusted HR for hip fracture in the subjects with dementia was highest within 2 years after the initial diagnosis (HR=2.862, 95% CI=2.053–3.990). Conclusions This study found that dementia could be an independent risk factor for hip fracture even at the early stage. This necessitates consideration of the future risk of falls and balance deficits in terms of physical activity after a diagnosis of dementia.

Justification for Integrated Care of Dementia and Presbycusis: Focused on National Dementia Policy

박시훈,한우재,박경호 한국청각언어재활학회 2021 Audiology and Speech Research Vol.17 No.1

Dementia management has become one of essential factors in the national policy globally in terms of the elderly health care service. In the brief communication, we compared various national reports from other countries to see whether current care service for the dementia had integrative approach for the patients with hearing loss in Korea. We also discussed a need of systematic hearing care for the elderly with dementia who was also a suspected case of aged-related hearing loss because many studies had confirmed that untreated hearing loss has a negative effect on dementia and vice versa. After analyzing the national policy from several countries, we found that the systems had been well established to screen dementia patients by using various clinical tests in UK, Canada, and Japan who provided appropriate services by classifying types of the dementia. Remarkably, the hearing test was included as the testing protocol for the dementia in Canada and the experts such as speech pathologists and music therapists had worked in a non-pharmacotherapy program for the elderly with dementia in France. Unfortunately, the dementia policy of Korea needs to be refined when considering the hearing care/management in that the integrated management of hearing and dementia are important. In addition, the clinicians who work for the dementia care home need to know audiological knowledge. Since the auditory training and rehabilitation for the elderly can reduce increased rate of cognitive decline, we strongly recommend that auditory training should be a part of the cognitive rehabilitation programs in the dementia care home.

부산지역 치매 재활의 현황 분석

신재욱,한혜경,신상화,박찬효,김혜진,김동인 대한고유수용성신경근촉진법학회 2020 PNF and Movement Vol.18 No.2

Purpose: The purpose of this study is to understand and analyze the current status of dementia management and rehabilitation services in Busan, South Korea, in response to the rapid increase of people with dementia due to the aging of the population. Methods: To investigate the current status of dementia rehabilitation in Busan, a survey was disseminated to dementia safety centers and day- and night-care centers in 16 districts/counties in Busan. Of the 209 day- and night-care centers, 23 institutes were registered in the National Health Insurance Service and received the highest grade (Grade A) in the institute evaluation that was implemented in each district. A telephone interview was conducted, and survey questions were related to the existence of an ongoing dementia rehabilitation program, program presenter, number of participants, progress method, program time, program duration, program contents, and participation path. Results: Dementia safety centers were implementing dementia prevention program, cognitive enhancing program, dementia program, self-help meeting and education program for family of dementia patient. The majority of the presenters of all four dementia-related programs were occupational therapists. The highest number of participants in the dementia prevention program was 15, and the highest number of participants in the cognitive enhancing program, dementia program, self-help meeting and education program for family of dementia patient was 10. All institutes’ programs delivered group therapy. As for the time and frequency of the program, most dementia program included three-hour sessions five times a week. Most dementia prevention program, cognitive enhancing program, self-help meeting and education program for family of dementia patient included 60-minute sessions once a week. The most frequently observed program duration for the dementia prevention program and cognitive enhancing program was six months, and the most frequently observed duration for the dementia program was three months. Lastly, study participants most often reported that self-help meeting and education program for family of dementia patient lasted for two months. Among day- and night-care centers in Busan, programs related to cognition were implemented in 18 institutes, and the majority of the program presenters were social workers. Conclusion: In response to the rapidly growing number of dementia patients due to the aging of the population, this study examined the current status of dementia rehabilitation in Busan. The study results underscore the need to develop systems that consider the circumstances in Busan and continuously and systematically support dementia programs.

치매환자들의 운전실태: 노인성치매임상연구센터 연구

최성혜,이지욱,김수정,최준용,권지원,윤병남,김종헌,윤보라,양영순,김상윤,정지향 대한치매학회 2014 Dementia and Neurocognitive Disorders Vol.13 No.4

Background: There are few studies about driving and dementia in Korea. The purpose of this study is to investigate the real condition of automobile driving in patients with dementia and the characteristics of those who continue to drive after diagnosis of dementia. Methods: A total of 4,377 patients including 3,792 with Alzheimer’s disease and 585 with vascular dementia were recruited from multiple nationwide hospitals. Clinical evaluations and neuropsychological tests were done in them according to the protocol of the Clinical Research Center for Dementia of South Korea study. Caregivers replied which patients drove an automobile, gave up driving, or has never driven. The same evaluations of them were followed after one year. Results: There were 272 (6.2%) drivers, 321 (7.3%) ex-drivers, and 3,784 (86.5%) non-drivers with dementia. Drivers with dementia were younger and had higher Korean Mini-Mental State Examination (K-MMSE) (21.5±4.3 vs 19.8±5.1 vs 17.4±5.2, p<0.001) and lower Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) scores (4.08±2.15 vs 5.80±3.41 vs 5.83±3.39, p<0.001) compared with ex-drivers and non-drivers with dementia. The drivers and ex-drivers with dementia had higher educational level and a higher proportion of male compared with non-drivers with dementia (77.6% vs 80.1% vs 23.3%, p<0.001). About 54.6% of the drivers with dementia continued to drive at one year after diagnosis of dementia. They had higher K-MMSE (23.2±3.6 vs 20.8±4.5, p=0.003) and lower CDR-SB scores (3.30±1.47 vs 4.40±1.85, p=0.001) at baseline compared with those who quitted driving after baseline. Conclusions: Male patients who were relatively young and had high educational level and mild dementia had a tendency to drive an automobile at that time of diagnosis of dementia. About half of them continued to drive after diagnosis of dementia.

요양시설에 입소한 치매환자의 사망과 관련된 임상적 변인에 관한 고찰

황영재(Youngjae Hwang),조경형(Kyeonghyeong Jho),최진숙(Jinsook Choi),신영민(Youngmin Shin) 대한노인정신의학회 2002 노인정신의학 Vol.6 No.2

저자들은 치매와 비치매 환자, 알쯔하이머형 치매와 혈관성 치매 환자의 사망과 관련된 변인들을 조사하였다. 특정 요양시설의 6년간 사망자 421명 중 부적합자 70명을 제외한 351명(치매 283명, 비치매가 68명)을 대상으로 하였다. 치매 환자는 알쯔하이머형 치매 환자 146명, 혈관성 치매 환자 101명, 비특이성 치매 36명으로 구성되었는데, 본 연구에서는 알쯔하이머형 치매와 혈관성 치매를 비교 연구하였다. 결과는 다음과 같다. 1) 치매 환자의 평균사망연령이 비치매 환자보다 높았고 알쯔하이머형 치매의 평균 사망 연령이 혈관성 치매보다 높았다. 2) 입소 후 사망 시까지의 기간은 치매와 비치매 군간 및 알쯔하이머형 치매와 혈관성 치매군간에 차이를 보이지 않았다. 남자 알쯔하이머형 치매는 기간이 유의 하게 짧았으나 여자 환자의 수보다 절대적으로 적어서 전체 통계에 큰 영향을 미치지 못 하였다. 3) 선행질환에서 알쯔하이머형 치매에 비하여 혈관성 치매에서 고혈압, 뇌혈관 질환, 당뇨병이 유의하게 높았다. 4) 사망원인은 감염, 전신대사성 질환이 공통적으로 많았다. 알쯔하이머형 치매에서는 전신대사성 질환이 유의미하게 많았고 혈관성 치매에서는 뇌혈관 질환이 유의하게 많았다. 앞으로 좀더 장기간에 걸쳐 생존율 분석 등을 추가하고 체계적 연구가 필요하다고 생각된다. Objective:This study was designed to evaluate the cause of mortality in patients with dementia, including Alzheimer's disease and multi-infarct dementia, and those without dementia. Method:Hospital records of geriatric patients (≥65) in nursing home having dementia were reviewed retrospectively for 6 years. The total number of patients was 351 (the number of demented patients was 146 and those without dementia was 68). Of the ones with dementia, 146 had dementia of Alzheimer's type, 101 patients had vascular dementia, and 36 patients had non-specific dementia. This study focused on the different complications associated with Alzheimer's disease and cerebrovascular dementia. Result:1) The average age at death of demented patient is higher than the non-demented population; however, there is no difference in age between Alzheimer's disease and vascular dementia. 2) There is no difference in time spent in the nursing home among the non-demented group, Alzheimer's disease and vascular dementia group from admission to death. The life expectancy of male patients with Alzheimer's disease after admission to the nursing home is significant shorter than their female counterpart. 3) Patients with vascular dementia have a higher incidence of hypertension, atherosclerotic disease, and diabetes than the Alzheimer's patients. 4) The main overall causes of the death (in nursing home patients) are infection and sepsis. In Alzheimer's disease's, sepsis is the major cause of death, while in vascular dementia, atherosclerotic disease is the number one cause. Conclusion:Knowledge of the causes of the death in demented patients may help the management of the possible complications associated with the different types of dementia. However, long-term research is then needed to analyze the survival rates of demented nursing home patients.

작업치료 전공 학생의 치매에 대한 지식, 태도 및 치매 교육 요구 분석

정혜영 ( Hye-young Jung ),유찬욱 ( Chan-uk Yoo ) 대한통합의학회 2021 대한통합의학회지 Vol.9 No.2

Purpose : This study was conducted to examine the knowledge of, attitude toward, and education requirements for dementia that students majoring in occupational therapy have and to determine the correlations between knowledge of and attitude toward dementia according to the degree of dementia education provided in a university. Methods : From January 2021 to February 2021, 150 students majoring in occupational therapy in Daejeon, Jeollanam-do, and Gyeongsangnam-do were enrolled in this study and surveyed using a questionnaire. The students who participated understood the purpose of this study and agreed to participate. For data analysis, SPSS version 20.0 was used. Results : The subjects scored, on average, 18.64 ± 3.23 of 30 points Knowledge of dementia. The subjects had many correct answers in the items on dementia assessment, diagnosis, and treatment and care, whereas they had few correct answers in the items on the risk factors of dementia. In terms of attitude toward dementia, the subjects scored 37.38 ± 8.32 on the stability subscale and 48.26 ± 9.11 on the knowledge subscale; thus, they had higher scores on the knowledge subscale. The subjects had high educational requirements regarding the cognitive activity and activities of daily living of occupational therapy for dementia. The subjects’ knowledge of dementia had a positive correlation with their attitude toward dementia according to the degree of dementia education (p<.05). Conclusion : The students majoring in occupational therapy had high educational requirements of the cognitive activity and activity of daily living for dementia. When they had more education of dementia, their attitude toward dementia had a positive correlation with their knowledge of dementia. Therefore, it is considered that students majoring in occupational therapy need to have professional education in their university curriculum.

우리나라 60세 이상 인구의 치매 사망에 관한 연구: 2014-2018

박상화 ( Sang Hwa Park ),이용운 ( Yong Woon Lee ),임달오 ( Dar Oh Lim ) 대한보건협회 2020 대한보건연구 Vol.46 No.4

Purpose : To compare the gender, age, regional and seasonal difference of dementia deaths (vascular & unspecified dementia, Alzheimer disease) in Korea between 2014 and 2018. Method : The study was based on dementia death data aged 60 years and older (45,969 deaths) from the 2014-2018 vital statistics of Korea. We estimated the age and gender specific dementia death rate, regional variance of age-gender standardized death rate, and seasonal variance of dementia deaths. Results : The percentage of dementia deaths attributed to Alzheimer disease was 55.1 percent, and percentage of unspecified dementia was 36.9 percent. Dementia death rate per 100,000 among people aged 60 years and older was 94.1. Cause specific dementia death rate were 51.8 in Alzheimer’s disease, 7.5 in vascular dementia and 34.8 in unspecified dementia. Death rates were higher for females (118.4) than for males (63.6). The women died more than men with odds ratio 1.86. Age specific dementia death rates were 4.6 in aged 60-69 years, 44.2 in aged 70-79 years, 367.7 aged 80-89 years, and 1,756.8 in aged 90 years and older. Dementia death rate of male was higher than those of female in aged 60-79 years, with the exception for age group 80 years and older. 80.4 percent of dementia’s decedents died in medical facility, and 12.5 percent in nursing home and others, and 7.1 percent in the home. In the age-gender standardized dementia death rate (per 100,000) by region, the highest death rate was observed in Gwangju metropolitan city (166.8), and the lowest in Jeju-do (60.6) and Gangwon-do (61.8). There was a significant increase the death rate in Gwangju metropolitan city (odds ratio: 2.36, 95% CI: 2.33-2.39), in Ulsan metropolitan city (1.86, 1.84-1.89), and in Busan metropolitan city (1.75, 1.72-1.77), as compared with the death rate in Seoul metropolitan city (70.8). Average number of dementia deaths in one day was 25.2 deaths during the period. The incidence of dementia deaths was highest in January (29.4 deaths per day) and December (29.1 deaths) and month with lowest incidence of dementia deaths was from June to August (21.2 - 21.9 deaths). There was a winter peak (28.8 deaths) and summer trough (21.6 deaths) in daily average number of dementia deaths. Conclusion : Alzheimer disease accounted for half of all dementia deaths. Death rate due to dementia varied by age, gender and season. Regional variance of dementia deaths was observed between provinces and metropolitan cities in Korea. Further investigation is needed to assess the risk factors (age, gender and regional variances) associated with these differences.

치매교육 참여여부가 치매예방행위에 미치는 영향: 치매두려움과 치매지식의 매개효과를 중심으로

한지나 한국보건교육건강증진학회 2023 보건교육건강증진학회지 Vol.40 No.2

Objectives: This study examines not only whether the participation to dementia education positively relate to fear, knowledge, and preventive behaviors but also whether dementia fear and knowledge mediate the relationship between dementia education and preventive behaviors among Korean individuals who are 50 years or older and live in Busan city. Methods: A total of 1,000 community-dwelling individuals from the Survey of Dementia Conditions of Busan city were included in this study. Regression models were tested for the direct and indirect effects. Results: Individuals who participated in dementia education programs were likely to have more dementia fear and exhibit more preventive behaviors than those who did not participate. Dementia fear mediated the association between dementia education and preventive behaviors. Dementia knowledge was not related to dementia education and preventive behaviors. Conclusion: Dementia education might be more effective for increasing preventive behaviors when the fear of dementia was appealed rather than dealing with only the knowledge of dementia.