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저자정보: 강수진 최스미

저널정보: 대한치매학회 Dementia and Neurocognitive Disorders(대한치매학회지) Dementia and Neurocognitive Disorders(대한치매학회지) 제8권 제2호

발행연도: 2009.1

수록면: 119 - 125 (7page)

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Background: Alzheimer’s disease (AD) is a neurodegenerative disorder that is characterized by a progressive deterioration of various cognitive, social and functional abilities. It has been reported that the clinical feature of AD may differ according to the onset of age the disease. Therefore, the aim of this study was to compare instrumental activities of daily living (IADL) in earlyonset AD (EOAD) and late-onset AD (LOAD). Methods: The patients diagnosed as AD between November 2005 and December 2008 were included in the study. Subjects consisted of 356 patients and were divided into EOAD and LOAD based on the onset age of 65 yr. We assessed their demographics and examined the Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Clinical Dementia Rating (CDR), and Seoul-instrument activities of daily living (S-IADL). We defined CDR 0.5 and 1 as mild and 2 as moderate severity of dementia. Results: Out of the 356 patients, 128 (36%) were EOAD and 228 (64%) were LOAD. EOAD patients demonstrated significantly greater impairment of IADL than LOAD when gender, level of education, CDR, level of depression, and duration of dementia were controlled (p<0.001). In mild severity of dementia, the total S-IADL score was not significantly different between the two groups (p=0.753). However, EOAD patients showed greater impairment of IADL than LOAD on 3 items (managing belongings, grooming, unlock and close entrance door, keeping appointment; p= 0.014, p=0.004, p=0.039, p=0.022, respectively), while LOAD showed greater impairment in preparing food and cooking than EOAD (p=0.003). In moderate severity of dementia, EOAD patients showed significantly greater impairment of IADL than LOAD (p=0.039) and greater impairment in unlock and close entrance door and talking recent events than LOAD (p=0.014, p=0.049, respectively). The IADL performance was significantly associated with cognitive function, duration of dementia, and level of education in EOAD, whereas in LOAD, it was significantly associated with cognitive function. Conclusions: Our study suggests that EOAD patients generally manifest greater impairment of IADL than LOAD and the MMSE may be strongly correlated with the IADL.

Background: Alzheimer’s disease (AD) is a neurodegenerative disorder that is characterized by a progressive deterioration of various cognitive, social and functional abilities. It has been reported that the clinical feature of AD may differ according to the onset of age the disease. Therefore, the aim of this study was to compare instrumental activities of daily living (IADL) in earlyonset AD (EOAD) and late-onset AD (LOAD). Methods: The patients diagnosed as AD between November 2005 and December 2008 were included in the study. Subjects consisted of 356 patients and were divided into EOAD and LOAD based on the onset age of 65 yr. We assessed their demographics and examined the Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Clinical Dementia Rating (CDR), and Seoul-instrument activities of daily living (S-IADL). We defined CDR 0.5 and 1 as mild and 2 as moderate severity of dementia. Results: Out of the 356 patients, 128 (36%) were EOAD and 228 (64%) were LOAD. EOAD patients demonstrated significantly greater impairment of IADL than LOAD when gender, level of education, CDR, level of depression, and duration of dementia were controlled (p<0.001). In mild severity of dementia, the total S-IADL score was not significantly different between the two groups (p=0.753). However, EOAD patients showed greater impairment of IADL than LOAD on 3 items (managing belongings, grooming, unlock and close entrance door, keeping appointment; p= 0.014, p=0.004, p=0.039, p=0.022, respectively), while LOAD showed greater impairment in preparing food and cooking than EOAD (p=0.003). In moderate severity of dementia, EOAD patients showed significantly greater impairment of IADL than LOAD (p=0.039) and greater impairment in unlock and close entrance door and talking recent events than LOAD (p=0.014, p=0.049, respectively). The IADL performance was significantly associated with cognitive function, duration of dementia, and level of education in EOAD, whereas in LOAD, it was significantly associated with cognitive function. Conclusions: Our study suggests that EOAD patients generally manifest greater impairment of IADL than LOAD and the MMSE may be strongly correlated with the IADL.

#Early-onset Alzheimer's disease #Late-onset Alzheimer's disease #Instrumental Activities of Daily Living #Mini-Mental State Examination

참고문헌 (24)

참고문헌 신청

Amaducci LA / 1986 / Origin of the distinction between Alzheimer’s disease and senile dementia: how history can clarify nosology / Neurology 36 : 1497 ~ 1499

American Psychiatric Association / 1994 / Diagnostic and statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) / American Psychiatric Association

Barclay LL / 1985 / Factors associated with duration of survival in Alzheimer’s disease / Biol Psychiatry 20 : 86 ~ 93

Bigio EH / 2002 / Synapse loss is greater in presenile than senile onset Alzheimer disease: implications for the cognitive reserve hypothesis / Neuropathol Appl Neurobiol 28

Choi SH / 2001 / Estimating the Validity of the Korean Version of Expanded Clinical Dementia Rating (CDR) Scale / J Korean Neurol Assoc 19 : 585 ~ 591

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