Impaired Design Fluency Is a Marker of Pathological Cognitive Aging; Results from the Korean Longitudinal Study on Health and Aging

OBJECTIVE: We investigated neuropsychological markers that can be used to discriminate pathological cognitive aging from normal cognitive aging. METHODS: We administered frontal lobe function tests including the Wisconsin Card Sorting Test (WCST), digit span test, lexical fluency test, fixed condition design fluency test, and Trail Making Test B (TMT-B) to 92 individuals with pathological cognitive aging (PCA) and 222 individuals with normal cognitive aging (NCA). We examined the main effects of participants' diagnoses (PCA, NCA) and age (65-69 years old, 70-74 years old and 75 years old or over) on their test performance using multivariate analysis of variance. RESULTS: The main effects of both the diagnosis (F=2.860, p=0.002) and the age group (F=2.484, p<0.001) were significant. The PCA group showed lower performance on the backward digit span test (F=14.306, p<0.001), fixed condition design fluency test (F=8.347, p=0.004) and also exhibited perseverative errors in the WCST (F=4.19, p=0.042) compared with the NCA group. The main effect of the diagnosis on the backward digit span test and the fixed condition design fluency test remained significant after Bonferroni correction. The main effect of age remained significant in the TMT-B (F=8.737, p<0.001) after Bonferroni correction. Other test scores were not influenced by diagnosis or age. CONCLUSION: The design fluency task may be a good neuropsychological marker to assess pathological cognitive aging.

Development of an Informant Report Questionnaire for Dementia Screening: Seoul Informant Report Questionnaire for Dementia(SIRQD) / 신경정신의학

OBJECTIVES: This study aimed to develop an informant report questionnaire for dementia screening and to verify its reliability and validity. METHODS: A preliminary questionnaire with 30 items was administered to a reliable informant for each of 81 dementia patients and 166 normal controls. Through item analyses, the 15-item Seoul Informant Report Questionnaire for Dementia (SIRQD) was clraum up. Internal consistency and inter-informant correlation were analyzed. Factor analysis and ROC curve analysis were also performed. RESULTS: SIRQD was found to have high internal consistency and inter-informant reliability. Optimal cut-off score of SIRQD was 9/10, and the sensitivity and specificity at that score were .850 and .873, respectively. SIRQD was composed of four major factors (remote memory, recent memory, language, and activity of daily living). SIRQD was closely equivalent to MMSE-KC in terms of overall dementia screening ability, and it appeared efficient in discriminating very mild dementia from normal. SIRQD showed low false positive and negative rates, irrespective of levels of education, age, and sex. CONCLUSION: SIRQD possess good psychometrical properties and is probably very useful to screen dementia, especially for the Korean elderly with a very wide range of educational background.

Prevalence of Cognitive Impairment and Depressive Symptoms among the Elderly in an Urban Community / 신경정신의학

OBJECTIVES: This study was to investigate the prevalence of cognitive impairment and depressive symptoms among the elderly in an urban community. METHODS: Korean version of Mini-Mental State Examination(MMSE-K), Short version of Geriatric Depression Scale(SGDS), and the Center for Epidemiologic Studies Depression(CES-D) were administered to 447 elderly persons(37.7% of all residents aged 65 and older) who resided in "Sanggye 10 Dong" by lay interviewers. Then a Psychiatrist and two Psychiatric residents interviewed the elderly scoring 23 or less on MMSE-K and diagnosed with dementia according to the criteria of DSM-III-R. RESULTS: The prevalence of cognitive impairment was estimated as 37.1%(male 18.8%, female 47.0%) by MMSE-Kor=25 and 15.8% by SGDS>or=10. Prevalences(CES-D>or=25) for the age groups 65 to 69, 70 to 74, 75 to 79, 80 to 84, and over 85 were, respectively 15.7%, 18.1%, 23.4%, 13.3%, and 23.5%. Caseness of depressive symptoms(CES-D >or= 25) was not related to sex, age, years of education, marital status, physical illness, occupation, living condition, and financial status. Of 166 persons who had cognitive impairment(MMSE-K