Vitamin D Deficiency/Insufficiency among Inpatients with Depressive Symptoms

OBJECTIVE: Although the association between low vitamin D levels and depressive symptoms has been widely reported, studies investigating the relationship between hypovitaminosis D and depressive symptomatology are scarce. METHODS: We retrospectively studied the relationship between vitamin D status and depressive symptoms in 196 patients hospitalized for a major depressive episode. RESULTS: The baseline 17-item Hamilton Depression Rating Scale total and depression factor (item 1, 2, 3, 7) scores were significantly higher in the vitamin-D-insufficiency/deficiency group than in the vitamin-D-sufficiency group. CONCLUSION: It is important to consider measuring the vitamin D levels of patients with severe and core depressive symptoms and providing vitamin D supplementation when necessary.

Neurobiological understanding of suicide

Suicide is a complex phenomenon resulting from interactions between individual vulnerabilities and socio-environmental factors. The current review primarily focuses on research into the serotonin system, hypothalamic-pituitary-adrenal axis, neurotrophic factors, lipid metabolism, and functional neuroimaging studies. It has been found that dysfunctions in the serotonin system, hypothalamic-pituitary-adrenal axis abnormalities, and low brain-derived neurotrophic factor and cholesterol levels may be linked to suicide. Additionally, recent neuroimaging studies have suggested that structural and functional abnormalities in brain areas related to cognitive and emotional regulation may be associated with suicide. More research incorporating advanced methodological approaches may shed further light on the neurobiological basis of suicide.

Neurobiological understanding of suicide

Suicide is a complex phenomenon resulting from interactions between individual vulnerabilities and socio-environmental factors. The current review primarily focuses on research into the serotonin system, hypothalamic-pituitary-adrenal axis, neurotrophic factors, lipid metabolism, and functional neuroimaging studies. It has been found that dysfunctions in the serotonin system, hypothalamic-pituitary-adrenal axis abnormalities, and low brain-derived neurotrophic factor and cholesterol levels may be linked to suicide. Additionally, recent neuroimaging studies have suggested that structural and functional abnormalities in brain areas related to cognitive and emotional regulation may be associated with suicide. More research incorporating advanced methodological approaches may shed further light on the neurobiological basis of suicide.

Overexpression of Cell Cycle Proteins of Peripheral Lymphocytes in Patients with Alzheimer's Disease

OBJECTIVE: Biological markers for Alzheimer's disease (AD) will help clinicians make objective diagnoses early during the course of dementia. Previous studies have suggested that cell cycle dysregulation begins earlier than the onset of clinical manifestations in AD. METHODS: We examined the lymphocyte expression of cell cycle proteins in AD patients, dementia controls (DC), and normal controls (NC). One-hundred seventeen subjects (36 AD, 31 DC, and 50 NC) were recruited. The cell cycle proteins CDK2, CDK4, CDK6, cyclin B, and cyclin D were measured in peripheral lymphocytes. Cell cycle protein expression in the three groups was compared after adjusting for age and sex. RESULTS: The levels of cell cycle proteins CDK2, CDK4, CDK6, cyclin B, and cyclin D were significantly higher in AD patients than in the NC subjects. The DC group manifested intermediate levels of cell cycle proteins compared with the AD patients and the NC subjects. The present study indicates that cell cycle proteins are upregulated in the peripheral lymphocytes of AD patients. CONCLUSION: Cell cycle dysregulation in peripheral lymphocytes may present a promising starting point for identifying peripheral biomarkers of AD.

Extrapyramidal Signs and Impairment of Cognitive Subdomains in Mild Cognitive Impairment : A Clinical Research Center for Dementia of South Korea (CREDOS) Study

OBJECTIVES: This study investigated the association between extrapyramidal signs (EPS) and five cognitive sub-domains in a large number of patients with mild cognitive impairment (MCI). METHODS: Our analyses considered 1,943 patients with MCI drawn from the nationwide Clinical Research of Dementia of South Korea study. EPS were defined as presence in patients with at least 1 of 11 operationally specified features. We assessed five cognitive sub-domains : attention, language, visuospatial function, memory, and frontal/executive function using the Seoul Neuropsychological Screening Battery-Dementia version. The associations of EPS with each cognitive sub-domain were analyzed with a multiple linear regression model after controlling for confounding factors : sex, age, education years, diabetes, hypertension, severity of global function, depressive symptoms, and white matter hyperintensities (WMH). RESULTS: 138 MCI patients (7.1%%) had EPS. This group had more global cognitive deterioration and severe WMH. MCI patients with EPS showed lower performance compared to those without EPS in 3 cognitive sub-domains: attention (p=0.05), visuospatial function (p=0.02), and frontal/executive function (p<0.0001). The language sub-domain and the memory sub-domain did not differ between the EPS positive and the EPS negative groups. CONCLUSION: EPS in MCI are associated with greater cognitive impairment in specific functional sub-domains rather than with global greater cognitive deterioration.

Alcohol Consumption as Risk Factor for Progression from Mild Cognitive Impairment to Dementia : A Clinical Research Center for Dementia of South Korea Study

OBJECTIVE: Patients with mild cognitive impairment (MCI) are at high risk for dementia. Excessive alcohol consumption is known to adversely affect cognitive function. This study aimed to investigate the relationship between alcohol consumption and the risk for dementia in a cohort of MCI patients. METHODS: Participants (n=416) with (MCI) who met Petersen's criteria were recruited from a nationwide, prospective cohort study of dementia and were followed for a median of 17.52 months (range 5.4-63.48). Alcohol consumption was evaluated at baseline. RESULTS: One hundred twenty seven individuals (30.5%) developed incident dementia (115 Alzheimer disease) during follow-up. Patients with current alcohol consumption at baseline had a higher rate of progression to Alzheimer's dementia than those without current alcohol consumption (hazard ratio 1.61 ; 95% confidence interval 1.03 to 2.53). CONCLUSION: Alcohol consumption may increase the risk of progression to Alzheimer's dementia in patients with MCI.

Association between Depression and Education Level in Alzheimer's Dementia : A CREDOS (Clinical Research Center for Dementia of South Korea) Study

OBJECTIVES: We aimed to identify the association depression with education level in patients with Alzheimer's dementia (AD). METHODS: We examined 911 patients with AD in CREDOS (Clinical Research Center for Dementia of South Korea) study and designed cross-sectional study. Each patient underwent psychiatrical, neurological and medical examination, interview for caregivers, laboratory tests, neuropsychological tests, and brain MRI. Cognitive function was measured using Korean version of Mini-Mental State Examination, Global Deterioration Scale and Clinical Dementia Rating. Psycho-Behavioral symptom was measured using Caregiver-Administered Neuropsychiatric Inventory. Daily Living was measured using Barthel Index for daily living activities and Seoul-Instrumental Activities of Daily Living. Depressive symptoms using the Korean version of the Short form on Geriatric Depression Scale were measured. Education was classified into low, intermediate, and high levels. 621 patients were performed APOE genotyping among the 911 patients. RESULTS: Out of the 911 patients, 477 were low education, 287 were intermediate education, and 147 were high education. 341 patients had depression. In logistic regression model we confirmed low education was the risk factor of depression (OR 2.26, 95% CI 1.66-3.07). CONCLUSION: This study confirmed that low education was associated with depression in Alzheimer's dementia.