Study on Cognitive Reserve in Korea Using Korean Version of Cognitive Reserve Index Questionnaire / 신경정신의학

OBJECTIVES: To evaluate cognitive reserve in Korea using Korean version of Cognitive Reserve Index questionnaire (K-CRIq) and to investigate the effects of gender and age on cognitive reserve. METHODS: Three hundred and fifty-eight healthy subjects aged 25–85 years old in one community participated in the study. K-CRIq was developed and administered to all subjects to assess the effects of gender and age on cognitive reserve. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were administered to subjects over 65 years old to test concurrent validity. RESULTS: Age and gender as well as their interaction significantly affected Cognitive Reserve Index (CRI) score. Men had higher cognitive reserve than women over 45 years old, but at younger ages there was no gender difference in cognitive reserve. CRI score and sub-scores were strongly associated with the MMSE and MoCA. CONCLUSION: The results indicate that the gender effect on cognitive reserve is disappearing in the young generation in Korea. Scores in neuropsychological tests are predicted well by the CRI score.

The Effectiveness of Free and Cued Selective Reminding Test Using Pattern Cue

OBJECTIVE: Memory Impairment has been proposed as the first sign in preclinical and early Alzheimer's disease (AD). This study aims to assess the utility of a new memory test based on Free and Cued Selective Reminding Test using pattern cue that seems useful for detecting memory impairments associated with AD. METHODS: Twenty-six patients with mild cognitive impairment, 24 AD patients at a mild stage, 35 normal controls and 8 Lewybody dementia (LBD) patients at a mild stage took part in the study. A newly devised Pattern Cued Recall Test (PCRT) was compared with established memory test, the word list recall from the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). To assess the ability of the PCRT subtests and CERAD-K to screen dementia, receiver operating characteristic curves were plotted. RESULTS: The distinctive feature of the PCRT was that encoding specificity was increased by adding an immediate cued recall stage at the encoding phase. PCRT was confirmed as having sufficient validity to diagnose dementias. Compared to CERAD-K, the PCRT had similar accuracy of discriminating AD. But the analysis showed better diagnostic validity of PCRT than CERAD-K in LBD. Therefore, this test appears to be, especially, well suited for the diagnosis of mild LBD. CONCLUSION: This study showed that a memory test based on controlled encoding and retrieval condition and especially using pattern cue could be effective methodology for mild AD and LBD from normal control. PCRT could be an alternative to diagnose LBD by testing visual impairments, which is a hallmark symptom of LBD. Therefore, a further clinical study should be promising.

The Utilization Rates and Predictors of Dementia Care Services of Low-Income Patients in One Community Based Dementia Care Center

OBJECTIVE: The aim of this study is to determine the utilization rates and predictors of dementia care services. METHODS: We recruited 66 low-income elderly patients who were registered to one community based dementia care center. The care services were composed of hygiene care items supply, nurse visiting service, education programs for caregivers and patients, and global positioning system (GPS) or identification tags supply. Service use prediction was evaluated by multiple logistic regression analysis. RESULTS: Use rate of hygiene care items supply was higher than others [44 of 66 (66.67%)]. The patients who lived with family had used more care items than who lived alone [odds ratio (OR), 3.43 ; 95% confidence interval (CI), 1.73 to 5.54]. The patients who had comorbid conditions used more hygiene care items than who had not (OR 2.50 ; 95% CI, 1.35 to 3.78). In participants with the higher education level, the higher use rate of education program was predicted (OR 1.14 ; 95% CI, 1.01 to 1.28). CONCLUSION: These findings suggested that living-alone and low education should be overcome for providing more effective dementia care services to low-income patients.