A Comparison of Five Types of Trail Making Test in Korean Elderly

BACKGROUND AND PURPOSE: Previously developed Korean versions of the Trail Making Test (TMT) that replaced the English in part B, has been unsuccessful in Korea. The current study identifies the type of TMT tasks from the among multiple TMT versions, which practically and accurately detects the stage of cognitive decline. METHODS: We applied five TMT versions, which include the original TMT, TMT-Korean letter (TMT-KL), TMT-Korean consonant (TMT-KC), TMT-black and white (TMT-B&W), and TMT-square and circle (TMT-S&C). A total of 168 participants were enrolled: 42 cognitively normal controls (NC), 72 patients with mild cognitive impairment (MCI), and 54 patients with Alzheimer's disease (AD). Two sets of TMT (set "A" including TMT, TMT-KL and TMT-B&W, and set "B" including TMT, TMT-KC, and TMT-S&C) were randomly administered to subjects within the contact of a fixed neuropsychological battery. RESULTS: The completion times of TMT-B and TMT-B&W successfully distinguished NC from MCI and AD. TMT-B&W also showed a high correlation with other neuropsychological tests, and correlated well with the original TMT. The other TMT were frequently not successfully completed, nor could they differentiate the clinical groups. CONCLUSIONS: Among the five TMT tasks, the original TMT and the TMT-B&W appeared to be most sensitive to the degree of cognitive impairment. TMT-B&W showed a pattern consistent with the original TMT; thus, this measure may be optimal in Korean older adults, where familiarity with the English alphabet is questionable.

A Comparison of the Prospective Memory among College Students, Normal Elderly, and Parkinson's Disease Patients

BACKGROUND: This study was conducted to examine the effects of normal aging and cerebral pathology on the prospective memory and the relationships between the prospective memory and frontal lobe functions. METHODS: The subjects were 30 college students, 30 normal elderly, and 30 Parkinson's disease patients. There was no significant difference in the mean age or education level between the normal elderly and Parkinson's disease patients. The Cambridge Prospective Memory Test and the Prospective and Retrospective Memory Questionnaire were administered to evaluate the prospective memory. The Seoul Verbal Learning Test and Rey Complex Figure Test were given to assess the verbal and visual episodic memories. The subjects also took the Sorting Test, the Korean-Color Word Stroop Test, and the Iowa Gambling Task to assess the frontal lobe functions. RESULTS: The results showed that the prospective memory declines with aging and pathological process. The normal elderly showed significantly lower scores on the time-based prospective memory than the event-based prospective memory, although the college students and Parkinson's disease patients did not show any differences between them. Many significant correlations were found between the prospective memory tests and frontal lobe tests in the normal elderly and Parkinson's disease patients, although only a few correlations were found in the college students. CONCLUSIONS: These quantitative and qualitative changes in the prospective memory by aging and frontal lobe dysfunction would support the de-differentiation hypothesis of aging.

HOME BASED EXERCISE EFFECTS ON COGNITION IN THE SEMI-INDEPENDENT ELDERLY / 体力科学

This study sought to determine whether aerobic exercise training affects cognitive functioning among semi-independent (> 75 years) and independent elderly people. Seventy-six semi-independent and independent elderly subjects were divided into the following groups: semi-independent control (n = 16); semi-independent training (n = 13); independent control (n = 22); independent training (n = 25). During the 12-week intervention, subjects in both training groups performed a bench-stepping exercise at the intensity of the lactate threshold. Subjects were assessed at baseline and post-intervention using the Frontal Assessment Battery test (FAB), the Modified Mini-Mental State Exam (3MS), and a bench-stepping test of aerobic capacity. During the intervention, FAB scores improved only in the semi-independent training group (<i>p</i> = .002), while 3MS and MMSE scores improved in both the semi-independent training (<i>p</i> = .032 and <i>p</i> = .004) and independent training groups (<i>p</i> = .001 and <i>p</i> = .013). FAB and 3MS scores were higher in the semi-independent training (<i>p</i> = .001 and <i>p</i> = .002) compared with the semi-independent control group after the intervention. Finally, post-intervention scores for FAB, and 3MS in the semi-independent training group almost reached the baseline levels of the independent control and independent training groups. These results indicate that moderate intensity bench-stepping exercise training can improve cognitive and frontal lobe functioning in semi-independent elderly people, almost to the level exhibited by independent elderly people.

Relationship of Nocturnal Sleep with Frontal Lobe Function in Mild Cognitive Impairment(MCI) Patients / 신경정신의학

OBJECTIVES: Nocturnal sleep disruption has been considered as a risk factor for cognitive impairment in the elderly. And the frontal lobe dysfunction was suggested to predict the progression to dementia. We aimed to illustrate the relationship of nocturnal sleep with frontal lobe function in mild cognitive impairment (MCI) patients. METHODS: Thirty MCI patients and 30 age- and sex-matched normal control (NC) subjects were selected. Frontal lobe function tests including Stroop Test, Similarity Test, Digit Span Test (DST), and Benton Visual Retention Test (BVRT) were administrated. Nocturnal polysomnography was done for each subject. RESULTS: There was no significant difference in the sleep parameters and diagnostic distributions of sleep disorders between the MCI and NC groups. In MCI patients, the mean hypopnea index (HI) of the ApoE4 positive group was higher than that of ApoE4 negative group. In the NC group, the wake time after sleep onset (WASO) was negatively correlated with the DST score (r=-0.545). In the MCI group, WASO tended to be negatively correlated with the Similarity Test score (r=-0.376, p=0.053), and slow wave sleep amount (SWS) was negatively correlated with the error score of BVRT (r=-0.489). CONCLUSION: Although there was no difference in the sleep quality and frequency of SAS between the MCI and NC groups, the severity of SDB was higher in MCI patients with ApoE4 compared to those without ApoE4. In the MCI group, the difficulty in maintaining sleep was associated with decreased executive function, and the decreased SWS was associated with impaired working memory. The relationship of nocturnal sleep with the frontal lobe function in MCI patients appears to be different from that of normal elderly subjects.