Research advance of cognitive reserve in brain aging / 医疗卫生装备

The current proxy indicators and quantitative strategy were summarized for cognitive reserve,the findings of cognitive reserve was discussed then in brain aging and Alzheimer's disease,and some future research directions were presented about cognitive reserve.The reserve of brain explains the disjunction between clinical symptoms and the degree of brain damage,whereby some people can tolerate more of age-related or Alzheimer's disease pathology than others and maintain brain function.The cognitive reserve hypothesis has been widely used in epidemiological and neuroimaging studies,but it lacks a unified quantitative indicator.The future research of cognitive reserve should be focused on the development of quantitative indicators that cover a variety of potential factors dynamically.

Research advance of cognitive reserve in brain aging / 医疗卫生装备

The current proxy indicators and quantitative strategy were summarized for cognitive reserve,the findings of cognitive reserve was discussed then in brain aging and Alzheimer's disease,and some future research directions were presented about cognitive reserve.The reserve of brain explains the disjunction between clinical symptoms and the degree of brain damage,whereby some people can tolerate more of age-related or Alzheimer's disease pathology than others and maintain brain function.The cognitive reserve hypothesis has been widely used in epidemiological and neuroimaging studies,but it lacks a unified quantitative indicator.The future research of cognitive reserve should be focused on the development of quantitative indicators that cover a variety of potential factors dynamically.

Is It Possible to Delay or Prevent Age-Related Cognitive Decline? / 가정의학회지

Already in the 90s, Khachaturian stated that postponing dementia onset by five years would decrease the prevalence of the late onset dementia by 50%. After two decades of lack of success in dementia drug discovery and development, and knowing that worldwide, currently 36 million patients have been diagnosed with Alzheimer's disease, a number that will double by 2030 and triple by 2050, the World Health Organization and the Alzheimer's Disease International declared that prevention of cognitive decline was a 'public health priority.' Numerous longitudinal studies and meta-analyses were conducted to analyze the risk and protective factors for dementia. Among the 93 identified risk factors, seven major modifiable ones should be considered: low education, sedentary lifestyle, midlife obesity, midlife smoking, hypertension, diabetes, and midlife depression. Three other important modifiable risk factors should also be added to this list: midlife hypercholesterolemia, late life atrial fibrillation, and chronic kidney disease. After their identification, numerous authors attempted to establish dementia risk scores; however, the proposed values were not convincing. Identifying the possible interventions, able to either postpone or delay dementia has been an important challenge. Observational studies focused on a single life-style intervention increased the global optimism concerning these possibilities. However, a recent extensive literature review of the randomized control trials (RCTs) conducted before 2014 yielded negative results. The first results of RCTs of multimodal interventions (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, Multidomain Alzheimer Prevention Study, and Prediva) brought more optimism. Lastly, interventions targeting compounds of beta amyloid started in 2012 and no results have yet been published.

Correlation between Head Circumference and Cognition in the Elderly by ApoE Genotype / 신경정신의학

OBJECTIVES: The aim of this study is to find out the effect of ApoE genotype on correlation between head circumference and cognition of the elderly in the community. METHODS: A total of 1,152 subjects (380 men and 772 women) aged 60-91 years were analyzed from preliminary data of GDEMCIS (Gwangju Dementia and MCI Study). The study questionnaire consisted of demographic characteristics, current and past illness history, drug history and K-MMSE (Korean version-Mini Mental State Examination). We also measured the head circumference and examined ApoE genotype. RESULTS: On regression analysis, as head circumference becomes smaller, K-MMSE scores decreased adjusted by age, sex, educational level, ApoE epsilon4 allele, current smoking and alcohol drinking status (beta=0.15, p=0.04). Only in the lowest quartile group, presence of ApoE epsilon4 allele reduced K-MMSE scores adjusted by age, sex, educational level, height, current alcohol drinking and smoking status (beta=-1.39, p=0.008). CONCLUSION: These results suggest that head circumference may have an influence on K-MMSE scores, and presence of ApoE epsilon4 allele may be a medicating factor.

Correlation between Head Circumference and Visuospatial Ability of Elderly in Community

OBJECTIVES: The aim of this study is to find out the correlation between head circumference and visuospatial function of the elderly in community. METHODS: A total of 463 subjects (170 men and 293 women) aged 60-91 years were analyzed from preliminary data of GDEMCIS (Gwangju Dementia and MCI Study). The study questionnaire consisted of demographic characteristics, current and past illness history, drug history, K-MMSE, SNSB-D. We also measured head circumference and examined ApoE genotype. RESULTS: On regression analysis, as head circumference become smaller, visuospatial memory scores (S-Rey immediate recall & delayed recall) decreased adjusted by age, height, sex, educational level, ApoE epsilon 4 allele, current smoking and alcohol drinking (beta=0.18, p=0.002, beta=0.15, p=0.01). Presence of ApoE epsilon 4 allele has no direct correlation with head circumference and cognitive decline. CONCLSION: As head circumference become smaller, only visuospatial memory scores decreased significantly. These results suggest that visuospatial memory function might be one of the sensitive markers of brain reserve differences.