Effect of ApoE Genotype on the Relationship between Nutritional Risk and Cognition in the Elderly

BACKGROUND: The purpose of this study is to find out the effect of ApoE genotype on the relationship between nutritional risk and cognition of the elderly in a community. METHODS: A total of 996 subjects (343 men and 653 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-SGDS (Korean version of Short Form Geriatric Depression Scale), K-MMSE (Korean version-Mini Mental State Examina- tion), and NSI (Nutritional Screening Initiative) checklist. We also examined blood pressure, fasting serum glucose, lipid profile, body mass index, and ApoE genotyping. RESULTS: 649 subjects (65.2%) were on good nutritional state (NSI score or = 3). On multiple logistic regression analysis, moderate or high nutritional risk was associated with an increa- sed risk for cognitive impairment (K-MMSE score < or = 17) after adjustment with age, sex, K-GDS and educational level in the absence of ApoE epsilon4 allele (OR 1.78, 95% CI 1.15-2.77). CONCLUSION: These results suggest that nutritional risk may be associated with cognitive function in the elderly only in the absence of ApoE epsilon4 allele.

Analysis of Current Status of Management for Dementia between City and Country Health Center

OBJECTIVES: The purpose of this study was as follows: 1) to compare the current status of management for dementia between city and country health center. 2) to check the amount and detailed items of budgets for dementia in dementia counseling center, referral courses for registration of dementia patient, number of dementia patient referred to welfare institutions for the elderly. 3) to understand the troubles in management for dementia in health center and to provide baseline data about future community dementia management system. METHOD: The questionnaire was administered to 248 public health centers. The 162 collected questionnaires were used in analysis and the whole response rate was 65.3%. Questionnaire composed by general contents about dementia management in health center and dementia counseling center. Statistical analysis was conducted to compare the difference about each item in city and country health center. RESULTS: City and country health center showed differences in number of registered dementia patient, budgets for dementia, referral courses for registration of dementia patient, number of dementia patient referred to institution, troubles in management for dementia in health center. CONCLUSION: Current dementia management system does not meet the various needs of community for management of dementia. Thus, complementary strategies are needed to solve this problem.