Association between Obesity Indices and MMSE-K in Elderly / 신경정신의학

OBJECTIVES: The aim of this study was to investigate associations between obesity indices and cognitive functions using data from individuals older than 65 years in South Korea. METHODS: A total of 151 Koreans older than 65 years participated in this study voluntarily. Obesity was determined using body mass index (BMI) and waist-hip ratio (WHR). Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination (MMSE-K). The participants were divided into four groups according to BMI : underweight (BMI or =25.0), and two groups according to WHR : normal (WHR or =0.8). Baseline characteristics were compared among different BMI or WHR subgroups. RESULTS: Older age and smoking habits showed an association with poor cognitive function. Among different BMI groups, the overweight group had the highest scores of MMSE-K ; the item scores for time and place orientation (4.48+/-0.770 and 4.80+/-0.500) and attention/calculation (4.00+/-1.258) as well as total score (25.88+/-2.877). Overweight in BMI showed an association with better cognitive function (OR(adjusted )=0.098, 95% confidence interval=0.017-0.577). CONCLUSION: In this study, the overweight group measured by BMI showed better cognitive function than other groups. Overweight in elderly might be acceptable in order to maintain cognitive performance. Further investigation regarding the underlying mechanism explaining the relationship between cognitive function and body weight will be needed.

A Combination of the Korean Version of the Mini-Mental State Examination and Korean Dementia Screening Questionnaire Is a Good Screening Tool for Dementia in the Elderly

OBJECTIVE: The aim of this study is to investigate whether a combination of the Korean version of the mini-mental state examination (K-MMSE) and the Korean dementia screening questionnaire (KDSQ) is better than the use of test alone when differentiating patients with dementia from those without dementia in Korea. METHODS: The subjects (patients without dementia, 1120; patients with dementia, 908) were recruited from the Clinical Research Center for Dementia of South Korea. K-MMSE and KDSQ were used. Diagnosis of dementia was made according to the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. The weighted sum rule derived from logistic regression analysis was used for the combination of K-MMSE and KDSQ. RESULTS: On comparing the Area Under the Curve for each test using the method of Hanley and McNeil, the weighted sum was significantly greater than KDSQ or K-MMSE, and K-MMSE was significantly greater than KDSQ. CONCLUSION: This study shows that when differentiating patients with dementia from those without dementia in Korea, a combination of K-MMSE and KDSQ achieved using the weighted sum method is better than either test performed alone. Further epidemiological studies in community-based settings are required before our results can be generalized to nonclinical samples.