The Effect of Living with Spouse on Cognitive Decline and Depressive Symptom in Elderly People

OBJECTIVE: The aim of this study was to determine whether living with spouse contributes to cognitive decline and depressive symptom among elderly people. METHODS: 939 participants were recruited through Keum-Cheon center for dementia in Seoul. All subjects were assessed using the Korean version of Mini-Mental Status Examination (MMSE-K), Korean version of Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) and Geriatric Depression Scale (GDS). Furthermore, epidemiological factors (age, sex, education year, and characteristics of family) assessed to find correlation with cognitive decline. RESULTS: Controlling for gender, age, and education year, living with spouse was significantly associated with cognitive decline (B=-0.486, S.E=0.203, Wald=0.331, Exp (B)=1.107, p=0.01). Living with spouse group has lower depressive symptom, compared to living without spouse group (F=14.6, p<0.01). CONCLUSION: Correctly, our results suggest that spouse absent state may accelerate cognitive decline and depression. Further, elderly people living alone should be closely monitored for both depression and cognitive impairment.

A Prospective Study on an Association between Apolipoprotein E epsilon4 and Cognitive Change in Community-Dwelling Elders with Alzheimer's Disease

OBJECTIVES: The aim of this study was to examine the prospective impact of the apolipoprotein E (APOE) epsilon4 on cognitive performance in the community-dwelling elderly individuals with Alzheimer's disease (AD). METHODS: The total number of subjects was 30 (12 men and 18 women) who were diagnosed with AD from a Korean project of "Early Detection of Dementia". People aged 65-85 years were included in the analysis. The eight neuropsychological domains from the Korean version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) were conducted to test subjects. They have been followed at 24-month intervals with the same assessments at each interval. Their cognitive performance at 2 year intervals was compared by the occurrence of the APOE epsilon4. RESULTS: The impact of epsilon4 allele was significant in the Word List Memory Test (WLMT, F = 4.345, df = 1, p = 0.021) and Word List Recall Test (WLRT, F = 5.569, df = 1, p = 0.033). CONCLUSIONS: The APOE epsilon4 allele was significantly correlated especially with verbal episodic memory domain in community-dwelling elders diagnosed with AD.

Screening for cognitive impairmentin late onset depression in a Brazilian sample using the BBRC-EDU / Rastreio de comprometimento cognitivo na depressão de início tardio em uma amostra brasileira usando o BBRC-EDU

ABSTRACT: Depression and dementia are the most prevalent neuropsychiatric disorders in the elderly population. Alzheimer's disease is the leading cause of dementia in most countries, being responsible for more than half of all dementia cases. Late-onset depression is a frequent cause of cognitive decline in the elderly. Differentiating between cognitive impairment secondary to depression and incipient dementia poses a challenge in the clinical setting. Objective: To evaluate the performance of elderly depressed patients using the BBRC-Edu. Methods: We studied 25 patients with late onset depression (mean age: 73.6 y (6.6); schooling: 9.1 y (5.7)) and 30 patients with mild AD (mean age 76.6 y (5.4); schooling: 7.5 y (7.1)), who were compared to a control group of 30 healthy elderly (mean age 73.8 y (5.8); schooling: 9.1 y (5.4)) using the CERAD and BBRC-Edu batteries. Results: For the CERAD battery, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Constructional Praxis (p>0.05), and performed poorer than controls on verbal fluency (animals) and Word List Recall tasks (p<0.0001). For the BBRC-Edu, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Digit Span (direct order) (p=0.076) and Incidental Memory (p>0.05), and performed worse than controls on Learning (second presentation) and verbal fluency (fruits) tasks (p<0.0001). Conclusion: Overall performance on the BBRC-Edu allowed differentiation of controls and depressed patients from AD patients.

RESUMO: Depressão e demência são os transtornos neuropsiquiátricos de maior prevalência na população idosa. A doença de Alzheimer é a principal causa de demência na maioria os países, sendo a responsável por mais da metade dos casos de demência. Depressão de início tardio é uma causa frequente de declínio cognitivo no idoso. A diferenciação entre transtorno cognitivo secundário à depressão e demência em fase inicial é um desafio na prática clínica. Objetivo: Avaliar o desempenho de pacientes idosos deprimidos usando a Bateria Breve de Rastreio Cognitivo (BBRC-Edu). Métodos: Estudamos 25 pacientes com depressão de início tardio, (idade média 73,6 (6,6); escolaridade: 9,1 (5,7)) e 30 pacientes com DA leve (CDR=1), (idade média 76,6 (5,4); escolaridade: 7,5 (7,1)). O desempenho de ambos os grupos foi comparado a um grupo controle de 30 idosos sadios (idade média 73,8 (5,8); escolaridade: 9,1 (5,4)). Resultados: Na Bateria CERAD pacientes deprimidos tiveram desempenho melhor que pacientes com DA em todos os testes (p<0,0001) exceto para Praxia Construcional (p>0,05), e desempenho pior que os controles na fluência verbal (animais) e Recordação da Lista de Palavras (p<0,0001). Na BBRC-Edu, pacientes deprimidos tiveram melhor desempenho comparados aos pacientes com DA em todos os testes (p<0,0001) exceto para Spam de Dígitos (ordem direta) (p=0,076) e Memória Incidental (p>0,05), e tiveram desempenho pior que os controles na Aprendizagem (segunda apresentação) e na fluência verbal (frutas) (p<0,0001). Conclusão: A Bateria Breve de Rastreio Cognitivo permite a diferenciação de controles e pacientes com transtorno depressivo, de pacientes com doença de Alzheimer.

The Relationship between Metabolic Syndrome and Cognitive Function / 가정의학회지

BACKGROUND: Metabolic syndrome has been reported to have adverse effects on cognitive function, although the results are conflicting. The purpose of this study was to examine the relationship between metabolic syndrome and cognitive function in elderly Korean participants older than 60 years. METHODS: We examined elderly participants who visited the health promotion center in Gyeonggi-do province. We categorized the participants into two groups based on the presence of metabolic syndrome (48 participants in the metabolic syndrome group and 45 in the control group). Cognitive function was assessed in all participants using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K). RESULTS: Compared with those without metabolic syndrome, participants with metabolic syndrome had lower mean total CERAD-K scores (64.2 +/- 11.1 vs. 69.8 +/- 9.2, P = 0.010). In the comparison of CERAD-K items, significantly lower scores were observed in the verbal fluency test, the construction recall test, the word list learning test, and trail making B in the group with metabolic syndrome. After controlling age, sex, education, smoking, alcohol, physical activity and the Korean version of the Short Geriatric Depression Scale of Korean, multiple regression analysis showed that metabolic syndrome was independently associated with cognitive function (P = 0.014). Alcohol intake (P = 0.002) and education years (P = 0.001) were also contributing factors to cognitive function. CONCLUSION: This study found a significant relationship between cognitive function and metabolic syndrome. It will be necessary to perform a prospective study to determine whether metabolic syndrome causes cognitive dysfunction or if the correction of metabolic syndrome can improve cognitive function.

An Association Between Apolipoprotein E epsilon4 and Cognitive Function in Community-Dwelling Elders with Questionable Dementia

OBJECTIVES: It was the aim of the present paper to examine the impact of the apolipoprotein E(APOE) epsilon4 on cognitive performance in community-dwelling elderly samples with'questionable dementia'. METHODS: Total 295 samples who were diagnosed with'questionable dementia'in the recent year and completed the Korean version of the Consortium Establish a Registry for Alzheimer's Disease(CERAD-K) neuropsychological assessment protocol, were recruited. The CDR test established score of 0.5. Genomic DNA was extracted from the venous blood and APOE genotyping was done in this group. Their cognitive performance was compared by the occurrence of the APOE epsilon4 allele. RESULTS: The impact of epsilon4 allele was significant in the Word List Recall Test(WLRT, F=4.511, df=1, p=0.035). The'young-old' group aged 75 years and under had a significantly lower performance on the Word List Recall Test(WLRT, F=5.090, df=1, p=0.015), but the'old-old'group over 75 years of age had not significantly different performance on the all the item of tests in epsilon4+ allele group. CONCLUSION: The conclusion to be drawn here is that community-dwelling elderly samples with epsilon4 allele in 'questionable dementia' had a significantly lower performance on the Word List Recall Test in the CERAD-K neuropsychological test batteries and the effect was prominent in the 'young-old' age group.

The Prevalence of Dementia in Patients with Hansen's Disease in a Sanatorium of Korea

OBJECTIVES: To identify prevalence of dementia and it's subtypes in patients with Hansen's disease in a sanatorium of Korea. METHODS: The study employs a two-stage design for case identification. One hundred-six patients with Hansen's disease aged 65 and over participated in the study. The Korean Version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) assessment packet was administered to One hundred-two patients with Hansen's disease. Dementia was defined using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic features of dementia. RESULTS: The prevalence was 15.1% in Hansen's sanatorium. The prevalence of Alzheimer's and vascular dementia were 10.4% and 4.7%. The age-adjusted prevalence rate for dementia was 11.9%. The rate of patients with dementia was 12.73% in males and 17.65% in females. CONCLSION: The prevalence of dementia in Hansen's disease sanatorium of Korea appears to be similar with those reported in previous study. Our result suggests that Hansen's disease was unrelated to prevalence of dementia, and also that the dementia is major neuropsychiatric disease in patient with Hansen's disease.