Hiroyoshi Adachi

Association of gastroesophageal reflux disease with weight gain and apnea, and their disturbance on sleep

Obesity is a common predisposition to gastroesophageal reflux disease (GERD) and obstructive sleep apnea syndrome (OSAS). By statistical analysis of the respondents to a questionnaire that was distributed to members of the Kansai Rugby Association, we examined whether weight gain increased the incidence of these diseases and whether GERD alone disturbs sleep. Prevalence distribution of GERD by age differed from another survey, which suggests that predispositions other than age may contribute to GERD. Weight gain tended to increase the incidence of GERD. In our epidemiological study, both GERD (particularly nocturnal reflux) and OSAS significantly contributed to sleep disturbance. Although GERD alone seemed to be one of several independent factors of sleep disturbance, it was not a weak factor.

Differences of Behavioral and Psychological Symptoms of Dementia in Disease Severity in Four Major Dementias

Background/Aims Behavioral and psychological symptoms of dementia (BPSDs) negatively impact the prognosis of dementia patients and increase caregiver distress. The aims of this study were to clarify the differences of trajectories of 12 kinds of BPSDs by disease severity in four major dementias and to develop charts showing the frequency, severity, and associated caregiver distress (ACD) of BPSDs using the data of a Japan multicenter study (J-BIRD). Methods We gathered Neuropsychiatric Inventory (NPI) data of patients with Alzheimer’s disease (AD; n = 1091), dementia with Lewy bodies (DLB; n = 249), vascular dementia (VaD; n = 156), and frontotemporal lobar degeneration (FTLD; n = 102) collected during a 5-year period up to July 31, 2013 in seven centers for dementia in Japan. The NPI composite scores (frequency × severity) of 12 kinds of items were analyzed using a principal component analysis (PCA) in each dementia. The factor scores of the PCA were compared in each dementia by disease severity, which was determined with Clinical Dementia Rating (CDR). Results Significant increases with higher CDR scores were observed in 1) two of the three factor scores which were loaded for all items except euphoria in AD, 2) two of the four factor scores for apathy, aberrant motor behavior (AMB), sleep disturbances, agitation, irritability, disinhibition, and euphoria in DLB, and 3) one of the four factor scores for apathy, depression, anxiety, and sleep disturbances in VaD. However, no increases were observed in any of the five factor scores in FTLD. Conclusions As dementia progresses, several BPSDs become more severe, including 1) apathy and sleep disturbances in AD, DLB, and VaD, 2) all of the BPSDs except euphoria in AD, 3) AMB, agitation, irritability, disinhibition, and euphoria in DLB, and 4) depression and anxiety in VaD. Trajectories of BPSDs in FTLD were unclear.

Sleep disturbances are key symptoms of very early stage Alzheimer disease with behavioral and psychological symptoms: a Japan multi‐center cross‐sectional study (J‐BIRD)

Sleep disturbances in Alzheimer disease (AD) may affect behavioral and psychological symptoms of dementia (BPSD). Our aim was to elucidate the associations between sleep disturbances and other BPSD at different stages of AD.

Anxiety, neuroticism and oxidative stress: cross-sectional study in non-smoking college students.

Aims:  Oxidative stress has gained attention recently in psychiatric medicine and has been reported to be associated with various diseases. However, the psychosocial factors involved in oxidative stress are still not well understood. Thus, the aim of this study was to examine whether anxiety levels and neuroticism were associated with serum oxidative and anti‐oxidative status in healthy college students.

Comparison of the utility of everyday memory test and the alzheimer's disease assessment scale-cognitive part for evaluation of mild cognitive impairment and very mild Alzheimer's disease

The purpose of this study was to compare the utility of the Rivermead Behavioural Memory Test (RBMT) and the Alzheimers Disease Assessment Scale‐Cognitive part (ADAS‐Cog) for the evaluation of mild cognitive impairment (MCI) or very mild Alzheimers disease (AD).

Sense of coherence, health problems, and presenteeism in Japanese university students

AIM Sense of coherence (SOC) is thought to be a major determinant in maintaining health. SOC gained attention recently in the fields of psychiatry after it was reported to be associated with a lowered risk of various health problems. However, the effect of SOC as a buffer against performance impairment caused by health problems is not well known. Thus, we aimed to examine the relationships among health problem, the degree of presenteeism (performance loss due to health problems), and SOC in adolescents. METHODS Participants were 2824 university students (1855 males, mean age; 18.35±0.84 years). SOC and self-reported health problems were assessed using an SOC scale (29 items) and the presenteeism scale for students, respectively. RESULTS SOC scores differed between students with and without health problems (t(2822)=5.75, P<0.001). The effect size (Cohens d) was 0.22 for this difference. In a multiple logistic regression analysis, male gender (odds ratio [OR]=0.62; 95% confidence interval [CI]=0.53-0.73), moderate SOC (within ±1 SD; OR=0.59; 95% CI=0.47-0.72), and high SOC (>1 SD; OR=0.43; 95% CI=0.33-0.58) were independently associated with a lower frequently of health problems. In addition, SOC showed a significant inverse correlation with presenteeism (r=-0.27, P<0.001). CONCLUSION These results suggest that application of the concept of SOC might aid in the prevention of health problems among university students. Students with a strong SOC might be less prone to a decline in performance when health problems arise.

Do depressive symptoms correlate with oxidative stress in a sample of healthy college students

Background and Objectives: Major depression and sub-threshold depressive symptoms are associated with health crisis. Oxidative stress may be a mechanism for major depression. In the present study, we examined the relationship between the degree of depressive symptoms and oxidative status using a reliable and inexpensive method that evaluates endogenous hydroperoxides. Methods: We conducted a cross-sectional study in 54 non-smoking college students and measured serum reactive oxygen metabolites (ROMs) and the biological antioxidant potential (BAP) as an index of oxidative status. Depressive symptoms were assessed by the Beck Depression Inventory (BDI). Results: The concentrations of ROMs did not differ between the lower BDI group (BDI < 14) and the higher BDI group (BDI ≥ 14) (282.7 ± 59.84 U.CARR vs 307.7 ± 67.51 U.CARR, z = -1.19, P = 0.239). We did find a significant relationship between ROM concentration values and higher BDI scores (rho = 0.30, P = 0.042). BAP levels in the higher BDI group were not significantly greater than those in the lower BDI group (z = -0.108, P = 0.287). There was no significant correlation between BAP and depressive symptoms (rho = 0.22, P = 0.140). Moreover, we conducted a multiple regression analysis to control for gender difference and difference in sleep perception of the previous night between the two BDI groups. However, depressive symptoms were not significantly predicted by ROM concentrations (β = 0.28, P = 0.076). Conclusions: While results of the present study demonstrated a slight correlation between depressive symptoms and oxidative stress, this linkage could not be confirmed after controlling for significant confounding factors. This result should be verified in a larger sample.

Detecting Dementia Through Interactive Computer Avatars

This paper proposes a new approach to automatically detect dementia. Even though some works have detected dementia from speech and language attributes, most have applied detection using picture descriptions, narratives, and cognitive tasks. In this paper, we propose a new computer avatar with spoken dialog functionalities that produces spoken queries based on the mini-mental state examination, the Wechsler memory scale-revised, and other related neuropsychological questions. We recorded the interactive data of spoken dialogues from 29 participants (14 dementia and 15 healthy controls) and extracted various audiovisual features. We tried to predict dementia using audiovisual features and two machine learning algorithms (support vector machines and logistic regression). Here, we show that the support vector machines outperformed logistic regression, and by using the extracted features they classified the participants into two groups with 0.93 detection performance, as measured by the areas under the receiver operating characteristic curve. We also newly identified some contributing features, e.g., gap before speaking, the variations of fundamental frequency, voice quality, and the ratio of smiling. We concluded that our system has the potential to detect dementia through spoken dialog systems and that the system can assist health care workers. In addition, these findings could help medical personnel detect signs of dementia.

Effects of donepezil on sleep disturbances in patients with dementia with Lewy bodies: An open-label study with actigraphy

We investigated whether donepezil, a cholinesterase inhibitor, can be used to treat sleep disturbances in patients with dementia with Lewy bodies (DLB). Sleep disturbances were evaluated with the sleep disturbances item of the Neuropsychiatric inventory (NPI) and an actigraph in 16 DLB patients and 24 normal elderly control (NC) subjects. The presence/absence of nine kinds of sleep symptoms, such as dream enactment, were also evaluated in the DLB patients. The DLB patients were then given 5mg/day donepezil for 14 weeks and evaluated again. Eight of the 16 DLB patients had some sleep disturbances before taking donepezil. The actigraphy data indicated that average activity count per minute in sleep (AAC), which reflects body activity at night, was significantly higher and total sleep time was significantly longer in DLB patients than in NC subjects. The NPI sleep disturbances score significantly improved and the number of DLB patients who had sleep disturbances decreased after taking donepezil. The actigraphy results indicate that the sum of all wake epochs within the sleep period, which reflects the degree of fragmented sleep, and the AAC decreased in the DLB patients after donepezil treatment. These results indicate that donepezil treatment reduced sleep disturbances in DLB patients.

Automatic detection of very early stage of dementia through multimodal interaction with computer avatars

This paper proposes a new approach to detecting very early stage of dementia automatically. We develop a computer avatar with spoken dialog functionalities that produces natural spoken queries referring to Mini Mental State Examination, Wechsler Memory Scale-Revised and other related questions. Multimodal interactive data of spoken dialogues from 18 participants (9 dementias and 9 healthy controls) are recorded, and audiovisual features are extracted. We confirm that the support vector machines can classify into two groups with 0.94 detection performance as measured by areas under ROC curve. It is found that our system has possibilities to detect very early stage of dementia through spoken dialog with our computer avatars.