Hyun-Ghang Jeong

Association between driving performance and neuropsychological deficits in elderly people with mild cognitive impairment

P2-276 ASSOCIATION BETWEEN DRIVING PERFORMANCE AND NEUROPSYCHOLOGICAL DEFICITS IN ELDERLY PEOPLE WITH MILD COGNITIVE IMPAIRMENT Hyun-Ghang Jeong, Hyeon Jeong, Tae Hui Kim, Ji Won Han, Jong Chul Youn, Joon Hyuk Park, Jin Hyeong Jhoo, Jung Jae Lee, Jeong-Lan Kim, Bong-Jo Kim, Shin Gyeom Kim, Seung-Ho Ryu, Il Han Choo, Dong Young Lee, Dong Woo Lee, Seok Bum Lee, Ki Woong Kim, Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea; 2 Seoul National University Bundang Hospital, Seongnamsi, South Korea; Seoul National University Bundang Hospital, Seongnamsi, South Korea; 4 Kyunggi Provincial Hospital for the Elderly, Younginsi, South Korea; 5 Jeju National Universtiy School of Medicine & Jeju National University Hospital, Jejusi, South Korea; Kanwon National University, Chuncheonsi, South Korea; Kyungbook University, Daegu, South Korea; Choongnam University Hospital, Daejeon, South Korea; 9 Kyunsang University, Jinjusi, South Korea; 10 Sunchunhang University, Kyunggi, South Korea; 11 Konkuk University Hospital, Seoul, South Korea; Seoul National University Hospital, Seoul, South Korea; Seoul National University, Seoul, South Korea; 14 Inje University Sanggye Paik Hospital, Seoul, South Korea; Dankook University Hospital, Cheonan, South Korea; Seoul National University, Seongnamsi, South Korea.

PHYSICAL ACTIVITY IN INDIVIDUALS WITH DEMENTIA OR MILD COGNITIVE IMPAIRMENT: A META-ANALYSIS STUDY

(non-surgery) or 6 months after surgery.Primary outcome measures are visual acuity and QoL (VF-14).43 participants have been enrolled with recruitment ongoing. The current analysis includes 28 protocol completers: 20 in the surgery group, 8 in the non-surgery group. Results: Analysis of these 28 subjects showed improvement in visual acuity (logMAR OD -0.329 and -0.072; logMar OS -0.238 and -0.026, respectively) and VF-14 (+5.5 vs. -4.9). Digit cancellation (mean changes -1.462; vs. -2.400) and MMSE (+0.625;vs. -2.125] were better in subjects with surgery. ADCS-ADL declined less (-1.2 vs. -3.5); total NPI scores and caregiver distress scores were reduced in the surgery group. Conclusions: Our preliminary results show that cataract surgery can improve visual acuity and visual QoL, while reducing decline in memory, and executive function and showing improvements in behavioral measures. Our findings suggest the need to aggressively address dementia co-morbidities such as cataract impairing vision while balancing safety and medical risks.

Association of Up-Regulated Plasma Adiponectin With Risk of Incident Depression in a Community-Dwelling Elderly Population

OBJECTIVEnDespite robust interest in the association between inflammation and depression, anti-inflammatory markers have been scarcely investigated as predictors of the future risk of depression. The aim of this study is to determine whether up-regulation of plasma adiponectin, an anti-inflammatory adipokine, precedes and predicts the development of depression in the elderly.nnnMETHODSnThis prospective cohort study was launched in 2005. Among 1,000 participants who were randomly sampled from community-dwelling individuals 65 years or older, 633 euthymic individuals without prior history of depressive disorders were enrolled for a baseline evaluation and follow-up after 5 years. Incident clinically significant depression, including major and minor depressive disorders (by DSM-IV criteria), subsyndromal depression (by operational criteria), and euthymia after antidepressant treatment, was assessed by clinical interviews.nnnRESULTSnBaseline plasma adiponectin values were divided into tertiles (low tertile: ≤ 5.685 μg/mL, middle tertile: 5.686-10.367 μg/mL, high tertile: ≥ 10.368 μg/mL). Among the 261 euthymic individuals who responded to the 5-year follow-up evaluation, 17 developed incident depression (7 from the high tertile, 8 from the middle tertile, and 2 from the low tertile). The risk of incident depression was much higher in the high tertile group than in the low tertile group after adjusting for age, sex, body mass index, burden of chronic medical illnesses, and Mini-Mental State Examination score (odds ratio = 10.64; 95% CI, 1.21-93.84; P = .033).nnnCONCLUSIONSnUp-regulation of plasma adiponectin may precede the onset of clinically significant depression in the elderly, and thus plasma adiponectin level is a potential candidate marker for the risk of depression.

Overview of the Korean Longitudinal Study on Cognitive Aging and Dementia

Objective Due to an unprecedented rate of population aging, South Korea is facing a dementia epidemic. For this reason, the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) was launched in 2009 with support from the Korean Health Industry Development Institute to investigate the epidemiology, biopsychosocial risk factors, and outcomes of dementia and dementia-related conditions. Methods The KLOSCAD is the first nationwide multi-center population-based prospective cohort study. In October 2010, 12,694 individuals were randomly sampled from residents aged 60 years or older who lived in 13 districts across South Korea. In the baseline assessment, which was conducted from November 2010 through October 2012, 6,818 (53.7%) individuals participated. Follow-up assessments have been conducted every two years, with the first follow-up assessment conducted between November 2012 and October 2014, and the second between November 2014 and October 2016. The third is now in progress, and will span from November 2016 to October 2018. Diagnosis of cognitive disorders, neuropsychological battery, behavioral and psychological symptoms of dementia, activities of daily living, physical and neurologic examination and laboratory tests, life styles, quality of life, and identification of death were evaluated in each assessment. Results The cumulative drop-out rate at the second follow-up assessment was 38.7%. Dementia and mild cognitive impairment were 5.0% and 27.0%, respectively. Conclusion The KLOSCAD may provide strong scientific evidence for advancing the fight against dementia both in Korea and globally.

Gait Variability Can Predict the Risk of Cognitive Decline in Cognitively Normal Older People

Background: The aim of this study was to investigate the association of gait speed and gait variability, an index of how much gait parameters, such as step time, fluctuate step-to-step, with risk of cognitive decline in cognitively normal elderly individuals. While high gait variability is emerging as an early indicator of dementing illnesses, there is little research on whether high gait variability predicts cognitive decline in cognitively normal elderly who have no evidence of cognitive impairment. Methods: In this 4-year prospective cohort study on 91 community-dwelling cognitively normal elderly individuals without cerebral ischemic burden or Parkinsonism, we evaluated gait speed and step time variability using a tri-axial accelerometer placed on the center of body mass, and diagnosed mild cognitive impairment (MCI) according to the International Working Group on MCI. We performed Kaplan-Meier analysis with consecutive log-rank testing for MCI-free survival by cohort-specific tertiles of gait speed; hazard ratios (HR) of incident MCI were estimated using Cox proportional hazards regression analysis adjusted for age, sex, education level, Cumulative Illness Rating Scale score, GDS score, and presence of the apolipoprotein E ε4 allele. Results: Out of the 91 participants in the baseline assessment, 87 completed one or more 2-year follow-up assessments, and the median duration of follow-up was 47.1 months. Kaplan-Meier curves of incident MCI show evident differences in risk by gait variability group (χ2 = 9.64, p = 0.002, log-rank test). Mean MCI-free survival in the high variability group was 12% shorter than in the mid-to-low tertile group (47.4 ± 1.74 [SD] vs. 54.04 ± 0.52 months), while it was comparable between gait speed groups (51.59 ± 0.70 vs. 50.64 ± 1.77 months; χ2 = 1.16, p = 0.281). In multivariate analysis, subjects with high gait variability showed about 12-fold higher risk of MCI (HR = 11.97, 95% CI = 1.29–111.37) than those with mid-to-low variability. However, those with slow gait speed showed comparable MCI risk to those with mid-to-high speed (HR = 5.04, 95% CI = 0.53–48.18). Conclusions: Gait variability may be a better predictor of cognitive decline than gait speed in cognitively normal elderly individuals without cerebral ischemic burden or Parkinsonism.

Effects of lifetime cumulative ginseng intake on cognitive function in late life

BackgroundWe investigated the effects of lifetime cumulative ginseng intake on cognitive function in a community-dwelling population-based prospective cohort of Korean elders.MethodsCommunity-dwelling elders (Nu2009=u20096422; mean ageu2009=u200970.2u2009±u20096.9xa0years, educationu2009=u20098.0u2009±u20095.3xa0years, femaleu2009=u200956.8%) from the Korean Longitudinal Study on Cognitive Aging and Dementia were included. Among them, 3918 participants (61.0%) completed the 2-year and 4-year follow-up evaluations. Subjects were categorized according to cumulative ginseng intake at baseline evaluation; no use group, low use (<u20095xa0years) group, and high use (≥u20095xa0years) group. One-way analysis of covariance (ANCOVA) was conducted to compare the impact of cumulative ginseng intake on baseline Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet neuropsychological battery total score (CERAD total score) and Mini-Mental State Examination (MMSE) score among the three groups while adjusting for potential covariates. A repeated-measures ANCOVA was performed to investigate the impacts on the changes in CERAD total scores and MMSE scores during the 4xa0years of follow-up.ResultsThe high use group showed higher CERAD total scores compared to the no use group after controlling for age, sex, education years, socioeconomic status, smoking, alcohol intake, presence of hypertension, stroke history, Geriatric Depression Scale, Cumulative Illness Rating Scale, and presence of the APOE e4 allele (F(2, 4762)u2009=u20093.978, pu2009=u20090.019). The changes of CERAD total score for 2 or 4xa0years of follow-up did not differ according to the use of ginseng.ConclusionsCumulative ginseng use for longer than 5xa0years may be beneficial to cognitive function in late life.

COMPARISON OF GRAY MATTER VOLUME AND FRACTIONAL ANISOTROPY IN MILD COGNITIVE IMPAIRMENT PATIENTS WITH AND WITHOUT AMYLOIDOPATHY

in the columnar cortical diffusionmeasurements were seen between Alzheimer’s and healthy aged participants with a diagnostic group classification accuracy of>95% (combined dataset of 81 subjects). The same measurements successfully categorised MCI participants who progressed to dementia within 2 years of scan, separately from stable MCI (20 subjects). Conclusions: These results indicate that cortical microstructure organisation in dementia is detectable using MRI of living subjects and may provide a marker of Alzheimer’s disease with high classification accuracy. These findings offer the prospect that future studies will be able to investigate the relationship between cognition and altered organisation of cerebral cortex microstructure, in vivo, in order to assess the damage to cellular networks as an index of disease progression. To significantly improve the lives of people with Alzheimer’s disease, an analysis method which improves early detection and differentiation of dementias has the potential to facilitate earlier and more effective care and to improve the success of drug trials.

Poster #M257 VARIABLES INFLUENCING SUBJECTIVE WELL-BEING IN PATIENTS WITH SCHIZOPHRENIA

Schizophrenia is often characterized by an alternation of deterioration and remission, adversely affecting the patients’ daily life, including their occupational and educational activities. In the past, the treatment of schizophrenia was focused on the reduction of positive symptoms. These days, due to the wide use of atypical antipsychotics, enhancement of the quality of life of patients has become more important, for instance, minimization of the side effects of the antipsychotics, alleviation of negative symptoms, depressive symptoms, and cognitive dysfunction. Although it is not easy to define the concept of quality of life in patients with schizophrenia, the recent studies have suggested that the multi-dimensional concept of subjective well-being is associated with the activities of daily life, including self-management and social roles, social support, treatments, and side effects of the antipsychotics. Subjective well-being in patients with schizophrenia is important because it is recognized as an important shift in the evaluation of treatment goals. Schizophrenia patients’ subjective well-being is an important index in evaluating the treatment course, and is being widely used in clinical settings. Subjective well-being is closely associated with the patients’ quality of life and is a predictive factor of complying with antipsychotics as well as of remission and recovery from symptoms. Various sociodemographic and clinical variables can affect Received: September 15, 2014 / Revised: September 25, 2014 Accepted: September 30, 2014 Address for correspondence: Seung-Hyun Kim, Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703, Korea Tel: 02-2626-3162, Fax: 852-1937 E-mail: gurokim@gmail.com Funding for this study was provided by CJ HealthCare. CJ HealthCare had no further role in the study design; in the collection, analysis or interpretation of data; in the writing of the manuscript; or in the decision to submit the paper for publication. Its contents are solely the responsibility of the authors. Variables Influencing Subjective Well-Being in Patients with Schizophrenia