Jeong-Lan Kim

Validity of the telephone interview for cognitive status (TICS) and modified TICS (TICSm) for mild cognitive imparment (MCI) and dementia screening

This study aimed to validate the TICS and modified TICS (TICSm) in Korean elderly population and to compare MCI and dementia screening ability between TICS and TICSm. TICS and TICSm were administered to 70 cognitively normal (CN), 75 MCI, and 85 dementia subjects, with mini-mental state examination (MMSE) and other cognitive and functional measures. TICS and TICSm scores were highly correlated with other global cognitive and functional scores. The CN vs. dementia discrimination ability of both instruments was as excellent as that of MMSE (sensitivity/specificity at optimal cutoff: 87.1/90.1 for TICS; 88.2/90.0 for TICSm). Although their CN vs. MCI discrimination performances were comparable to that of MMSE, they were far from perfect (sensitivity/specificity: 69.3/68.6 for TICS; 73.3/67.1 for TICSm). There was no significant difference in dementia or MCI screening accuracy between TICS and TICSm. Both of them also showed high test-retest reliability. Our findings indicate that TICS and TICSm are reliable and as valid as MMSE in regard of screening cognitively impaired elderly. In terms of the comparison between TICSm and TICS, however, TICSm has little advantage over TICS for screening dementia and even MCI, in spite of longer administration time and more efforts required.

Availability of brain serotonin transporters in patients with restless legs syndrome

Background: Selective serotonin reuptake inhibitors have been associated with the risk of restless legs syndrome (RLS), suggesting that dysregulation of serotonergic neurotransmission may provoke or exacerbate RLS. Methods: We compared the availability of serotonin transporter (SERT) between 16 drug-naïve patients with RLS and 16 healthy controls. SERT was measured in the pons and medulla via [123I]-2β-carbomethoxy-3β-(4-iodophenyl) tropane (β-CIT) SPECT. A ratio of specific to nonspecific brain uptake (V3″) was used for all comparisons. RLS was diagnosed according to the criteria proposed by the National Institute of Health, and its severity was measured using the International RLS Study Group (IRLSSG) Severity Scale. Results: The availability of SERT was similar in the RLS group and the control group with regards to the pons (1.24 ± 0.31 vs 1.24 ± 0.25, p > 0.1) and the medulla (0.99 ± 0.25 vs 1.00 ± 0.23, p > 0.1). However, IRLSSG Severity Scale scores increased with decrease of SERT availability in both the pons (β = −0.50, t = −3.19, p = 0.009) and the medulla (β = −0.42, t = −2.44, p = 0.03). Conclusions: Although serotonin transporter (SERT) availability in pons and medulla was similar in the restless legs syndrome (RLS) group and the control group, the severity of RLS symptoms increased as the availability of SERT decreased. These data partially support the hypothesis that an increase of serotonergic neurotransmission in the brainstem may exacerbate RLS, possibly via dual modulations on striatal dopaminergic neurotransmission and on the activities of spinal motor and sensory neurons.

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.

The impact of social support on caregiver burden in dementia

79(8.5) years and MMSE was 14.6(6.8). GLM confirmed a significant association between dependence and ZBI score (P <0.0001), when controlling for patient age, and gender, caregiver age and gender, caregiver relationship to patient and patient accommodation status. Other significant predictors of ZBI score were patient accommodation (P <0.0001) and whether the caregiver was the patient’s child (i.e. son/daughter, P <0.05)).The model suggests that a one point increase in dependence is associated with 2.15 point increase in ZBI. In addition, if the patient is not in a nursing home/residential care facility, the ZBI score is expected to increase by 19 points. If the caregiver is a son/daughter of the patient, an increase of 9.2 points in ZBI is expected. For co-resident caregivers, the proportion of the time that patients can be left alone decreases as DS score increases. Conclusions: The results suggest that perceived caregiver burden increases with patient dependence on others and is higher when caregivers are the son/daughter of patient compared with spouse/partner caregivers. The decrease in perceived caregiver burden associated with a patient’s transition to nursing home care/residential care is not unexpected given the significant decrease in the time that co-residing caregivers can leave the patient alone as dependence increases.

Development and validation of a screening algorithm for Alzheimer's disease using the categorical fluency test

Methods: After translating into Spanish and adapting to Chilean population, the TYM-S was developed and administered to 30 dementia patients, 14 mild cognitive impairment (MCI) subjects and 30 controls in addition to MMSE and ACE-R-Ch for assessing global cognitive efficiency. Caregivers of dementia patients and collateral sources of MCI and control subjects were interviewed with measures of dementia severity, functional status in activities of daily living and cognitive changes. Convergent validity, internal consistency reliability, cut-off points, sensitivity and specificity for the TYM-S were estimated. Results: Table 1 summarizes the demographic characteristics and clinical profiles of the sample. Regarding convergent validity, the TYM-S showed significant correlations (p<0.001) with other cognitive measures (r1⁄40.902 with MMSE; r1⁄40.922 with ACER-Ch; r1⁄40.923 with MoCA and r1⁄40.862 with FAB), a rating for dementia severity (r1⁄4-0.757 with CDR), functional capacity assessments (r1⁄4-0.864

Dementia epidemiology in Korea: Comparison of the results from the Nationwide Survey on the Dementia Epidemiology (NaSDEK) 2008 and the NaSDEK 2012

3M/4F), were assessed at UCL. Based on Clinical Dementia Rating (CDR), 12 carriers were asymptomatic (aMut+; CDR 1⁄4 0; mean age 1⁄4 35; 4M/8F) and eight symptomatic (sMut+; CDR 1⁄4 0.5-1; mean age 1⁄4 47; 5M/3F). Frontal, striatal (caudate and pallidum) and thalamic ’nodes’ of the loops of interest were automatically parcellated from structural MRI. Thalamofrontal tractography was performed for the NC, both via striatal ’waypoints’ and directly. The tracts were normalized, registered to standard space, averaged and thresholded. Tract average fractional anisotropy (FA) and mean diffusivity (MD) were then computed from native images using these template tracts. Effective connectivity between nodes was sDCM-estimated from the fMRI data (Figure.). Linear regression was used to compare metrics between groups (NC, aMut+, sMut+), adjusted for age and gender. Results: Both tract FA and MD revealed group differences: significant sMut+ > NC differences were found for all three loops (aCC, dlPFC and latOFC) bilaterally. Compared to aMut+, sMut+ had higher MD in right dlPFC-thalamus tract and lower FA and higher MD in right latOFC-thalamus tract. The aMut+ had lower FA than NC in left thalamus-latOFC tract. sDCM suggested left-hemisphere aCC connectivity abnormalities for sMut+ relative to both NC and aMut+. No sDCM differences were observed between aMut+ and NC. The Table shows these results and group-average FA, MD and connectivity values. Conclusions: Fronto-striato-thalamic tract structure is altered in FAD. Abnormal effective connectivity was also suggested by sDCM, but requires confirmation in a larger cohort.