Jin-Sup Eom

Characteristic Profiles of Instrumental Activities of Daily Living in Different Subtypes of Mild Cognitive Impairment

Background/Aims: The purposes of this study were to describe restrictions in instrumental activities of daily living (IADL) in mild cognitive impairment (MCI) and to assess different patterns of IADL in each MCI subtype. Methods: A total of 566 participants, those not cognitively impaired (NCI; n = 311) and MCI patients (n = 255), 60–94 years old (71.25 ± 6.00), were examined. Neuropsychological tests were administered to participants, and each MCI patient was classified into one of four subtypes. They completed the Barthel ADL and Seoul-IADL (S-IADL) for ADL measures. Results: There was a significant difference between NCI and MCI in terms of total S-IADL scores. ANOVA and a post hoc Dunnett analysis revealed that MCI patients performed significantly worse on four out of a total 15 items (i.e. telephone, transportation, finances and household appliances). ANCOVA showed a significant difference in S-IADL-MCI (4 of 15 items) between NCI and amnestic MCI-multiple domains after adjusting for age, gender, education and Geriatric Depression Scale (F = 4.257, d.f. = 1,556, p = 0.002). Conclusion: These findings suggest that scorings of specific IADL items are different in MCI subjects, and these items can possibly help in the identification of MCI subtypes, especially amnestic MCI-multiple domains.

Effects of age, gender, and weight on the cerebellar volume of Korean people

The average cerebellar volume of Korean men (135.19 cm3) is larger than that of Korean women (123.06 cm3), and that of subjects in their twenties (134.28 cm3) is larger than that of subjects in their forties (121.83 cm3). Atrophy of the cerebellum is more markedly observed in men than in women. There is a relation between body weight and cerebellar volume for men, but not for women.

Intranasal oxytocin attenuates attentional bias for eating and fat shape stimuli in patients with anorexia nervosa

We examined the impact of oxytocin on attentional processes for eating, shape, and weight stimuli in patients with anorexia nervosa (AN). A double-blind, placebo-controlled within-subject crossover design was used. Intranasal oxytocin or placebo followed by a visual probe detection task with food, weight, and shape images was administered to 64 female subjects: 31 patients with AN and 33 control students. The AN group showed significant reductions in the attentional biases toward eating-related stimuli (p=0.030, d=0.516) and toward negative shape stimuli (p=0.015, d=0.498) under the influence of intranasal oxytocin. The effect of oxytocin was correlated with autistic spectrum traits in the AN group. Oxytocin had no effect on the amount of juice consumed in either group. The results of this study suggest that oxytocin attenuates the attentional vigilance to eating and fat shape stimuli in patients with AN. Further studies using oxytocin as a form of intervention for patients with AN are needed.

Effects of Head Circumference and Metabolic Syndrome on Cognitive Decline

Background: Brain volume progressively decreases with an increase in atrophy, and the brain becomes more susceptible to degenerative brain diseases such as Alzheimer’s disease. Metabolic syndrome has also been associated with an increased risk of cognitive decline in the elderly. Aims: In this study, we aimed to examine the effects of head circumference and metabolic syndrome on cognitive decline. Methods: This study was part of a longitudinal study conducted on Koreans aged 60 years or older. We analyzed a final sample of 596 Korean participants with complete baseline and 2-year follow-up data. The cognitive function of the subjects was assessed using the Korean version of the Mini Mental State Examination (MMSE). Head circumference was measured from the glabella to the occipital protuberance using a measuring tape. Metabolic syndrome was defined according to the NCEP-ATP III standards. Central obesity was assessed on the basis of waist-circumference values, in accordance with the World Health Organization Western Pacific Region report on Asians. We used a longitudinal factorial design in which the MMSE score was the dependent variable, and head circumference and metabolic syndrome were considered as factors. Results: After adjusting the results for age, gender, education, height, weight, baseline MMSE, and number of follow-up years, we observed that smaller head circumference and the presence of metabolic syndrome were independently associated with rapid cognitive decline. Conclusion: All these findings suggest that smaller head circumference and the presence of metabolic syndrome have additive effects on cognitive decline.

The Factors Affecting the Development of National Identity as South Korean in North Korean Refugees Living in South Korea

Objective This study aims to observe the factors that influence the development of national identity of North Korean refugees who have resettled in South Korea. Methods The study population was comprised of 500 North Korean refugees who immigrated to South Korea in 2007. The variables measured national identity as South Korean, a scale for discrimination perceived during daily life, a social for supporting social network, a for childhood trauma experience, traumatic experiences in North Korea, and traumatic experiences during the escape process. Factor analysis was conducted on the result from the scale for national identity as South Korean which produced 4 factors including national consciousness, positive emotions, positive values, and negative values. Multiple regression was done to identify how variables such as demographic data, discrimination, social network, and past trauma had influenced each of 4 factors. Results National identity was negatively related by traumatic experience during childhood, perceived discrimination, and positively influenced by social networks. Positive emotion was related negatively to education level in North Korea and perceived discrimination, but positively related to traumatic experiences in North Korea. Negative value was related positively age and perceived discrimination but negatively related to supporting social network. Conclusion The results of this study suggests that promoting social networks, decreasing discrimination and healing past traumas were important factors for North Korean refugees in South Korea to facilitate a new national identity as a South Korean.

Cognitive decline is associated with nutritional risk in subjects with small head circumference (HC).

Nutrition has been found to be associated with cognitive impairment, but it has not been established whether these associations are present solely in later life or whether they are present in younger age as well. HC is a good indicator of brain development and the most sensitive anthropometric indicator of prolonged malnutrition during early life. This study examined the interaction between early HC and later (nutrition screening initiative) nutritional factors on the risk of cognitive decline in the elderly. The longitudinal factorial design had the mini-mental state examination (MMSE) score as the dependent variable, with HC as one factor and nutritional risk as another. We studied a sample of 495 not cognitively impaired Korean participants with 2 years follow-up data. After multivariable adjustment, interactive effect between HC and nutritional risk was significantly associated with cognitive decline (F=2.449, p=0.045). Simple main effect analysis showed that compared with highest HC, lowest HC was associated with a cognitive decline. Nutritional risk was associated with cognitive function decline only in individuals with small HC. Therefore, the prevention for cognitive impairment and dementia should involve nutritional strategies throughout life.

Relation between nutritional risk and metabolic syndrome in the elderly

Nutrition is regarded as a major factor in the development of metabolic syndrome (MS). Undernutrition or nutritional imbalance, rather than overnutrition, can be associated with MS. We evaluated the relationship between nutritional risk and MS in the elderly. We analyzed 2284 Koreans aged over 60 years (689 men and 1595 women) from baseline data of a large prospective study called the Gwangju Dementia and Mild Cognitive Impairment Study (GDEMCIS). MS was determined according to the National Cholesterol Education Program Adult Treatment Panel III, and nutritional risk was evaluated using the Nutrition Screening Initiative (NSI) checklist. Among 2284 subjects, 1219 (53.4%) had MS. NSI score was higher in subjects with MS than in those without MS (2.46 ± 1.89 vs. 2.18 ± 1.87, p<0.001). The risks of abdominal obesity, elevated blood pressure, elevated glucose, and MS were higher in subjects with moderate or high nutritional risk compared to subjects in a good nutritional state. Nutritional risk was independently associated with MS for subjects in their 60s, but not in their 70s or 80s and above. In conclusion, high nutritional risk is associated with increased risk of MS in the elderly. Measurement of nutritional status in the elderly may serve as a marker for MS, especially for the younger elderly.

Effects of intranasal oxytocin on the attentional bias to emotional stimuli in patients with bulimia nervosa

BACKGROUND Bulimia nervosa (BN) is characterized by binge eating and emotional dysregulation including increased negative affectivity (anger, anxiety). The aim of this study was to examine the effect of oxytocin on attentional processes towards anger in patients with BN. METHOD The study design consisted of a double-blind, placebo-controlled within-subject crossover, single dose experiment. Sixty-four women (31 patients with BN and 33 healthy comparisons) completed self-reported measures to evaluate emotional difficulties and were administered a single dose of intranasal oxytocin (40IU) or placebo followed by a visual probe detection task to examine attentional orienting to angry or happy faces. RESULTS Patients with BN reported higher emotional dysregulation and more difficulties in controlling anger compared to the healthy comparison group. Patients with BN and the healthy women exhibited similar attentional bias to angry faces in the placebo condition. Intranasal oxytocin reduced the attentional bias towards angry faces in both the BN patients and the healthy women. CONCLUSIONS We found that a single dose of oxytocin reduced vigilance towards angry faces in patients with BN as well as healthy women. The results showed that patients with BN are not different from healthy women in terms of vigilance towards threat.