Maeng-Je Cho

Restless legs syndrome in older people: a community-based study on its prevalence and association with major depressive disorder in older Korean adults

The prevalence of restless legs syndrome (RLS) and its relationship with the demographic variables in an older Korean population were examined.

Prevalence of insomnia and associated factors in a community sample of elderly individuals in South Korea

BACKGROUND Insomnia is a common psychiatric complaint among elderly individuals. This study investigates the prevalence and sociodemographic correlates of insomnia by considering a community sample of elderly individuals in South Korea. METHODS A face-to-face household survey was conducted in five regions of South Korea from June 2008 to August 2008. Among a total of 3,074 individuals aged 65 years and over, 2,002 participants were interviewed. The presence of insomnia was defined as having at least one of four sleep complaints that included difficulty in initiating sleep (DIS), difficulty in maintaining sleep (DMS), early morning awakening (EMA), and non-restorative sleep (NRS) more than three times per week in the last month. The Restless Legs Syndrome (RLS) Questionnaire, a short form of the Geriatric Depression scale (GDS), and a medical review of systems were implemented. RESULTS Insomnia was found in 29.2% of the participants. DIS, DMS, EMA, and NRS accounted for 19.4%, 21.7%, 19.6%, and 8.0% of the participants respectively. Insomnia accompanied by daytime consequences accounted for 17.1% of the participants. The participants who were females, had no education, lived alone, showed symptoms of RLS or depression, and had a lifetime history of physical illness were significantly more likely to report insomnia. The prevalence of DIS, DMS, EMA, or insomnia increased slightly with age, whereas that of NRS decreased slightly. The lifetime history of head trauma, hyperlipidemia, heart disease, anemia, or depression was significantly related to insomnia. CONCLUSION Sleep problems are common among elderly individuals and are closely related to their lifetime history of physical illness.

The role of depression in the insomnia of people with subjective memory impairment, mild cognitive impairment, and dementia in a community sample of elderly individuals in South Korea.

BACKGROUND This study investigates the relationship between insomnia and cognitive dysfunctions including, subjective memory impairment (SMI), mild cognitive impairment (MCI), and dementia, by considering depression in a community sample of elderly individuals. METHODS Data for 1,740 elderly individuals aged 65 years and over were obtained from a nationwide dementia epidemiological study conducted in South Korea. Cognitive functional status was assessed by the Mini-Mental State Examination and the Consortium to Establish a Registry for Alzheimers Disease Assessment Packet Clinical Assessment Battery. Insomnia was defined as the presence of at least one of the four sleep complaints (difficulty in initiating sleep, difficulty in maintaining sleep, early morning awakening, and non-restorative sleep), accompanied by moderate to severe daytime consequences. Depression was evaluated using the Geriatric Depression Scale. RESULTS The prevalence of insomnia in the patients with SMI, MCI, and dementia was found to be 23.2%, 19.6%, and 31.0%, respectively. The patients with SMI, MCI, and dementia were significantly more likely to have insomnia and the four sleep complaints than the normal comparison patients. After adjusting for sociodemographic factors, the significant relationships between cognitive dysfunctional status and insomnia remained. However, after adjusting for sociodemographic factors and depression, no significant relationships with any of the sleep complaints or insomnia remained. CONCLUSION Insomnia is a very common complaint in the elderly with SMI, MCI, and dementia. Depression might play an important factor in the relationship between insomnia and cognitive dysfunctional status in the elderly.

Lifetime prevalence of psychiatric morbidities, suicidality, and quality of life in a community population with the bimodal chronotype: A nationwide epidemiologic study

ABSTRACT Chronotypes are classified as morning, evening, or intermediate, but there are reports of a bimodal type. This study was undertaken to describe the characteristics of the bimodal chronotype and to explore relationships between the bimodal type and psychiatric disorders, fatigue, and quality of life. A total of 2389 subjects from a Korean national epidemiological survey of psychiatric disorders responded during face-to-face interviews. The Korean Composite International Diagnostic Interview was used to diagnose psychiatric disorders, and the Composite Scale of Morningness was used to assess chronotypes. Among intermediate-type subjects, those with a positive bimodal index were classified as bimodal type. In the present study, the proportions of bimodal, morning, intermediate, and evening types were 4.8%, 10.8%, 73.3%, and 11.1%, respectively. Distributions of sociodemographic variables were similar for the bimodal and intermediate types. After controlling for sociodemographic variables, any mood disorder and major depressive disorder were found to be significantly more associated with the bimodal type than the morning type, and dysthymic disorder was significantly more associated with the bimodal type than the intermediate type. For quality-of-life domains, moderate or extreme pain/discomfort was complained about more by subjects with the bimodal type than other types. In summary, the study shows chronotypes differ with respect to their relationships with mood disorder and quality of life. Before the bimodal type is classified as a clinically valid type, further investigations are needed to examine its psychological, physiological, and genetic characteristics.

Sleep duration and associated factors in a community sample of elderly individuals in Korea

This study estimates the duration of sleep and its relationships with clinical correlates in a community sample of elderly individuals in Korea.

ASSOCIATIONS BETWEEN SUBJECTIVE MEMORY COMPLAINTS AND EXECUTIVE FUNCTIONS IN A COMMUNITY SAMPLE OF ELDERLY WITHOUT COGNITIVE DYSFUNCTION

P3-535 ASSOCIATIONS BETWEEN SUBJECTIVE MEMORY COMPLAINTS AND EXECUTIVE FUNCTIONS IN A COMMUNITY SAMPLE OF ELDERLY WITHOUT COGNITIVE DYSFUNCTION Jae-Nam Bae, Won-Hyoung Kim, Byung-Soo Kim, Sung-Man Chang, Dong Woo Lee, Maeng-Je Cho, Inha University Hospital, Incheon, Republic of South Korea; Kyungpook National University Hosptial, Daegu, Republic of South Korea; Inje University College of Medicine, Seoul, Republic of South Korea; Seoul National University Hospital, Seoul, Republic of South Korea. Contact e-mail: jnbae@inha.ac.kr

Prevalence of executive dysfunction and associated factors in a community sample of Korean elderly

Background: The national prevalence of dementia was 8.40% in 2008. However, there was lack of longitudinal research on risk factors affecting development of dementia in South Korea. The aim of this study was to investigate the risk factors developing dementia in a population of community-dwelling elderly (aged 60 over) participated in the Seoul Dementia Management Programme. Methods: A prospective cohort study with a 3-year follow-up period (N 1⁄4 24,266). A trained nurse evaluated the subjects using Korean version of Mini-mental state examination (KMMSE) to screen cognitive functioning. Scoring 21 or below led to a second examination by a neurologist or psychologist, including the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) and a neurological examination, to decide diagnosis of dementia. At baseline, demographic data including comorbidity and healthy lifestyle habits were gathered. Results: The cumulative incidence rate of dementia was 2.9% (n1⁄4 692). To examine the risk factors affecting development of dementia, we performed theCox proportional hazard regression analysis adjusting for age, educational level, marital status, type of health insurance, body mass index, history of stroke, and life style including smoking status and exercise. We found the significant relationships between older age, lower educational level, Medical Aid beneficiaries, elderly with a history of stroke, ever smokers, those who do not exercise and the subsequent development of dementia. Increasing or decreasing body mass index was not risk factor for developing dementia. Conclusions: To the best of our knowledge, this is the first Community-Based Cohort study to investigate the risk factor for incident dementia in South Korea. In order to prepare and cope with Korea’s aging society, further epidemiological studies are needed to establish a strategic and effective dementia management programme.

Differences in suicidal idea and behavior according to cognitive function in elderly people

BEHAVIOR ACCORDING TO COGNITIVE FUNCTION IN ELDERLY PEOPLE Jaenam Bae, Young-Soo Lee, Daham Cho, Byungsoo Kim, SungMan Chang, Dong Woo Lee, Maeng-Je Cho, Inha hospital, Incheon, South Korea; 2 In-Ha university, Incheon, South Korea; 3 Inha university hospital, Incheon, South Korea; National Cancer Center, Goyang-si Gyeonggi-do, South Korea; Kyungpook university hospital, Daegu, South Korea; 6 Inje university Sanggye Paik hospital, Seoul, South Korea; 7 Seoul National University Hospital, Seoul, South Korea.

Differences in sleep disturbance according to mild cognitive impairment subtypes in the community

Background: Mild Cognitive Impairment (MCI) describes cognitive impairment that does not meet criteria for dementia, and includes memory (amnestic) and non-memory (eg executive, language, visuospatial) types. Diagnostic criteria also includes no significant functional decline, but recent studies suggest subtle deficits often exist. The objective of this study was to investigate the level and type of functional impairment in MCI patients, by amnestic versus non-amnestic subtype. Methods: We studied 498 patients with MCI, evaluated at the California Alzheimer’s Research and Care Centers (ARCC) between 2006 and 2009. All patients had multidisciplinary evaluations by experts, including comprehensive neurological examination and neuropsychological testing. Patients with significant deficits in at least one cognitive domain who did not meet DSM IV criteria for dementia were defined as MCI (amnestic versus non-amnestic). Function was assessed using the Blessed Roth Dementia Rating Scale (BRDRS, range 0-17 for total score, higher being more impaired). Results: The mean participant age was 75.4 years, 50.7% were female, 81.7% were white, 78.7% (n 1⁄4 392) had amnestic and 21.3% (n 1⁄4 106) non-amnestic MCI. Amnestic and nonamnestic patients had similar total BRDRS scores (1.6 6 1.8 points vs. 1.5 6 2.1, respectively, p 1⁄4 0.84) and MMSE scores (26.5 6 2.9 vs. 26.7 6 3.0, p 1⁄4 0.60). However, amnestic patients were more likely to have difficulty remembering lists, recent events, and dwelling in the past (p < 0.05 for all) compared to non-amnestic. Non-amnestic patients were more likely to have difficulty eating, dressing, and with continence (p < 0.05 for all). Conclusions: Despite the MCI diagnostic criteria suggesting no functional impairment, these results indicate that patients with MCI are experiencing mild functional deficits which vary according to the type of MCI.