Weerasak Muangpaisan

Neuropsychiatric symptoms in the community-based patients with mild cognitive impairment and the influence of demographic factors

To investigate the pattern of neuropsychiatric symptoms of MCI patients in the Thai population and the influence of demographic factors on the symptoms.

Quality of life of the community-based patients with mild cognitive impairment

Aim:  To determine quality of life (QOL) in patients with mild cognitive impairment (MCI) compared to normal subjects and to investigate the impact of demographic factors on QOL.

Prevalence of potentially reversible conditions in dementia and mild cognitive impairment in a geriatric clinic

Aim:  To examine the prevalence of potentially reversible conditions in dementia and mild cognitive impairment (MCI) patients in a geriatric clinic.

Systematic review of statins for the prevention of vascular dementia or dementia

Aim:  Non‐hypolipidemic effects of statins, known as pleiotropic effects, are likely to explain the effect of statins on dementia. Results of the relationship between statins and dementia in previous studies are conflicting. There is no systematic review investigating the effect of statins on vascular dementia (VaD). This systematic review evaluates the role of statins in the prevention of VaD or dementia. The possible causes of conflicting results in the existing published work will be explored.

The association between body mass index and Barrett's esophagus: a systematic review

Biological plausibility and evidence from case series indicate that an increased body mass index could be a risk factor for Barretts esophagus. The aim of this study was to assemble and appraise the available evidence on the association of body mass index and Barretts esophagus in a narrative approach. A systematic literature review identified a nested case-control study and 10 case-control studies, with sample sizes of between 129 and 953. Overall, cases were on average older than controls, more often male and white, but did not differ with regards to body mass index. An increased body mass index (> or =30 and > or =35 kg/m(2)) was associated with greater risk of Barretts esophagus in four studies (odds ratio range: 2.0-4.0). These studies, however, did not adjust for symptoms suggestive of gastroesophageal reflux disease. No significant association was reported in the other six studies. To conclude, the existing evidence on the association between body mass index and risk of Barretts esophagus relates primarily to case-control studies and is inconsistent. Gastroesophageal reflux symptoms can be a potential confounder and further research should better address this issue. Evidence from cohort studies may help shed further light on this putative association, which is of relevance to public health and cancer control.

Cut‐off points of quadriceps strength, declines and relationships of sarcopenia‐related variables among Thai community‐dwelling older adults

To define quadriceps strength cut‐off points for both sexes to be used in the working diagnosis of sarcopenia in older Asian people, and to investigate the age‐related declines of sarcopenia‐related variables and correlations between those variables among community‐dwelling older adults.

Attitudes of Medical Students and Residents Toward Care of the Elderly

The research reported in this article examined attitudes toward the care of the elderly between and among medical students and residents in training. Data were collected with a 16-item attitude questionnaire. Participants were medical students in their introduction period (prior to clinical experience) and residents of the Department of Internal Medicine, Faculty of Medicine at Siriraj Hospital to answer. There was no difference in the attitudes toward the care for the elderly between medical students and residents. Prior exposure to the elderly may have an influence on attitudes toward the care of the elderly. The geriatric curriculum should be developed to correct misunderstandings and improve the attitudes of the students and residents.

Health expectancies in the older Thai population

This study aims to investigate health expectancies in five domains: cognitive health, psychological health, physical health, functional ability and self-perceived global health (SPGH) in the older Thai population. There are few studies reporting health expectancies in multidimensional health domains, most of which reported only one health dimension. The dataset used was from the Bangkok Longitudinal Study by Siriraj Hospital for the Older Men and Women (BLOSSOM), which is a community cohort study in Bangkok, Thailand. This analysis is based on the cross-sectional data in the year 2005-2006 and includes 5936 participants aged 50 years and over from community settings within six suburban areas in Bangkok. The study found that women had a longer total life expectancy (LE), but had shorter cognitive impairment-free (CIFLE), physical illness-free (PHILE) and disability-free (DIFLE) LEs, than men. However, there was no difference between the life expectancies for living with good SPGH in men and in women. Differences in health expectations might explain this finding. Health promotion and disease prevention should be initiated at a younger age and should target all health domains.

Antioxidant-Enhancing Property of the Polar Fraction of Mangosteen Pericarp Extract and Evaluation of Its Safety in Humans

Crude extract from the pericarp of the mangosteen (mangosteen extract [ME]) has exhibited several medicinal properties in both animal models and human cell lines. Interestingly, the cytotoxic activities were always observed in nonpolar fraction of the extract whereas the potent antioxidant was often found in polar fraction. Although it has been demonstrated that the polar fraction of ME exhibited the antioxidant activity, the safety of the polar fraction of ME has never been thoroughly investigated in humans. In this study, we investigated the safety of oral administration of the polar fraction of ME in 11 healthy Thai volunteers. During a 24-week period of the study, only minor and tolerable side effects were reported; no serious side effects were documented. Blood chemistry studies also showed no liver damage or kidney dysfunction in all subjects. We also demonstrated antioxidant property of the polar fraction of ME both in vitro and in vivo. Interestingly, oral administration of the polar fraction of ME enhanced the antioxidant capability of red blood cells and decreased oxidative damage to proteins within red blood cells and whole blood.

Development of a Thai Parkinson's Disease Screening Tool and the Prevalence of Parkinsonism and Parkinson's Disease, Based on a Community Survey in Bangkok

Introduction: Few epidemiological data of parkinsonism and Parkinsons disease (PD) exist in Southeast Asia. We aimed to develop and validate a screening tool, and investigate the prevalence of parkinsonism and PD via a community survey. Methods: A PD-screening tool comprising 11 “yes/no” items was developed in a clinical setting and validated in the community. The prevalence of PD and parkinsonism was investigated in a survey that included PD screening tools, face-to-face interviews, and physical examinations. Receiver operating characteristic curves were constructed for a range of cutoff points to explore the screening tools sensitivity and specificity. Results: Of 1,846 participants surveyed, the mean age was 64.4 ± 8.0 years. The age-standardized prevalence of parkinsonism was 1,954 per 100,000 people, and that of PD was 706. Of 36 parkinsonism cases, 13 were PD, 13 were vascular parkinsonism, 8 were drug-induced parkinsonism, and 2 were head-injury related. Three cases were previously diagnosed with PD. A cutoff score of 5 on the screening tool showed a sensitivity of 98%, a specificity of 94%, and positive and negative likelihood ratios of 16.33 and 0.02, respectively. The area under the curve was 0.985. Conclusions: The prevalence of parkinsonism and PD in Thailand is similar to that in Western countries but slightly higher than that for other Asian countries. Differing methodologies, diagnostic criteria, and case identification strategies may contribute to variations in the reported prevalence of PD. Widespread use of the Thai PD-screening tool should be implemented to facilitate early detection of new cases and, in turn, better healthcare.