Yoshitaka Ouchi

Kenichi Meguro; Naofumi Tanaka; Mari Kasai; Kei Nakamura; Hiroyasu Ishikawa; Masahiro Nakatsuka; Masayuki Satoh; Yoshitaka Ouchi

Background:  There have been no reports on the prevalence of dementia among the old‐old people in Japan.

Mari Kasai; Kenichi Meguro; Kei Nakamura; Masahiro Nakatsuka; Yoshitaka Ouchi; Naofumi Tanaka

Aims: To examine the effectiveness of the Montreal Cognitive Assessment (MoCA) to screen people with mild cognitive impairment (MCI), to associate the MoCA score with the presence of infarction, and to detect the characteristics of people with very mild subcortical vascular dementia (vmSVD). Methods: 392 out of 886 community dwellers aged 75 years and above living in Kurihara, Northern Japan, agreed to participate in our study; 164 scored a Clinical Dementia Rating (CDR) of 0 (healthy), 184 scored a CDR of 0.5 (MCI) and 44 scored a CDR of 1+ (dementia). The participants scoring a CDR of 0.5 were divided into 2 subtypes: 37 had vmSVD and 147 had other types of dementia. The objective variables were the total MoCA, the MoCA subscale and the Mini-Mental State Examination (MMSE). Results: There was a difference in the MoCA and MMSE scores between the 3 CDR groups. The MoCA score overlapped in participants with CDR 0 and 0.5. There were significant CDR effects, while there were no significant infarction effects for the MoCA and MMSE. vmSVD participants had lower scores on the total MoCA, the MoCA attention subscale and MMSE than healthy elderly people and participants with other types of dementia. Conclusion: Our results suggested that MMSE performed rather well and that the MoCA is not superior to MMSE in MCI and vmSVD participants aged 75 and above in a community.

Kei Nakamura; Mari Kasai; Yoshitaka Ouchi; Masahiro Nakatsuka; Naofumi Tanaka; Yuriko Kato; Megumi Nakai; Kenichi Meguro

The aim of this study was to estimate the prevalence of apathy, and to compare vascular mild cognitive impairment (vMCI), amnestic MCI (amMCI), and other type using Clinical Assessment for Spontaneity (CAS).

Yoshitaka Ouchi; Kyoko Akanuma; Mitsue Meguro; Mari Kasai; Hiroshi Ishii; Kenichi Meguro

Aim:  To determine whether impaired instrumental activities of daily living affect conversion from mild cognitive impairment to dementia for subjects in a community.

Yoshitaka Ouchi; Mari Kasai; Kei Nakamura; Masahiro Nakatsuka; Kenichi Meguro

Background/Aims: We investigated quantitative/qualitative changes of instrumental activities of daily living (IADL) in people with a Clinical Dementia Rating (CDR) of 0.5. Methods: IADLs were evaluated in older residents: CDR of 0 (healthy) and CDR 0.5 (questionable/very mild dementia). The subjects with CDR 0.5 were divided into 2 types: the very mild Alzheimers disease (vmAD) type and the other type including very mild subcortical vascular dementia. IADLs were evaluated quantitatively using the Lawton and the original qualitative IADL scales. Results: CDR 0.5/vmAD type subjects had impairment of only one Lawton item (Shopping) compared to CDR 0 subjects. However, the CDR 0.5/vmAD type group and the CDR 0.5/other type group showed impairment of 3 items in the qualitative assessment (Shopping, Food preparation, and Mode of transportation). Conclusion: We suggest using both quantitative/qualitative IADL scales for assessing older adults with very mild dementia.

Yoshitaka Ouchi; Kenichi Meguro; Kyoko Akanuma; Yuriko Kato; Satoshi Yamaguchi

Background. Alzheimers disease (AD) patients have a poor response to the voices of caregivers. After administration of donepezil, caregivers often find that patients respond more frequently, whereas they had previously pretended to be “deaf.” We investigated whether auditory selective attention is associated with response to donepezil. Methods. The subjects were40 AD patients, 20 elderly healthy controls (HCs), and 15 young HCs. Pure tone audiometry was conducted and an original Auditory Selective Attention (ASA) test was performed with a MoCA vigilance test. Reassessment of the AD group was performed after donepezil treatment for 3 months. Results. Hearing level of the AD group was the same as that of the elderly HC group. However, ASA test scores decreased in the AD group and were correlated with the vigilance test scores. Donepezil responders (MMSE 3+) also showed improvement on the ASA test. At baseline, the responders had higher vigilance and lower ASA test scores. Conclusion. Contrary to the common view, AD patients had a similar level of hearing ability to healthy elderly. Auditory attention was impaired in AD patients, which suggests that unnecessary sounds should be avoided in nursing homes. Auditory selective attention is associated with response to donepezil in AD.

Keiichi Kumai; Mari Kasai; Kei Nakamura; Masahiro Nakatsuka; Yoshitaka Ouchi; Kenichi Meguro

Frontotemporal Dementia (FTD) and Parkinson Disease (PD). The rationale for retraining is the notion that practice on carefully selected tasks promote recovery of the disrupted neural circuits and restore functions in the impaired cognitive processes themselves. Methods: The two main objectives were (a) to develop a cognitive training programme to improve cognitive functions (b) to evaluate the impact of 30-session cognitive training on the cognitive and functional performance of older adults with MCI, FTD and PD. A pre-post experimental design was employed. The sample consisted of 3 case studies of Mild Cognitive Impairment, Frontotemporal Dementia and Parkinson Disease (with memory issues) from the geriatric clinic of NIMHANS, Bangalore. Their socio-demographic data was collected and further, they were assessed on Neuropsychological test for the Elderly (Tripathi, Kumar, Bharath&Marimuthu, 2012) and other rating scales (GHQ, HMSE, AD8, EASI, CDR, NPI and NIMHANS Geriatric Screening Proforma). Results: The result of the present study reveals a significant difference in Verbal memory, Logical Memory, Delayed Visuospatial memory and Visual working memory when pre and post intervention scoreswere compared.Conclusions:The study highlights the importance of cognitive retraining in improving certain areas of cognition brought about by age related cognitive decline.

Yoshitaka Ouchi; Yuriko Kato; Megumi Nakai; Hiroyasu Ishikawa; Kei Nakamura; Masahiro Nakatsuka; Mari Kasai; Naofumi Tanaka; Kenichi Meguro

ing was an early marker of decline, with abnormalities even at the pre-MCI stage. Lower volumes of the hippocampus and the basal forebrain area were associated with an increased likelihood of MCI. Different MCI subtypes showed distinct grey matter atrophy patterns. A suite of novel plasma proteins was a good biomarker. Genome-wide association studies of cognitive performance and decline, white matter lesions and hippocampal volume have shown suggestive results which warrant replication. Conclusions: MCI is a heterogeneous condition, and its risk and protective factor studies should take age, sex and subtype into consideration. Many biomarkers, with modest predictive value, are being developed, using neuroimaging and proteomics, and novel gene discovery and replication studies are being undertaken.

Yoshitaka Ouchi; Masayuki Satoh; Satoshi Yamaguchi; Kenichi Meguro

test scores were as follows: SMMSE 11-30, NPI 0-57, CDT 0-14, ZBI 1-40, Katz’s ADL 0-6 and Lawton’s IADL 9-27. MMSE was better correlated to Lawton’s IADL (directly), and also to the NPI (inversely) and to the ZBI (inversely). CDR showed good (inverse) correlations to the MMSE and to the SMMSE scores, and also to the CDT, to Lawton’s IADL and to Katz’s ADL. All other comparisons among these scales resulted in statistical differences in regard to their respective scores. Conclusions: In this sample of patients with low average schooling, the MMSE had a better correlation with functional independence tests and with caregiver burden. Scales may be differentially sensitive according to the objective of the evaluation.

Masahiro Nakatsuka; Kenichi Meguro; Masahiro Tsuboi; Kei Nakamura; Kyoko Akanuma; Yoshitaka Ouchi; Naofumi Tanaka; Satoshi Yamaguchi

Results: PCA patients showed a clinical syndrome primarily characterized by visual object agnosia and prosopagnosia. Compared with controls, they had significantly higher MD, ParD and TraD and lower FA in the left ILF and IFOF. In addition, the right ILF had significantly higher MD and TraD and lower FA, the right IFOF had higher MD and TraD, and the CC higher MD. The fronto-parietal SLF, arcuate fasciculus, and CST were spared bilaterally. PCA patients also had GM atrophy in posterior temporal, inferior parietal and occipital regions bilaterally, and WM atrophy in the ventral occipito-temporal region, bilaterally. Conclusions: PCA patients in the present series harbor a prevalent damage to the ventral WM pathways of both hemispheres, with relative sparing of dorsal fronto-parietal connections. These results contribute to the definition of a more complete picture of the anatomical changes that occur in PCA in term of involved pathologic networks, and shed light onto the cognitive deficits and the different phenotypes of the syndrome.