OBJECTIVES: The abnormal eating behaviors are revealed in neurodegenerative disease, especially frontotemporal dementia. Several studies have demonstrated that structural changes are related to functional changes in regulation of feeding. But areas in determining eating disorder in dementia remain unclear. We applied voxel-based morphometry (VBM) to assess brain tissue abnormalities in neurodegenerative patients with abnormal eating behaviors. METHODS: We assessed abnormal eating behaviors of sixty three patients with dementia using the modified Manchester Behavior Questionnaire. Volumetric brain magnetic resonance imaging was performed in all patients and gray matter changes were assessed using VBM. RESULTS: Dementia patients with eating problems showed gray matter loss predominantly involving right insula, right anterior cingulate, right superior medial frontal cortex, right orbitofrontal cortex. Overeats scores were associated with atrophy of right anterior cingulate, right superior orbitofrontal cortex, right superior medial frontal cortex, right insula, and right putamen. CONCLUSION: This results suggest that right orbitofrontal cortex, insula, anterior cingulate, striatum regions integrate sensory and motivational information regarding food. The dementia patients with abnormal eating behaviors may be explained by disruption of this integrating system.

OBJECTIVES: This study was to investigate the trends in anger and aggression with aging in Korean population aged from twenties to eighties. METHODS: Two hundreds ninety-five subjects included, ranged 22 to 92 years old. All subject participate in a clinical interview with psychiatrists who use the MINI (Mini international Neuropsychiatric Interview) to diagnosis psychiatric disorders, and were not any psychiatric disorders. RESULTS: In elderly group, the scores of Trait anger, Anger expression, and totol of STAXI were higher than adult group, where as the scores of State anger of STAXI, Hostility of AQ, and Disturbances, Embarrassing, Unpleasant circumstances, and total of RI were higher in adult group. Trait anger and Anger expression were shown trends to increase with age. On the other hands, State anger, Hostility, and Reaction to external stimuli were shown trends to decrease with age. CONCLUSION: The reaction to anger situation and aggression decrease with age, although anger increase with age. Various factor, such as defense mechanism may affect on aggressive expression and response. There will be needed to investigate associated factors between anger and aggression.
Adult ; Male ; Female ; Humans

BACKGROUND AND OBJECTIVES: Recently the number of geriatric depressed people has been increasing tremendously. Among many factors affecting depression, quality of life seems to be closely related to depression. Thus, a screening tool for assessing both geriatric depression and quality of life is needed. The purpose of this study is to estimate the utility of the Korean version of the WHO-Five Well-Being Index (WHO-5) in evaluating geriatric depression as compared with SGDS-K (Short Geriatric Depression Scale of Korean version) that is being used widely and quality of life. METHODS: A sample of 244 subjects over 65-year old living in Yanggu and Inje area in Gangwon Province, Korea were interviewed and responded to scales, including WHO-5, SGDS-K, MMSE-KC (Mini Mental Status Examination in the Korean version of the CERAD assessment packet) and GQOL-D (Geriatric Quality of Life-Dementia). The total score of WHO-5 below 13 indicates low well-being. RESULTS: The WHO-5 inversely correlated with SGDS-K and positively with GQOL-D, but showed no significant correlation with MMSE-KC. The SGDS-K negatively correlated with WHO-5, MMSE-KC, and GQOL-D. Low well-being group (WHO-5 score<13) had lower GQOL-D score (t=1.9698, p<0.05) and higher SGDS-K score (t=1.9798, p<0.05) than high well-being group. In multiple regression analysis, WHO-5 was significantly associated with GQOL-D and SGDS-K (r2=0.29422, p=0.0000). CONCLUSION: The Korean version of WHO-5 was very useful to evaluate both depressive symptoms and quality of life in the aged dwelling in community.

Sleep-related breathing disorder in the elderly is common but not diagnosed and treated properly. Sleep apnea in the elderly differs from that in young adults and does not show overt sign of it such as snoring and excessive daytime sleepiness. Co morbidities of elderly patients make it difficult to diagnosis and treatment of sleep apnea. Untreated sleep-related breathing disorders can cause cardiovascular disease, cognitive impairment and dementia. Sleep-related breathing disorder is diagnosed with thorough history taking and polysomnography. Continuous positive airway pressure (CPAP) is treatment of choice for sleep apnea in elderly. When patient failed to adapt in CPAP, oral appliance or surgical approach can be considered.
Adult ; Male ; Female ; Humans

Rapid eye movement sleep behavior disorder (RBD) is characterized by violent behaviors during sleep, related to loss of REM sleep atonia and enactment of dreams. In this article, clinical characteristics, diagnosis and management of RBD will be reviewed. In the next section, recent studies on relationships between associated neurodegenerative disorders and RBD will be discussed. Clinical implications of idiopathic RBD to potential neurologic disorders, especially synucleinopathy will be presented.

The aim was to evaluate the diagnostic utility of beta-amyloid positron emission tomography (PET) in elderly patients with cognitive impairment in the clinical setting. Five subjects underwent beta-amyloid PET imaging to explore the cerebral beta-amyloid deposition. The two male patients with minor neurocognitive disorder due to Alzheimer's disease, who displayed similar degree of cognitive impairment and medial temporal atrophy but different in apolipoprotein E4 status, both showed negative for beta-amyloid PET. On the other hand, a female major neurocognitive disorder due to probable Alzheimer's disease patient was tested positive for beta-amyloid PET, with increased beta-amyloid density in frontal and parietal lobes. Beta-amyloid PET was also used for the differential diagnosis of neurocognitive disorder from other psychiatric disorders in two elderly patients. The results were negative but assisted the diagnositic confirmation. A female patient was determined to be a case of late-onset schizophrenia and a male patient was determined as delirium due to minor traumatic brain injury, persistent. Beta-amyloid PET imaging was able to demonstrate cerebral beta-amyloid deposition in major neurocognitive disorder due to probable Alzheimer's disease in visual scale. However, further studies are needed for its clinical utility in the minor neurocognitive disorders. Moreover, beta-amyloid PET imaging may provide additional information in diagnosing primary psychiatric disorders with new onset in the old age.
Late Onset Disorders ; Aged* ; Alzheimer Disease ; Amyloid beta-Peptides ; Apolipoprotein E4 ; Atrophy ; Brain Injuries ; Delirium ; Diagnosis, Differential ; Electrons* ; Female ; Hand ; Humans ; Male ; Parietal Lobe ; Positron-Emission Tomography* ; Schizophrenia

OBJECTIVE: This study aims to examine association of temporal discounting with well-being of Korean community-dwelling elderly. METHODS: The subjects of this research were 4,373 community-dwelling older persons without dementia. Each subject was administered the questionnaires regarding the socio-demographic characteristics, temporal discounting which was measured using standard questions in which participants were asked to choose between an immediate, smaller payment and a delayed, larger one. Outcome variable is Korean version of the World Health Organization Five Well-Being Index (WHO-5). Statistical analyses including the Pearson's correlation test and logistic regression were performed in this study. RESULTS: At baseline, temporal discounting was negatively associated with WHO-5 in the Pearson's correlation test (r=-0.04, p=0.006). In a adjusted model for confounding variables, temporal discounting was negatively associated with WHO-5 [odd ratio (95% confidence interval)=0.57 (0.35–0.92), p=0.021]. CONCLUSION: Elderly individual with a higher temporal discounting (which indicates impulsivity) may have a lower quality of life.
Aged* ; Confounding Factors (Epidemiology) ; Dementia ; Humans ; Logistic Models ; Quality of Life ; World Health Organization

OBJECTIVE: This study aimed to explore the effect of cognitive function, social activity participation and social support on quality of life (QoL) of community-dwelling elderly. METHODS: The data on 194 elderly were selected from the nationwide community cohort named Korean Longitudinal Study on Cognitive Aging and Dementia. All subjects were assessed QoL-Alzheimer's Disease (QoL-AD), Cumulative Illness Rating Scale, exercise habit, Mini-Mental State Examination, social activities, The Medical Outcomes Study-Social Support Survey. The data were analyzed with SPSS WIN V. 21.0 program. RESULTS: The mean of QoL among community-dwelling elderly was 35.49 (24–46) for QoL measured by QoL-AD. The variables of professional, residence status, physical health, exercise, cognitive function, social activity participation and social support explained 29.3% of variance in QoL of community-dwelling elderly. Among these factors, the significant predictors of QoL were social support (β=0.322, p<0.001), cognitive function (β=0.152, p=0.021), and religion activity (β=0.152, p=0.025). CONCLUSION: The study suggests that the focus of intervention program should be on cognitive function and social activity participation to improve QoL for elderly. Improving cognitive function and social activity will lead to the network of social support, consequently to increase QoL for elderly living in the community.
Aged* ; Aging ; Cohort Studies ; Dementia ; Humans ; Longitudinal Studies ; Quality of Life*

OBJECTIVE: This study aims to investigate the association between alcohol use disorder and cognition in Korean community-dwelling elderly, especially the gender-specific difference. METHODS: Data obtained from 1,141 subjects (976 men and 165 women) aged above 60 years was analyzed from the Gwangju Dementia and Mild Cognitive Impairment Study. All subjects completed the study questionnaire including demographic characteristics, history of current and past illnesses, drug history, Korean Mini-Mental State Examination (K-MMSE), and cut down, annoyed, guilty feelings, eye-opener (CAGE), Short Form of Geriatric Depression Scale-Korean version (SGDS-K). RESULTS: Of the 1,141 subjects (mean age 72.17±6.20, mean educational level 6.50±4.48), 267 demonstrated alcohol use disorder (23.40%) and 874 were non-alcohol use disorder (76.60%). The mean of K-MMSE for alcohol use disorder group was 23.23±4.99, and for non-alcohol use disorder group was 23.70±3.94. When alcohol use disorder is accompanying, the decrement of K-MMSE score was 3.07 for female, and 0.35 for male. And we confirmed the interactive effect on K-MMSE score between sex and alcohol use disorder after adjusting for age, education level, depression (F=5.798, p=0.016). CONCLUSION: In conclusion, our study demonstrates an association between alcohol use disorder and cognitive impairment by gender in the elderly.
Aged* ; Alcohols ; Cognition ; Dementia ; Depression ; Education ; Female ; Gwangju ; Humans ; Male ; Mild Cognitive Impairment

OBJECTIVE: The aim of this study was to examine the relationship between late-life depression and resilience in the Korean community-dwelling elderly with depression. METHODS: The subjects were 102 depressed elderly people who lived in Suwon and Gwangju, Korea. Each subject was administered the questionnaires regarding the socio-demographic characteristics, Korean version of the Mini-Mental State Examination for Dementia Screening (MMSE-DS), Brief Resilience Scale (BRS), and Short Form Geriatric Depression Scale-Korean version (SGDS-K). RESULTS: In a cross-sectional aspect, BRS score were negatively correlated with SGDS-K score in the Pearson's correlation test (r=-0.301, p=0.002). After multivariable adjustments, linear mixed model analysis showed that subjects with baseline higher BRS score had significantly lesser SGDS-K score (β=-0.16, p=0.006). CONCLUSION: The level of resilience should be considered in predicting the change of depressive symptoms in the elderly.
Aged ; Dementia ; Depression* ; Gwangju ; Gyeonggi-do ; Humans ; Korea ; Mass Screening