Dementia is a syndrome of global cognitive disability and is not a single disease. There are many risk factors of dementia, and some factors are adjustable. Therefore it is important to have knowledge about dementia risk factors, and modulate the risk factors for prevention of dementia. Through this paper, we review the risk factors for dementia with unadjustable factors (age, sex, genetic factors) and adjustable factors (diabetes melitus, hypertention, hypercholesterolemia, hypothyroidism, alcohol intake, depression, etc) in the aspects of the impact of them on the incidence of dementia.
Alzheimer Disease ; Dementia ; Dementia, Vascular ; Depression ; Hypercholesterolemia ; Hypothyroidism ; Incidence ; Risk Factors

Background: and Purpose Stereopsis refers to the perception of depth and awareness of the distance of an object from the observer that results from the brain receiving visual stimuli from both eyes in combination. Patients with idiopathic Parkinson’s disease (PD patients) typically experience problems with vision, eyeball movements, and visual perception due to degeneration of the cells that generate dopamine in the brain. We therefore hypothesized that stereopsis is affected more by visual cortical dysfunction in idiopathic PD than by retina and subcortical structural dysfunction. Methods: We analyzed stereopsis in 12 PD patients and 7 healthy controls using a three-dimensional (3D) television (TV). Before allowing patients to watch TV, we examined their visual acuity and strabismus using the Titmus Stereo Fly Test, and evaluated their cognitive function using cognitive tests. The patients watched 3D and two-dimensional (2D) versions of a movie with an approximate duration of 17 minutes, and then completed a questionnaire about stereopsis. All subjects underwent brain F-18 fluorodeoxyglucose (FDG) positronemission tomography after watching the 3D version of the movie. One week later, subjects watched the 2D version of the same movie under the same conditions. Each scan was analyzed using statistical parametric mapping (version 8) software. Results: The visual cortex was activated less in the PD patients than in the healthy controls when watching the 2D or 3D movie. However, there was no significant difference between watching 2D and 3D movies in the PD patients or healthy controls. Conclusions The lower activation of the primary visual cortex in PD patients suggests the presence of dysfunction of the visual cortex. In addition, there was less activation of the visual association cortex in PD patients when watching a 3D movie than in controls under the same conditions. This might be one reason why PD patients do not recognize real and dynamic stereopsis. These findings have clinical significance since they suggest that safety needs to be considered when making devices or programs using 3D or virtual reality for use by patients with various cerebral degenerative diseases.

Transient memory impairment can be occurred by many causes. One of them is acute focal brain lesion in strategic site. Caudate nucleus and medial basal ganglia (globus pallidus) are lesion of strategic site. They play its role in cognitive processing. But lateral basal ganglia (putamen) is known as a structure involving movement, not cognitive function. We report a interesting case of transient memory dysfunction with acute focal putamen ICH with old caudate nucleus infarction.
Basal Ganglia ; Brain ; Caudate Nucleus ; Infarction ; Intracranial Hemorrhages ; Memory ; Putamen

Preliminary studies have evaluated the effects of interferon beta formulations in the treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) because of pathogenic similarities between CIDP and multiple sclerosis (MS). However, the efficacy of Interferon, which has been widely used for relapsing-remitting MS, is controversial in CIDP. We report here a 31year old woman with relapsing-remitting type MS treated with IFN beta-1b over 2 years who developed overt CIDP. She responded favorably to steroids. This case suggests that IFN beta-1b treatment may not prevent development of CIDP.
Female ; Humans ; Interferon-beta* ; Interferons ; Multiple Sclerosis* ; Polyneuropathies* ; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating ; Steroids

BACKGROUND: Anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis was discovered less than 10 years ago. Its symptoms and characteristics are not well-defined yet. We experienced a case of anti-NMDA receptor encephalitis with phonemic paraphasia and acalculia that were not classical characteristics. CASE REPORT: A 44-year-old woman started to show dyslexia, phonemic paraphasia, and dyscalculia. These symptoms were gradually worsening for over 30 days. Various brain images were not helpful for primary diagnosis. Anti-NMDA receptor encephalitis was confirmed in two different laboratories. The patient started to recover with various immunosuppressive therapies. CONCLUSIONS: Anti-NMDA receptor encephalitis can have various symptoms, including phonemic paraphasia and acalculia.
Adult ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis* ; Brain ; Diagnosis ; Dyscalculia ; Dyslexia* ; Encephalitis ; Female ; Humans

Background: and Purpose Screening tests for dementia such as the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment are widely used, but there are drawbacks to their efficient use. There remains a need for a brief and easy method of assessing the activities of daily living (ADL) that can be administered to elderly individuals by healthcare workers. We have therefore developed a new scale named the Simple Observation Checklist for Activities of Daily Living (SOC-ADL). Methods: We developed the SOC-ADL scale as a team of experts engaged in caring for individuals with dementia. This scale comprises eight items and was designed based on the Korean instrumental activities of daily living (K-IADL) scale and the Barthel activities of daily living scale (Barthel Index). The new scale was validated by enrolling 176 patients with cognitive dysfunction across 6 centers. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed. We assessed its concurrent validity by performing comparisons with the Korean-MMSE, Clinical Dementia Rating, Clinical Dementia Rating-Sum of Boxes, K-IADL, and Barthel Index, and its criterion validity by performing comparisons between mild cognitive impairment (MCI) and dementia. We also used Cronbach’s alpha to assess the interitem reliability. The appropriate cutoff values were determined by analyzing receiver operating characteristic curves, including the areas underneath them. Results: EFA extracted one factor and CFA revealed that all of the model fits exceeded the minimum acceptable criteria. The SOC-ADL scores were strongly correlated with those of the other tools for dementia and could be used to differentiate MCI from dementia. Cronbach’s alpha values indicated that the results were reliable. The optimal cutoff value of the SOC-ADL for discriminating dementia from MCI was 3 points, which provided a sensitivity and specificity of 74.5% and 75.7%, respectively. Conclusions Our results demonstrate that the SOC-ADL is a valid and reliable tool for differentiating dementia from MCI based on an assessment of ADL. This new tool can be used for screening ADL in elderly subjects who have difficulty communicating, and to increase the efficiency of dementia screening at the population level.

BACKGROUND AND PURPOSE: Disability associated with activities of daily living (ADL) is the basis of dementia diagnosis and is an important factor in the care of dementia patients. The status of awareness and burden of ADL disability in dementia patients was investigated six years ago and used as an important reference for “Il-sang-ye-chan” campaign. They were re-investigated in six years and compared with previous results. METHODS: The survey included caregivers of 100 dementia patients listed at the four regional dementia centers. Structured open and closed questions about ADL were asked. Assessments included age, sex, education level, economic status, severity of dementia, caregiving pattern, current statues and cognition of ADL, and caregiver needs. RESULTS: The cognition of ADL was still very low (43%). Increased stress among caregivers was the biggest burden, and they frequently suffered from outing disability (56%), recent memory loss (48%), and loss of bowel/bladder control (40%). The economic burden has been greatly reduced compared with the burden six years ago and the needs of caregivers were still highly about educational guide lines or programs. CONCLUSIONS: Continued interest and further investigation into ADL disability of dementia patients are needed. Korean Dementia Association will further expand the “Il-sang-ye-chan” program: via a multi-domain cognitive intervention program under the Care for ADL in dementia and Relieve symptoms in Dementia Project.
Activities of Daily Living ; Caregivers ; Cognition ; Dementia ; Diagnosis ; Education ; Humans ; Memory Disorders