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

OBJECTIVE: This study was to investigate the factors that influence the propensity of Koreans in choosing care settings of dementia patients. METHODS: This study analyzed the data from the '2014 Nationwide Survey on Dementia Awareness of Koreans' that was conducted by the National Institute of Dementia. Korean's perception of care burden for dementia was measured with grading on its types. Also its influences on preference for care between facilities and homes were evaluated using multivariate analysis with socio-demographic characteristics. RESULTS: In terms of preferred care settings, respondents preferred facilities over homes in case of themselves and their family, respectively 77.5% and 68.2%. The preference for facilities was significantly influenced by the respondents' age for both themselves and their family. Additionally, the perception of relatively higher emotional and physical burden compared to economic burden significantly influenced preference for facilities for their family. CONCLUSION: Improving public awareness and setting-up a practical social supporting system are needed to reduce emotional and physical burden as well as economic burden of dementia. Furthermore, building up an appropriate and safer communities for dementia patients and their caregivers is much demanded for reducing their burdens.
Caregivers ; Surveys and Questionnaires ; Dementia* ; Humans ; Multivariate Analysis

Memory is one of the most important mental mechanisms which is crucial for us to adapt to environmental surroundings and to maintain our identity. The neurobiological mechanisms for memory are based upon the synaptic plasticity that involve both functional and structural changes at the synapses in the neural circuits participating in learning and memory. Memory is not a single process but has two forms of short-term and long-term memory that are two independent but overlapping processes that blend into one another. The short-term memory depends upon the functional change of synaptic strength but the long-term memory requires anatomic changes of synapses in the neural circuit. Memory storage seems to use elements of a common genetic switch, involving cyclic adenosine monophospate (cAMP)-dependent protein kinase, mitogen activated protein kinase, and cAMP response element-binding protein, to convert short-term memory into long-term memory.
Adenosine ; Cyclic AMP Response Element-Binding Protein ; Learning ; Memory* ; Memory, Long-Term ; Memory, Short-Term ; Plastics ; Protein Kinases ; Synapses

OBJECTIVE: The positive and negative predictive values are more important as the diagnostic validity than the sensitivity and specificity in the general population with a low prevalence rate of a disease. The present study is about the diagnostic predictive values of the Korean version of mini-mental state examination and Cognitive Impairment Diagnosing Instrument in an unselected community elderly group. METHOD: The positive and negative diagnostic values were calculated based on the Bayes theorem, using the sensitivity and specificity of the Korean version of mini-mental state examination and Cognitive Impairment Diagnosing Instrument and a previously reported prevalence rate. RESULTS: When the prevalence of dementia is 10.8% among elderly people living in a community, the positive predictive value, negative predictive value and combined error were estimated as being 56.7%, 99.0%, and 8.4%, respectively, at cutoff score of 23 of the Korean version of mini-mental state examination for diagnosing dementia. In the case of the Cognitive Impairment Diagnosing Instrument, they were 64.2%, 99.1% and 6.3%, respectively, at the point of 57 or less in an unselected community sample with the same prevalence. If the sensitivity and specificity are constant, the positive predictive values of the Korean version of mini-mental state examination and Cognitive Impairment Diagnosing Instrument incresed markedly with the rising prevalence while the negative predictive values and combined errors changed little. CONCLUSION: If a variety of diagnostic tests available are similar in the diagnostic sensitivity and specificity, a test with higher positive predictive value should be prefered because the negative predictive value and combined error are not significantly influenced by the prevalence. In this regard, the Cognitive Impairment Diagnosing Instrument may be superior to the Korean version of mini-mental state examination.
Aged ; Bayes Theorem ; Dementia ; Diagnostic Tests, Routine ; Humans ; Predictive Value of Tests ; Prevalence ; Sensitivity and Specificity

OBJECTIVE: The positive and negative predictive values are more important as the diagnostic validity than the sensitivity and specificity in the general population with a low prevalence rate of a disease. The present study is about the diagnostic predictive values of the Korean version of mini-mental state examination and Cognitive Impairment Diagnosing Instrument in an unselected community elderly group. METHOD: The positive and negative diagnostic values were calculated based on the Bayes theorem, using the sensitivity and specificity of the Korean version of mini-mental state examination and Cognitive Impairment Diagnosing Instrument and a previously reported prevalence rate. RESULTS: When the prevalence of dementia is 10.8% among elderly people living in a community, the positive predictive value, negative predictive value and combined error were estimated as being 56.7%, 99.0%, and 8.4%, respectively, at cutoff score of 23 of the Korean version of mini-mental state examination for diagnosing dementia. In the case of the Cognitive Impairment Diagnosing Instrument, they were 64.2%, 99.1% and 6.3%, respectively, at the point of 57 or less in an unselected community sample with the same prevalence. If the sensitivity and specificity are constant, the positive predictive values of the Korean version of mini-mental state examination and Cognitive Impairment Diagnosing Instrument incresed markedly with the rising prevalence while the negative predictive values and combined errors changed little. CONCLUSION: If a variety of diagnostic tests available are similar in the diagnostic sensitivity and specificity, a test with higher positive predictive value should be prefered because the negative predictive value and combined error are not significantly influenced by the prevalence. In this regard, the Cognitive Impairment Diagnosing Instrument may be superior to the Korean version of mini-mental state examination.
Aged ; Bayes Theorem ; Dementia ; Diagnostic Tests, Routine ; Humans ; Predictive Value of Tests ; Prevalence ; Sensitivity and Specificity

Behavioral problems are thought to be pervasive and devasting to patients with dementia of the Alzheimer's type and their families. Despite this, little empirical data are available concerning the nature of such impairments, their rate of occurrence or their relationship to the disease process. This study was designed to investigate the nature and the rates of behavioral disturbance among DAT patients. The subjects involved in this study were 72 patients who were hospitalized and had primary diagnosis of dementia of the Alzheimer's type. Severity of the dementia was assessed by MMSE, and abnormal behavior by E-BEHAVE-AD. Pearson correalation was used to analysis data. The subjects were divided into mild/moderate dementia group and severe, and then evaluated significant differences. Independent-samples T-test was used to analysis data. The results were as follows: 1) Wandering and delusional ideation were associated with declining MMSE score 2) Wandering was only differenciated between mild to moderate group. In conclusion, problems found associated with level of impairment such as wandering and delusion are thought to be characteristic of the disease and therefore predictable. Problems found not associated with level of impairment, are likely to be idiosyncratic. The former should probably be incorporated into education and intervention programs, the latter addressed as needed on an individual basis.
Alzheimer Disease* ; Delusions ; Dementia* ; Diagnosis ; Education ; Humans ; Psychopathology*