Objectives: This study aimed to investigate the association between self-reported sleep and cognitive function in individuals with mild cognitive impairment (MCI) to understand potential implications for Alzheimer’s disease prevention. Methods: This retrospective cohort study included 80 patients with MCI and 70 controls. Participants completed standardized questionnaires to assess self-reported sleep quality (Korean version of the Pittsburgh Sleep Quality Index [PSQI-K]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and insomnia severity (Insomnia Severity Index [ISI]). Cognitive function was evaluated using the Seoul Neuropsychological Test and the Korean version of the Mini-Mental State Examination. The Korea Instrumental Activities of Daily Living Scale was used to assess instrumental activities of daily living. Correlation analyses examined the relationship between sleep-related parameters and cognitive function. Results: The results indicated no significant differences in PSQI-K and ESS scores between patients with MCI and the control group. Correlation analyses revealed that poorer sleep quality was associated with reduced frontal and executive functions in patients with MCI, particularly in tests such as Controlled Oral Word Association Test (supermarket, -0.311, p<0.001) and Trail Making Test (TMT) B (0.232, p<0.001). Additionally, daytime dysfunction was associated with poorer cognitive performance across language and executive domains (e.g., Korean Boston Naming Test: -0.290, p<0.001; TMTA: 0.248, p<0.001). In both groups, ISI scores were linked to cognitive functions, particularly in attention, phonemic fluency, and executive function (e.g., digit span, backward: -0.225, p<0.01; TMTA: 0.327, p<0.01). Conclusions These findings suggest that sleep disturbances significantly impact cognitive function and daily living abilities in patients with MCI.

Objectives: This study aimed to investigate the association between self-reported sleep and cognitive function in individuals with mild cognitive impairment (MCI) to understand potential implications for Alzheimer’s disease prevention. Methods: This retrospective cohort study included 80 patients with MCI and 70 controls. Participants completed standardized questionnaires to assess self-reported sleep quality (Korean version of the Pittsburgh Sleep Quality Index [PSQI-K]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and insomnia severity (Insomnia Severity Index [ISI]). Cognitive function was evaluated using the Seoul Neuropsychological Test and the Korean version of the Mini-Mental State Examination. The Korea Instrumental Activities of Daily Living Scale was used to assess instrumental activities of daily living. Correlation analyses examined the relationship between sleep-related parameters and cognitive function. Results: The results indicated no significant differences in PSQI-K and ESS scores between patients with MCI and the control group. Correlation analyses revealed that poorer sleep quality was associated with reduced frontal and executive functions in patients with MCI, particularly in tests such as Controlled Oral Word Association Test (supermarket, -0.311, p<0.001) and Trail Making Test (TMT) B (0.232, p<0.001). Additionally, daytime dysfunction was associated with poorer cognitive performance across language and executive domains (e.g., Korean Boston Naming Test: -0.290, p<0.001; TMTA: 0.248, p<0.001). In both groups, ISI scores were linked to cognitive functions, particularly in attention, phonemic fluency, and executive function (e.g., digit span, backward: -0.225, p<0.01; TMTA: 0.327, p<0.01). Conclusions These findings suggest that sleep disturbances significantly impact cognitive function and daily living abilities in patients with MCI.

Objectives: This study aimed to investigate the association between self-reported sleep and cognitive function in individuals with mild cognitive impairment (MCI) to understand potential implications for Alzheimer’s disease prevention. Methods: This retrospective cohort study included 80 patients with MCI and 70 controls. Participants completed standardized questionnaires to assess self-reported sleep quality (Korean version of the Pittsburgh Sleep Quality Index [PSQI-K]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), and insomnia severity (Insomnia Severity Index [ISI]). Cognitive function was evaluated using the Seoul Neuropsychological Test and the Korean version of the Mini-Mental State Examination. The Korea Instrumental Activities of Daily Living Scale was used to assess instrumental activities of daily living. Correlation analyses examined the relationship between sleep-related parameters and cognitive function. Results: The results indicated no significant differences in PSQI-K and ESS scores between patients with MCI and the control group. Correlation analyses revealed that poorer sleep quality was associated with reduced frontal and executive functions in patients with MCI, particularly in tests such as Controlled Oral Word Association Test (supermarket, -0.311, p<0.001) and Trail Making Test (TMT) B (0.232, p<0.001). Additionally, daytime dysfunction was associated with poorer cognitive performance across language and executive domains (e.g., Korean Boston Naming Test: -0.290, p<0.001; TMTA: 0.248, p<0.001). In both groups, ISI scores were linked to cognitive functions, particularly in attention, phonemic fluency, and executive function (e.g., digit span, backward: -0.225, p<0.01; TMTA: 0.327, p<0.01). Conclusions These findings suggest that sleep disturbances significantly impact cognitive function and daily living abilities in patients with MCI.

Objective: Second-generation antipsychotics (SGAs) have revolutionized the treatment of psychiatric disorders, but are associated with significant metabolic risks, including diabetes and hyperglycemic crises. This review explores the complex interplay between antipsychotics, diabetes, and hyperglycemic crises, highlighting the mechanisms underlying SGA-induced diabetes. Methods: We present the case of a patient with schizophrenia who was taking antipsychotic medication and was admitted to the emergency room due to the sudden onset of diabetic ketoacidosis (DKA) without any history of diabetes. We extensively searched databases, including Elsevier, PubMed, IEEE, SpringerLink, and Google Scholar, for papers on the effects of antipsychotic drugs on DKA from 2002 to 2021. We focused on DKA, hyperglycemia, and atypical antipsychotics, and retrieved 117 papers. After full-text review, 32 papers were included in this comprehensive review. Results: DKA was significantly more frequent in patients taking SGAs. Antipsychotics can induce insulin resistance either directly or through the onset of obesity. Antipsychotics can reduce insulin secretion from pancreatic β-cells, which is associated with absolute insulin deficiency. Conclusion As the use of antipsychotics continues to increase, understanding their risks and mechanisms is crucial for clinicians to enable informed treatment decisions and prevent potentially life-threatening complications.

Objective: Exposure to stressful events is associated with the progression of white matter hyperintensity (WMH). The purpose of this study was to determine the difference in WMH depending on the presence of Post-traumatic stress disorder (PTSD). Methods: The patients who underwent brain magnetic resonance imaging and clinician-administered PTSD scale (CAPS) at the Veteran Health Service Medical Center were reviewed retrospectively. WMH were evaluated using the Fazekas scale. The patients with PTSD (n=51; age 66.25±10.43 years) were compared with patients exposed to trauma without PTSD (n=67; age 69.45±10.44 years). Results: The scores of Beck Depression Scale, Beck Anxiety scale, and CAPS were significantly higher in the PTSD group. The PTSD group showed a significant difference on the Fazekas scale compared to the trauma-exposed group without PTSD (periventricular white matter, p=0.001; deep white matter, p=0.008). After adjusting for age, smoking and comorbidity, WMH was higher in the PTSD group than in the trauma exposed group (periventricular white matter, p<0.001; deep white matter, p=0.006). Conclusion The results suggests that there may be an association between PTSD and WMH as well as stressful events.

REM sleep behavior disorder is parasomnia characterized by unpleasant dreams and dream-enactment behaviors associated with excessive electromyography activity in REM sleep. This may appear idiopathic or secondary to other neurological or medical conditions. REM sleep behavior disorder, which appears to be idiopathic, most often implies the possibility of later neurodegenerative diseases due to synucleinopathy, so accurate diagnosis is important in predicting prognosis. For the diagnosis of REM sleep behavioral disorder, REM sleep without atonia, which appears in the polysomnography, is essential. Obstructive sleep apnea, trauma-related sleep disorders, and vigorous periodic leg movements during sleep are known as diseases that show dream enactment behavior in elderly patients. Considering that it may be accompanied by other sleep disorders that can mimic REM sleep behavioral disorders, it is important to differentiate sleep