Abstract Background: Sarcopenia and frailty are common geriatric syndromes that may contribute to mild cognitive impairment (MCI). Evidence regarding the independent roles of individual sarcopenia components and frailty in MCI remains limited in low- and middle-income countries. This study evaluated the association between sarcopenia components, frailty, and MCI among older adults in Indonesia. Methods: An ambispective cohort study was conducted among adults aged ≥60 years attending the Geriatric Outpatient Clinic of Dr. Cipto Mangunkusumo National General Hospital, Jakarta. Sarcopenia components were assessed using SARC-Calf (low muscle mass indicator), handgrip strength, and the five-times sit-to-stand test. Frailty was evaluated using the FRAIL scale. Cognitive function was assessed using the Rapid Cognitive Screening. Multivariate log-binomial or Poisson regression with robust variance was used to estimate adjusted risk ratios (RRs) for MCI. Results: A total of 121 participants (median age 74 years; 68.6% female) were included, with an MCI prevalence of 21.5%. After adjustment for confounders, low muscle mass indicator (RR 2.206; 95% CI 1.045–4.652) and low muscle strength (RR 3.006; 95% CI 1.202–7.517) were independently associated with MCI. Low physical performance (RR 1.773; 95% CI 0.796–3.773) and frailty (RR 1.086; 95% CI 0.377–3.134) were not significantly associated with MCI. Conclusion: Low muscle mass indicators and reduced muscle strength were independently associated with MCI, supporting the integration of simple sarcopenia screening tools into routine geriatric cognitive assessment.
sarcopenia ; frailty ; mild cognitive impairment ; rapid cognitive screening

Objective To explore the change of gait of middle-aged and elderly people with mild cognitive impairment in the community,the correlation between gait and cognitive domain,and the role of gait in early recognition of cognitive decline. Methods 140 people over 40 years old in Tongxing Village,Yancheng City,Jiangsu Province were enrolled.The subjects were divided into normal cognitive group (n=64) and mild cognitive impairment group(n=76)through the Montreal Cognitive Assessment and the Minimum Mental State Examination,and gait tests were conducted at the same time.The data were collected and statistically analyzed to explore the difference of gait indicators between the two groups,the relationship between gait indicators and cognitive domains,and the ability of gait indicators to recognize mild cognitive impairment. Results The gait of the mild cognitive impairment group was worse than that of the normal cognitive group in terms of space (stride length,step height,step width) and time (step speed,stride speed,swing speed).Partial correlation analysis showed that step width was negatively correlated with delayed recall;Step size,step width and delayed recall,step height and naming were positively correlated.The logistic regression model constructed by step speed,stride length,stride speed,swing speed,step height and step width can reliably identify the existence of MCI (AUC=0.761,95%CI 0.683-0.840,P<0.05). Conclusion In the middle-aged and elderly community,the spatial and temporal performance of gait of patients with mild cognitive impairment is worse than that of the normal cognitive population.There is a close relationship between spatial indicators and delayed recall and naming.The temporal and spatial characteristics of gait have the potential to identify cognitive decline at an early stage.
Mild cognitive impairment

cognitive enhancement training combined treatment on cognitive function in mild cognitive impairment (MCI) patients, comparing to the application of the rTMS alone and the sham stimulation.METHODS: Six MCI patients received high-frequency rTMS applied to the bilateral dorsolateral prefrontal cortex, followed by the computerized cognitive enhancement training. In addition, six MCI patients took high-frequency rTMS alone. A sham stimulation was used as a control condition in 7 MCI patients. All stimuli were delivered at a frequency of two sessions per week for four weeks. Neuropsychological test was performed at each time points in each group.RESULTS: Although there was the main effect of interaction between time and group on the score of the Korean version of Montreal Cognitive Assessment, only participants of the rTMS single treatment group showed significant improvement of this score.CONCLUSION: In order to overcome the weaknesses of previous studies confirming the efficacy of the combination therapy, this study included patients with MCI, which was the pre-dementia stage, and included rTMS single treatment group, but did not confirm the clinical efficacy of the combination therapy. Small sample size, the baseline cognitive function score, and the ceiling effect of the group were considered to be the bias factor of this study and further studies supplementing these factors are needed.]]>
Bias (Epidemiology) ; Cognition ; Humans ; Mild Cognitive Impairment ; Neuropsychological Tests ; Pilot Projects ; Placebos ; Prefrontal Cortex ; Sample Size ; Transcranial Magnetic Stimulation ; Treatment Outcome

mild cognitive impairment (MCI) groups and to investigate the correlations between blood-based inflammatory factors and cognitive functions.METHODS: Seventy one subjects participated in this study [AD : 28, MCI : 23, normal control (NC) : 20]. The overall cognitive function of the subjects and the severity of the disease stage were assessed using Mini-Mental Status Examination in the Korean Version of the the CERAD Assessment Packet (MMSE-KC), Global Deterioration Scale (GDS), Clinical Dementia Rating (CDR), Korean neuropsychiatric inventory (K-NPI) and Geriatric Depression Scale (K-GDS). Plasma fibrinogen and CRP were also measured in AD, MCI, and NC groups.RESULTS: Fibrinogen and CRP levels were not significantly different among AD, MCI, and NC groups. Fibrinogen and CRP did not show a significant correlation with MMSE-KC, CDR, GDS, K-NPI and K-GDS scores.CONCLUSION: In this study, it was found that plasma fibrinogen and CRP did not increase as cognitive function decreased. But this study was the first meaningful study in Korea about the relationship between cognitive impairment and plasma fibrinogen and CRP levels. It is necessary to conduct prospective cohort studies on more patients in the future.]]>
Alzheimer Disease ; C-Reactive Protein ; Cognition ; Cognition Disorders ; Cohort Studies ; Dementia ; Depression ; Fibrinogen ; Humans ; Korea ; Mild Cognitive Impairment ; Plasma ; Prospective Studies

cognitive training program entitled Web-based Cognitive Training (Web-CoT) developed for the elderly in the community.METHODS: Of the elderly aged 65 or older who have visited in the Local Dementia Centers located in Chungcheongbuk-do, a total of 29 participants took part in a 10-week Web-CoT program. The Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) Assessment Packet 2nd edition and short form of Geriatric Depression Scale (SGDS) were evaluated before and after the program.RESULTS: Total SGDS scores have decreased and a significant increase in CERAD-K total scores was confirmed. Details including word list memory, word list recall, constructional praxis, trail making, and stroop tests, improved. Especially in the case of free recall test, the greater increase of scores in elderly with high risk of dementia was shown.CONCLUSION: Participation in this program has confirmed improvements in verbal memory registration and retrieval ability, attention and executive function. Since the improvement was especially prominent in memory retrieval ability in elderly with high risk of dementia, it can be said that early application of the program before the diagnosis of dementia is important.]]>
Aged ; Alzheimer Disease ; Chungcheongbuk-do ; Dementia ; Depression ; Diagnosis ; Education ; Executive Function ; Humans ; Memory ; Mild Cognitive Impairment ; Program Development ; Stroop Test

BACKGROUND AND PURPOSE: Mild cognitive impairment (MCI) is a prodromal stage of dementia. Amyloid deposits in positron-emission tomography (PET) imaging of MCI patients imply a higher risk for advancing to dementia, with rates of 10%–15% yearly. The purpose of this study was to investigate the clinical characteristics of subgroups of amnestic MCI (aMCI) that may have a higher impact on amyloid positivity.METHODS: We recruited 136 aMCI patients. All patients underwent a 20-minute F-18 florbetaben or flutemetamol PET scan. We classified amyloid PET images as positive or negative according to a semi-quantitative method. We evaluated the amyloid positivity of subgroups of aMCI (early vs. late type, single vs. multiple amnestic type, verbal vs. verbal, and visual amnestic type), and compared baseline clinical characteristics including key risk factors, apolipoprotein E4 (apoE4) genotype, and neuropsychological assessments with amyloid positivity in aMCI.RESULTS: The amyloid positivity in total aMCI was 41%. The positivity rate according to subgroup of aMCI were as follow: Late aMCI (49%) vs. early aMCI (33%) (p=0.13), multiple aMCI (40%) vs. single aMCI (38%) (p=0.51), and verbal and visual aMCI (59%) vs. verbal aMCI (35%) (p=0.01), respectively. The mean age and the frequency of apoE4 allele of the amyloid-positive group was higher than that of the amyloid-negative group in aMCI (p< 0.01).CONCLUSIONS: We found that the amyloid positivity was related to patterns of clinical subtypes, characteristics, and risk factors in patients with aMCI.
Alleles ; Amyloid ; Apolipoprotein E4 ; Dementia ; Genotype ; Humans ; Methods ; Mild Cognitive Impairment ; Plaque, Amyloid ; Positron-Emission Tomography ; Prodromal Symptoms ; Risk Factors

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the impact of multi-tasking exercise on cognitive and motor function in patients with mild cognitive impairment (MCI) and cognitive normal elderly (CNE).METHODS: A total of 144 subjects were recruited from 14 regional dementia centers in Busan Metropolitan City. With the exception of 77 subjects unsuitable for the study, 67 subjects participated in the intervention. The Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Subject Memory Complain Questionnaire (SMCQ), and the Korean version of the Short-Form Geriatric Depression Scale (SGDS-K) were used to determine changes in cognitive function and depressive symptoms pre-post intervention in patients with MCI and CNE, respectively. To observe changes in motor function, 5-chair sit to stand and 5-meter walking speed on the lower body strength and walking ability were also measured in both groups.RESULTS: For the MCI group, changes in cognitive and depressive symptoms on the tasks of MMSE-DS (p=0.006), SMCQ (p=0.000), SGDS-K (p=0.000) and the result of the motor function analysis on the items of 5-chair sit to stand (p=0.000), normal speed (p=0.004) and maximal speed (p=0.002) of 5-meter walking speed (p< 0.005). In the CNE group, all the items except MMSE-DS (p=0.068) and SGDS-K (p=0.095) showed statistically significant improvement.CONCLUSIONS: Multi-tasking exercise intervention, including exercise and cognitive tasks, may possibly improve the cognitive and motor function in patients with MCI and CNE.
Aged ; Busan ; Cognition Disorders ; Cognition ; Dementia ; Depression ; Humans ; Mass Screening ; Memory ; Mild Cognitive Impairment ; Walking

BACKGROUND AND PURPOSE: Subjective cognitive decline (SCD) may be the first stage corresponding to subtle cognitive changes in patients with Alzheimer's disease (AD) spectrum disorders. We evaluated the differences in cortical thinning patterns among patients with SCD who progressed to mild cognitive impairment or dementia (pSCD), those who remained stable (sSCD), and healthy normal controls (NCs).METHODS: We retrospectively recruited SCD subjects (14 pSCD and 21 sSCD cases) and 29 NCs. Structural 3-dimensional-T1-weighted magnetic resonance imaging was performed using a single 1.5 Tesla scanner. Freesurfer software was used to map cortical thickness for group comparisons.RESULTS: Compared with NC group, the sSCD group showed diffuse cortical atrophy associated with bilateral fronto-parieto-temporal area. The pSCD group showed further characteristic cortical atrophy in AD-vulnerable regions including the inferior parieto-temporal and middle temporal areas. Cortical thinning in the bilateral medial frontal areas was observed in patients with sSCD and involved the right inferior temporal and left precentral areas in those with pSCD.CONCLUSIONS: Our study showed that SCD subjects exhibit different cortical thinning patterns depending on their prognosis.
Alzheimer Disease ; Atrophy ; Dementia ; Humans ; Magnetic Resonance Imaging ; Mild Cognitive Impairment ; Prognosis ; Retrospective Studies

OBJECTIVES: The aim of this study was to investigate the association of plasma levels of inflammatory cytokines with dementia and mild cognitive impairment.METHODS: We compared serum levels of tumor necrosis factor-alpha(TNF-alpha), interleukin-6(IL-6), and insulin-like growth factor-1(IGF-I) in patients with dementia(n=8), mild cognitive impairment(MCI, n=15) and normal elderly (n=14). The diagnosis of dementia was made by the Diagnostic Statistical Manual of Mental Disorders-4th edition (DSM-IV). MCI was diagnosed based on the criteria of the National Institute of Aging and Alzheimer Association(NIA-AA) working group.RESULTS: When compared with normal controls, the levels of TNF-alpha and IL-6 were increased and level of IGF-I was decreased in MCI and dementia. Higher levels of TNF-alpha and IL-6 and lower level of IGF-I were also associated with increased age. However, when adjusted for age, the association between diagnosis and TNF-alpha, Il-6 and IGF-I was not significant.CONCLUSION: The difference in plasma levels of inflammatory cytokines in dementia and MCI may be associated with aging.
Aged ; Aging ; Cytokines ; Dementia ; Diagnosis ; Humans ; Insulin-Like Growth Factor I ; Interleukin-6 ; Mild Cognitive Impairment ; Necrosis ; Plasma ; Tumor Necrosis Factor-alpha

PURPOSE: This study was conducted to investigate effects of welfare center's cognitive improvement program on the community elderly provided by nursing student volunteers and social welfare.METHODS: A quasi-experimental with non-equivalent control group pretest-posttest design was implemented. The participants were the community elderly with or without mild cognitive impairments (experimental group: 17, control group: 15). The experimental group participated in the cognitive improvement program for four months based on the demonstration program of the special grade of dementia in long-term care insurance for the elderly.RESULTS: After the intervention, the satisfaction with perceived social support (F=9.30, p=.005) was improved statistically between the experimental group and the control group, but there was no significant difference in MMSE-K, IADL, depression, EQ-VAS, and EQ-5D variables.CONCLUSION: These results indicated that a multidisciplinary approach or a variety of manpower is needed, in order to prevent the dementia of the elderly. However, in order to provide a systematic cognitive-based intervention, it was once again recognized that the training of relevant experts and the quality planning on them were very important.
Aged ; Cognitive Therapy ; Dementia ; Depression ; Humans ; Insurance, Long-Term Care ; Mild Cognitive Impairment ; Nursing ; Social Welfare ; Students, Nursing ; Volunteers