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

BACKGROUND AND OBJECTIVES: Mild cognitive impairment (MCI) is a disorder that usually occurs in the elderly, leading to dementia in some progressive cases. The purpose of this study is to examine the utility of central auditory processing tests as early diagnostic tools for identifying the elderly with MCI. SUBJECTS AND METHODS: This study was conducted on 20 elderly patients with MCI and 20 healthy matched peers. The speech perception ability in a quiet environment and in the presence of background noise and also temporal resolution were assessed by using Speech Perception in Noise (SPIN) and Gap in Noise (GIN) tests, respectively. RESULTS: The results indicated that the ability to understand speech in a quiet environment did not differ significantly between the two groups. However, SPIN at the three signal-tonoise ratios and the temporal resolution scores were significantly different between the two groups (p<0.001). CONCLUSIONS: Individuals with MCI appear to have poorer speech comprehension in noise and a lower temporal resolution than those of the same age, but without cognitive defects. Considering the utility of these tests in identifying cognitive problems, we propose that since the GIN test seems to be less influenced by intervening factors, this test can therefore, be a useful tool for the early screening of elderly people with cognitive problems.
Aged ; Auditory Perceptual Disorders ; Cognition ; Cognition Disorders ; Comprehension ; Dementia ; Humans ; Mass Screening ; Mild Cognitive Impairment ; Noise ; Speech Perception

BACKGROUND AND PURPOSE: There are only a few cognitive screening tests for the Chinese-speaking population, and so this study aimed to validate the Chinese version of Addenbrooke's Cognitive Examination III (ACE-III) for detecting mild cognitive impairment (MCI) and mild dementia. Its diagnostic accuracy was compared with the Chinese versions of the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). METHODS: The 176 included individuals were divided into 3 groups: mild dementia group, MCI group, and normal control group. MMSE, MoCA, and ACE-III were administered to all participants by researchers who were blinded to the clinical grouping. The receiver operating characteristic (ROC) curves were analyzed. RESULTS: ACE-III exhibited good internal consistency and convergent validity. Age and education level significantly influenced the total ACE-III scores. When screening MCI, the area under the ROC curve (AUC) was significantly larger for ACE-III than for MMSE (0.88 vs. 0.72, p<0.05) and MoCA (0.88 vs. 0.76, p<0.05). ACE-III showed higher sensitivity (0.75) and specificity (0.89) than MMSE (0.64 and 0.63, respectively) and MoCA (0.67 and 0.77) at the optimal cutoff score of 88/89. For detecting mild dementia, ACE-III yielded satisfactory sensitivity (0.94) and specificity (0.83) at the optimal cutoff score of 74/75. The AUC of ACE-III was 0.95, which was comparable to those of MMSE (0.95) and MoCA (0.91). In participants with ≥12 years of education, the AUC was significantly larger for ACE-III than for MMSE when detecting MCI (0.90 vs. 0.68, p<0.05) and mild dementia (0.97 vs. 0.90, p<0.05). CONCLUSIONS: The present study has verified that ACE-III is a reliable and accurate tool for screening MCI and mild dementia in the Chinese-speaking population, and is significantly superior to MMSE and MoCA for detecting MCI.
Area Under Curve ; Asian Continental Ancestry Group ; Dementia ; Education ; Humans ; Mass Screening ; Methylenebis(chloroaniline) ; Mild Cognitive Impairment ; ROC Curve ; Sensitivity and Specificity

BACKGROUND AND PURPOSE: Epidemiological studies have suggested the presence of strong correlations among diet, lifestyle, and dementia onset. However, these studies have unfortunately had major limitations due to their inability to fully control the various potential confounders affecting the nutritional status. The purpose of the current study was to determine the nutritional status of participants in the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease (KBASE) and to identify clinical risk factors for being at risk of malnutrition or being malnourished. METHODS: Baseline data from 212 participants [119 cognitively unimpaired (CU), 56 with mild cognitive impairment (MCI), and 37 with dementia] included in the KBASE database were analyzed. All participants underwent a comprehensive cognitive test and MRI at baseline. The presence of malnutrition at baseline was measured by the Mini Nutritional Assessment score. We examined the cross-sectional relationships of clinical findings with nutritional status using multiple logistic regression applied to variables for which p<0.2 in the univariate analysis. Differences in cortical thickness according to the nutritional status were also investigated. RESULTS: After adjustment for demographic, nutritional, and neuropsychological factors, participants with dementia had a significantly higher odds ratio (OR) for being at risk of malnutrition or being malnourished than CU participants [OR=5.98, 95% CI=1.20–32.97] whereas participants with MCI did not (OR=0.62, 95% CI=0.20–1.83). Cortical thinning in the at-risk/malnutrition group was observed in the left temporal area. CONCLUSIONS: Dementia was found to be an independent predictor for the risk of malnutrition compared with CU participants. Our findings further suggest that cortical thinning in left temporal regions is related to the nutritional status.
Aged ; Aging ; Alzheimer Disease ; Brain ; Cerebral Cortex ; Dementia ; Diet ; Early Diagnosis ; Epidemiologic Studies ; Humans ; Life Style ; Logistic Models ; Magnetic Resonance Imaging ; Malnutrition ; Mild Cognitive Impairment ; Nutrition Assessment ; Nutritional Status ; Odds Ratio ; Risk Factors ; Temporal Lobe

BACKGROUND AND PURPOSE: Semantic memory remains more stable than episodic memory across the lifespan, which makes it potentially useful as a marker for distinguishing pathological aging from normal senescence. To obtain a better understanding of the transitional stage evolving into Alzheimer's dementia (AD), we focused on the amnestic mild cognitive impairment (aMCI) stage stratified based on β-amyloid (Aβ) pathology. METHODS: We analyzed the raw data from Korean version of the Boston Naming Test (K-BNT) and the Controlled Oral Word Association Test (COWAT). For K-BNT, the frequencies of six error types and accuracy rates were evaluated. For a qualitative assessment of the COWAT, we computed the number of switching, number of clusters, and mean cluster size. RESULTS: The data from 217 participants were analyzed (53 normal controls, 66 with Aβ− aMCI, 56 with Aβ+ aMCI, and 42 disease controls). There were fewer semantically related errors and more semantically unrelated errors on the K-BNT in Aβ+ aMCI than in Aβ− aMCI, without a gross difference in the z score. We also found that Aβ+ aMCI showed a more prominent deficit in the number of clusters in the semantic fluency task [especially for animal names (living items)] than Aβ− aMCI. CONCLUSIONS: In spite of similar clinical manifestations, Aβ+ aMCI was more similar to AD than Aβ− aMCI in terms of semantic memory disruption. Semantic memory may serve as an early indicator of brain Aβ pathology. Therefore, semantic memory dysfunction deserves more consideration in clinical practice. Longitudinal research with the follow-up data is needed.
Aging ; Alzheimer Disease ; Animals ; Brain ; Dementia ; Follow-Up Studies ; Humans ; Memory* ; Memory, Episodic ; Mild Cognitive Impairment* ; Pathology ; Semantics* ; Word Association Tests

PURPOSE: The purpose of this study is to develop and evaluate the effects of a multifaceted cognitive training program on cognitive function, depression, and instrumental activities of daily living (IADL) in community dwelling elders with mild cognitive impairment. METHODS: A non-equivalent control group pretest-posttest design was used. The subjects were recruited from a community health center in D metropolitan city and were assigned to the experimental or control group. Weekly 50-minute session intervention was delivered to the experimental group over 12 weeks. 8 weeks and 12weeks after intervention, the changes in cognitive function, depression, and IADL in the groups were measured and compared. Data were analyzed with Mann-Whitney U test, Wilcoxon Signed Rank test, and post-hoc test with Bonferroni correction using SPSS/WIN 23.0. RESULTS: When compared with their counterparts (n=15), the elders in the experimental group (n=12) showed significant improvement in cognitive function and depression at week 12. The mean scores of IADL at week 12 were not significantly different between the groups. CONCLUSION: The results indicate that this multifaceted cognitive training program is effective in improving cognitive function, depression, and avoiding deterioration of IADL among elders with mild cognitive impairment.
Activities of Daily Living ; Aged ; Cognition ; Cognitive Therapy ; Community Health Centers ; Depression ; Education ; Humans ; Independent Living ; Mild Cognitive Impairment

OBJECTIVE: The aim of this study is to investigate the effects of cognitive training and cognitive trainer on cognitive function in persons with mild cognitive impairment (MCI). METHODS: A randomized controlled single blind trial with 2 treatment groups was designed and 40 participants were included in this study. They received cognitive training intervention by cognitive professional and non-professional. The cognitive training focused on memory strategies. This cognitive intervention consisted of 8 sessions training and once a week. The effect of program was examined in performance-based measures of cognitive abilities; memory, language, constructional praxis, attention, and working memory. The comparison of effect of trainer was examined by repeated measure analysis of variance. RESULTS: Thirty-six MCI completed the cognitive intervention and was assessed neurocognitive test on pre- and post-intervention. Attention, language inhibition and semantic language were significantly improved compared with baseline in total group. The memory (p=0.003) was significantly improved in Professional Program Group and attention (p=0.007) was significantly improved in Non-Professional Program Group (NPG). Distinctively, Korean version of Short form of Geriatric Depression Scale mean score in NPG was statistically improved from 4.24 to 3.29 (p=0.018) after intervention, but the comparison between groups was not significant. CONCLUSION: This study shows that the cognitive intervention program may improve on memory, attention and language in cognitive functions of MCI. But there is difference in improvement of the domains of cognitive abilities depending on the trainer.
Cognition ; Depression ; Humans ; Memory ; Memory, Short-Term ; Mild Cognitive Impairment ; Semantics

OBJECTIVE: The aim of this study is to assess the efficacy of cognitive health promotion workbook for community-dwelling elderlies with mild cognitive impairment and dementia performed by trained dementia partners. METHODS: The trained dementia partners performed cognitive training program with the workbook developed by Incheon Metropolitan Dementia Center to 36 participants with mild cognitive impairment or dementia at their home. The cognitive training program consisted of 60-minute sessions held twice weekly for 10 weeks. We evaluated their cognitive performances at baseline and after intervention. Pre- and post-intervention measures included Korean version of Mini-Mental Status Examination for Dementia Screening (MMSE-DS), Global Deterioration Scale, Korea Activities of Daily Living Scale, Korea Instrumental Activities of Daily Living Scale, Korean Version of Short Form Geriatric Depression Scale (SGDS-K) and Korean Quality of Life-Alzheimer's Disease (KQoL-AD). RESULTS: Participants showed significant improvements compared with their baseline in MMSE-DS (p=0.002), SGDS-K (p=0.001) and KQoL-AD (p<0.001). There were no significant differences of improvement between high cognitive function group (MMSE ≤20, n=16) and low cognitive function group (MMSE ≤20, n=20). CONCLUSION: These findings suggest that the cognitive training program with cognitive health promotion workbook can improve cognitive function, quality of life and depression for community-dwelling elderlies with mild cognitive impairment and dementia and it would be efficient that trained dementia partners perform the cognitive training program regularly at their home.
Activities of Daily Living ; Cognition ; Dementia ; Depression ; Education ; Health Promotion ; Incheon ; Korea ; Mass Screening ; Mild Cognitive Impairment ; Quality of Life

BACKGROUND: Korea has a periodic general health check-up program that uses the Korean Dementia Screening Questionnaire-Cognition (KDSQ-C) as a cognitive dysfunction screening tool. The Alzheimer Disease 8 (AD8) and Subjective Memory Complaints Questionnaire (SMCQ) are also used in clinical practice. We compared the diagnostic ability of these screening questionnaires for cognitive impairment when completed by participants and their caregivers. Hence, we aimed to evaluate whether the SMCQ or AD8 is superior to the KDSQ-C and can be used as its replacement. METHODS: A total of 420 participants over 65 years and their informants were recruited from 11 hospitals for this study. The patients were grouped into normal cognition, mild cognitive impairment, and dementia subgroups. The KDSQ-C, AD8, and SMCQ were completed separately by participants and their informants. RESULTS: A receiver operating characteristic analysis of questionnaire scores completed by participants showed that the areas under the curve (AUCs) for the KDSQ-C, AD8, and SMCQ for diagnosing dementia were 0.75, 0.8, and 0.73, respectively. Regarding informant-completed questionnaires, the AD8 (AUC of 0.93), KDSQ-C (AUC of 0.92), and SMCQ (AUC of 0.92) showed good discriminability for dementia, with no differences in discriminability between the questionnaires. CONCLUSION: When an informant-report is possible, we recommend that the KDSQ-C continues to be used in national medical check-ups as its discriminability for dementia is not different from that of the AD8 or SMCQ. Moreover, consistent data collection using the same questionnaire is important. When an informant is not available, either the KDSQ-C or AD8 may be used. However, in the cases of patient-reports, discriminability is lower than that for informant-completed questionnaires.
Alzheimer Disease ; Caregivers ; Cognition ; Cognition Disorders ; Data Collection ; Dementia ; Humans ; Korea ; Mass Screening ; Memory ; Mild Cognitive Impairment ; ROC Curve ; Self-Assessment

BACKGROUND: There has been no study on the time trends of dementia incidence in Korea. We report the 5-year incidence and its correlates of all-cause and Alzheimer's disease (AD) dementia, and compared our results with those of a 12-year-prior cohort study conducted in the same area. METHODS: A total of 751 community-dwelling older adults were followed up for a mean duration of 5.4 years. The age-, gender-, and educational attainment-specific incidence of all-cause and AD dementia were reported as cases per 1,000 person-years. We performed univariate and multivariate cox proportional hazard regression analyses to determine whether baseline sociodemographic, lifestyle, and clinical variables were associated with the risk of all-cause and AD dementia. A 12-year-prior cohort study was used for descriptive comparison to indicate the time trends of dementia incidence. RESULTS: The incidence rates were 16.2 and 13.0 cases per 1,000 person-years for all-cause and AD dementia, respectively. The baseline diagnosis of mild cognitive impairment increased the 5-year incidence of all-cause dementia by more than 4-fold. Old age and low baseline global cognitive function were noted as risk factors for both all-cause and AD dementia. CONCLUSION: Upon comparing the results with those from the earlier cohort study in Yeoncheon, the incidence of all-cause and AD dementia decreased by approximately 40% over 12 years; it has been mainly driven by the increase in the educational level of older adults. The declining time trends of incidence should be taken into account for estimating the future prevalence of dementia in Korea.
Adult ; Alzheimer Disease ; Cognition ; Cohort Studies ; Dementia ; Diagnosis ; Humans ; Incidence ; Korea ; Life Style ; Mild Cognitive Impairment ; Prevalence ; Risk Factors