OBJECTIVE: Conventional methods for organotypic hippocampal tissue slice culture (OHSC) have shown several disadvantages or limitations regarding age of animals used, duration of culture and difficulty using neurodegenerative models. Therefore, we tried to establish OHSC from old 3xTg-Alzheimer’s disease (AD) mice for longer period (over 4 weeks) and to validate utility of this system as a valid platform for translational neuroscience of AD. METHODS: OHSC was performed with old 3xTg-AD mice (12–14 months), old wild type mice (12–14 months) and young 3xTg-AD mice (2–4 months) using serum-free medium for 4 weeks. Hippocampal structure was evaluated by 4’, 6-diamidino-2-phenylindole (DAPI) intensity and neuronal metabolism was measured by Alamarblue assay. Pathologic characteristics of AD were also investigated; β-amyloid levels by ELISA, amyloid plaque deposition by Thioflavin-S staining, and glial activation by immunohistochemistry. RESULTS: Following 4-week culture in serum-free media, hippocampal cells and layers were well preserved in cultured slices from old AD mice as was in those from young AD and old wild type mice. On the contrary, excessive regression of total visible cells was observed in conventional serum-containing medium regardless of genotype of mice. In parallel with this well preserved structure, major pathologic characteristics of AD were also well manifested in hippocampal slices from old AD mice. CONCLUSION: Our findings suggest that long-term OHSC from old 3xTg-AD mouse can serve as a promising ex vivo system for studies on pathophysiology of AD, especially with the minimum number of sacrifice of experimental animals.
Alzheimer Disease ; Animals ; Culture Media, Serum-Free ; Enzyme-Linked Immunosorbent Assay ; Genotype ; Hippocampus ; Immunohistochemistry ; Metabolism ; Mice ; Neurons ; Neurosciences ; Plaque, Amyloid

OBJECTIVES: Insomnia is one of the major concerns in the elderly population. Cognitive behavioral treatment for insomnia is the first line treatment option, but there are some limitations including time and cost burdens and the requirement for sufficient cognitive resources to obtain a proper treatment effect. The Brief intervention for insomnia (BII) is a treatment that focuses on behavioral aspects of insomnia in primary care practices. The purpose of this study was to evaluate the effects of BII in community-dwelling older adults. METHODS: A total of 47 older adults with insomnia were enrolled from community centers between May 2016 and January 2018. They participated in the BII program for three weeks. We gathered sleep-related participant information with using the Pittsburgh sleep quality index (PSQI), the Sleep hygiene index, and a sleep diary. Clinical efficacy was evaluated by comparing total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) before and after the treatment. RESULTS: There was significant improvement in sleep-related features after BII. Global score and sleep quality from the PSQI, freshness, and WASO from the sleep diary showed statistically significant improvement. CONCLUSION: We found BII showed positive clinical efficacy in community dwelling older adults, especially from the perspective of subjective sleep quality and WASO. This finding implies that BII can be effectively applied for the managment of elderly insomnia patients in a community setting.
Adult ; Aged ; Humans ; Hygiene ; Independent Living ; Primary Health Care ; Sleep Initiation and Maintenance Disorders ; Treatment Outcome

OBJECTIVE: Fall is one of major causes of morbidity and mortality in the elderly. It is known that sleep is associated with quality of life in the elderly. Snoring is one of the factors affecting sleep quality. The aim of the study was to examine whether snoring affect fall in the community elderly. METHODS: This survey was performed as a part of the Korean Social Life, Health, and Aging Project, which studied the elderly living in Ganghwa-gun. Fall was defined as any history of fall in the last year through face-to-face interview. We examined the following variables: age, sex, snoring, insomnia, hypertension, diabetes, stroke, bone disease, vision problems, depression, alcohol intake, mini-mental state examination, and body mass index. The data was analyzed by multiple logistic regression to determine the association of fall with the risk factors. RESULTS: In the multivariate analysis of 516 participants, the adjusted odd ratios (95% confidence interval) of simple snoring affecting fall was 1.70 (1.10–2.63). In addition, sex (female), age, and diabetes were significantly predicted the fall. CONCLUSION: Our result suggested that snoring could be a risk factor of fall. A more comprehensive study of the relationship between snoring and fall is needed to improve the quality of life of the community elderly.
Aged* ; Aging ; Body Mass Index ; Bone Diseases ; Depression ; Humans ; Hypertension ; Logistic Models ; Mortality ; Multivariate Analysis ; Quality of Life ; Risk Factors* ; Sleep Initiation and Maintenance Disorders ; Snoring* ; Stroke

OBJECTIVE: This study determined whether cognitive behavioral therapy for insomnia (CBT-i) decreased the need for sleep medications and produced better treatment outcomes than pharmacotherapy alone. METHODS: We reviewed data from patients with insomnia in the outpatient clinic of a general hospital between 2009 and 2015. We compared 41 patients who received five sessions of CBT-i with 100 age- and sex-matched patients who received pharmacotherapy only. We evaluated the change in prescription for sleep (i.e., antidepressants, hypnotics, and others) between the first and last visits using repeated measures analysis of variance (ANOVA). Clinical global impressions and completion status at the last visit were assessed using the chisquare test. RESULTS: We found a significant decrease in the prescription rate and the dosage of hypnotics among patients who received CBT-i when compared with control patients. There was no significant change in the dosage of antidepressants between the two groups. Achievement of case closure was better in the CBT-i group at the trend level. Clinical global impression at the last visit was not significantly different. CONCLUSION: These results show that CBT-i reduces the need for hypnotics among insomnia patients. Our results indicate that CBT-i offers additional benefits beyond improving sleep characteristics and thus provides another reason for recommending CBT-i as a first-line treatment for insomnia.
Ambulatory Care Facilities ; Antidepressive Agents ; Cognitive Therapy* ; Drug Therapy ; Hospitals, General ; Humans ; Hypnotics and Sedatives ; Prescriptions* ; Sleep Initiation and Maintenance Disorders*

OBJECTIVE: Sleep disturbance is common in the elderly, which is result from multi-factorial causes encompassing socio-demographic, behavioral, and clinical factors. We aimed to identify factors associated with insomnia among the elderly in a rural community in South Korea, a country with a rapidly growing aged population. METHODS: This cross-sectional study used the data from the second wave of the Korean Social life, Health and Ageing Project, which is a cohort study of individuals living in a typical rural community in South Korea. Socio-demographic, behavioral, and clinical characteristics were obtained through face-to-face interviews. Various factors suspected to be associated with insomnia were compared between elderly participants with and without insomnia, and multiple logistic regression analyses were conducted to identify independent risk factors for insomnia. RESULTS: We found that 32.4% of 509 participants (72.8±7.7 years old) had insomnia. Female sex [odds ratio (OR)=2.19], low education level (OR=2.44), current smoking (OR=2.26), number of chronic diseases (OR=2.21 for 2–3 chronic diseases; OR=2.06 for 4 or more chronic diseases), and depression (OR=2.53) were independently associated with insomnia. CONCLUSION: We found that sex, education, chronic disease, and depression independently increase the risk of insomnia of the elderly in a Korean rural community. To overcome the elderly's insomnia, interventions should target modifiable factors such as depression. To promote active aging, longitudinal studies of factors associated with insomnia among the elderly should be performed in different regions and communities.
Aged* ; Aging ; Chronic Disease ; Cohort Studies ; Cross-Sectional Studies ; Depression ; Education ; Female ; Humans ; Korea ; Logistic Models ; Longitudinal Studies ; Republic of Korea ; Risk Factors ; Rural Population* ; Sleep Initiation and Maintenance Disorders* ; Smoke ; Smoking

Empathy is the ability to identify with or make a vicariously experience of another person's feelings or thoughts based on memory and/or self-referential mental simulation. The default mode network in particular is related to self-referential empathy. In order to elucidate the possible neural mechanisms underlying empathy, we investigated the functional connectivity of the default mode network in subjects from a general population. Resting state functional magnetic resonance imaging data were acquired from 19 low-empathy subjects and 18 medium-empathy subjects. An independent component analysis was used to identify the default mode network, and differences in functional connectivity strength were compared between the two groups. The low-empathy group showed lower functional connectivity of the medial prefrontal cortex and anterior cingulate cortex (Brodmann areas 9 and 32) within the default mode network, compared to the medium-empathy group. The results of the present study suggest that empathy is related to functional connectivity of the medial prefrontal cortex/anterior cingulate cortex within the default mode network. Functional decreases in connectivity among low-empathy subjects may reflect an impairment of self-referential mental simulation.
Empathy ; Functional Neuroimaging ; Gyrus Cinguli ; Magnetic Resonance Imaging ; Memory ; Prefrontal Cortex

OBJECTIVES: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. METHODS: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. RESULTS: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. CONCLUSION: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.
Aged* ; Aging ; Anger ; Angina Pectoris ; Arthritis ; Asthma ; Cataract ; Cognition ; Cohort Studies ; Comorbidity ; Dementia ; Depression ; Education ; Epidemiologic Studies ; Follow-Up Studies* ; Glaucoma ; Hepatitis B ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy ; Korea ; Logistic Models ; Mass Screening ; Myocardial Infarction ; Osteoporosis ; Prevalence ; Prostate ; Sleep Initiation and Maintenance Disorders ; Stroke ; Tuberculosis, Pulmonary ; Urinary Incontinence

PURPOSE: Alexithymia, defined as a deficit in the ability to recognize and describe one's own feelings, may be related to the development and maintenance of obsessive-compulsive symptoms. The aim of this study was to evaluate the association between the catechol-O-methyltransferase (COMT) Val158Met polymorphism and alexithymia in patients with obsessive-compulsive disorder (OCD). MATERIALS AND METHODS: We recruited 244 patients with OCD (169 males, 75 females). Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20), and genotyping of the COMT Val(158)Met polymorphism was evaluated. RESULTS: Patients with the COMT Val/Val genotype had significantly higher total and "difficulty identifying feelings" (DIF) subdimension scores than those with the Val/Met or Met/Met genotypes. Patients with the COMT Val/Val genotype had significantly higher "difficulty describing feelings" (DDF) subdimension scores than those with the COMT Val/Met genotype. However, there were no differences in the scores for the "externally oriented thinking" (EOT) subdimension among the three genotypes. CONCLUSION: These results indicate that the high-activity Val allele of the COMT Val(158)Met polymorphism is associated with increased alexithymic traits in patients with OCD. The present finding suggests that alexithymia is an endophenotype of OCD that is mediated by the COMT Val(158)Met polymorphism.
Adult ; Affective Symptoms/*diagnosis/genetics/psychology ; Alleles ; Catechol O-Methyltransferase/*genetics ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/*diagnosis/genetics/psychology ; Phenotype ; *Polymorphism, Genetic ; Republic of Korea

OBJECTIVES: Stigma resistance is an individual capacity to fight the stigma of mental illness and is an issue of ongoing research regarding the stigma. The aim of this study was to evaluate predictors of stigma resistance in patients with bipolar disorder. METHODS: Demographic, clinical, and psychosocial data were collected from 102 bipolar patients in a university mental hospital. Stigma resistance was measured using a subscale of the Internalized Stigma of Mental Illness Scale. Patients completed self-reported questionnaires including items on self-esteem, hopelessness, social support, and social conflict. RESULTS: Stigma resistance showed positive association with functioning, self-esteem, and social support, and showed negative association with depressive symptoms, hopelessness, and social conflict. In multivariate analysis, stigma resistance was predicted by sex, education, and self-esteem. Self-esteem was the strongest predictive factor of stigma resistance. CONCLUSION: In accordance with previous studies, self-esteem was a central role of predicting stigma resistance. A program for improving self-esteem and its related psychosocial factors will be helpful to enhancing stigma resistance in bipolar patients.
Bipolar Disorder* ; Depression ; Education ; Hospitals, Psychiatric ; Humans ; Multivariate Analysis ; Psychology ; Self Concept

OBJECTIVES: To determine the influence of parental behaviors on the onset and severity of eating disorders, this study compared aspects of perceived parental styles, according to eating disorder subtypes and age at onset in Korean women with eating disorders. METHODS: One hundred and sixty-seven patients with eating disorders[Anorexia Nervosa (AN), N=49; Bulimia Nervosa(BN), N=118] were recruited for this study. Perceived parent behaviors were assessed with Parental Behavior Inventory(PBI) self-rating scale. The study subjects also completed the Eating Disorder Inventory -2 (EDI-2) to assess the severity of eating disorder symptoms. RESULTS: In anorexia nervosa, early onset group(<16 years) reported low paternal affection and high paternal rational expression, low maternal interference than group with age at onset over 16 years. The severity of eating disorder symptoms was negatively associated with mother affection and rational expression in two subtypes of eating disorder(AN and BN). On stepwise regression analysis, paternal affection and maternal over-protection were associated with age of onset only in AN group and maternal affection was associated with the severity of symptoms in both groups of eating disorder. CONCLUSIONS: Considering the role of family function and perceived parental styles could help improve the management of eating disorders. These results emphasize the importance of fathers' role in the eating disorder on the age of onset, a relatively unexplored area of eating disorder research. Also, we investigated the importance of mothers' affection on the severity of symptoms.
Age of Onset ; Anorexia Nervosa* ; Bulimia ; Bulimia Nervosa* ; Eating ; Eating Disorders ; Female ; Humans ; Mothers ; Parents*