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

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

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

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

OBJECTIVES: The association between thyroid-related hormones and cognitive function has been controversial. The purpose of this study is to compare the levels of thyroid-related hormones in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Furthermore, we investigated the relationship between thyroid-related hormones and cognitive function. METHODS: From January 2011 to December 2018, we retrospectively reviewed 105 patients who were diagnosed with AD and MCI by visiting a dementia clinic at Ilsan Paik Hospital. Thyroid-related hormones [triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH)] was measured using chemiluminescent immunoassay. An independent sample t-test was performed to analyze the mean value of thyroid-related hormones in patients of AD and MCI. To investigate whether thyroid-related hormones correlate significantly with Global deterioration scale (GDS), Clinical dementia rating (CDR) and scores of each The Korean version of the consortium to establish a registry for Alzheimer's disease items, we conducted a partial correlation analysis with geriatric depression scale-Korean version (GDS-K) scores as covariates. RESULTS: There was no significant difference in the mean serum T3, T4 and TSH levels between patients of the AD and the MCI, but the Construction Praxis Test (CPT) showed a significant positive correlation with the serum TSH concentration (p-value=0.004). CONCLUSIONS: In our study, the positive correlation between serum TSH level and the CPT associated with executive function was found to be helpful in understanding the association between thyroid-related hormones and the pathophysiology of dementia. Prospective studies in regard of the pathophysiology of thyroid-related hormones on cognitive function will be necessary in the future.
Alzheimer Disease ; Cognition ; Dementia ; Depression ; Executive Function ; Humans ; Immunoassay ; Mild Cognitive Impairment ; Prospective Studies ; Retrospective Studies ; Thyroid Hormones ; Thyrotropin ; Thyroxine

OBJECTIVE: We investigated the impact of depressed mood (dysphoria) and loss of interest or pleasure (anhedonia)on the risk of dementia in cognitively-normal elderly individuals. METHODS: This study included 2,685 cognitively-normal elderly individuals who completed the baseline and 4-year follow-up assessments of the Korean Longitudinal Study on Cognitive Aging and Dementia. We ascertained the presence of dysphoria and anhedonia using the Mini International Neuropsychiatric Inventory. We defined subjective cognitive decline as the presence of subjective cognitive complaints without objective cognitive impairments. We analyzed the association of dysphoria and anhedonia with the risk of cognitive disorders using multinomial logistic regression analysis adjusted for age, sex, education, Cumulative Illness Rating Scale score, Apolipoprotein E genotype, and neuropsychological test performance. RESULTS: During the 4-year follow-up period, anhedonia was associated with an approximately twofold higher risk of mild cognitive impairment (OR=2.09, 95% CI=1.20–3.64, p=0.008) and fivefold higher risk of dementia (OR=5.07, 95% CI=1.44–17.92, p=0.012) but was not associated with the risk of subjective cognitive decline. In contrast, dysphoria was associated with an approximately twofold higher risk of subjective cognitive decline (OR=2.06, 95% CI=1.33–3.19, p=0.001) and 1.7-fold higher risk of mild cognitive impairment (OR=1.75, 95% CI=1.00–3.05, p=0.048) but was not associated with the risk of dementia. CONCLUSION: Anhedonia, but not dysphoria, is a risk factor of dementia in cognitively-normal elderly individuals.
Aged ; Anhedonia ; Apolipoproteins ; Cognition Disorders ; Cognitive Aging ; Cohort Studies ; Dementia ; Depression ; Education ; Follow-Up Studies ; Genotype ; Humans ; Logistic Models ; Longitudinal Studies ; Mild Cognitive Impairment ; Neuropsychological Tests ; Pleasure ; Prospective Studies ; Risk Factors

PURPOSE: This study aimed to examine the effects of subjective memory complaints, depression and cognitive function on performance of activities of daily living (ADL) in individuals with mild cognitive impairment (MCI). METHODS: A total sample consisted of 250 MCI patients diagnosed within one year. All participants were assessed with a battery of standardized neuropsychological tests, self-report measures of subjective memory complaints and depression, and performance of basic and instrumental ADL. Correlational and multiple linear regression analyses were conducted to identify the factors associated with performance of basic and instrumental ADL, respectively. RESULTS: Executive function and depression explained 9.4% of the variance in basic ADL. Reduced executive function and greater depressed mood were associated with worse performance on basic ADL. Executive function, subjective memory complaints, and time since onset of cognitive symptoms accounted for 22.2% of the variance in instrumental ADL in individuals with MCI. Lower executive function (t=−2.02, p=.044), greater memory complaints (t=5.36, p<.001), and longer periods of experiencing cognitive symptoms (t=2.24, p=.026) were associated with worse instrumental ADL performance. CONCLUSION: These results may help healthcare professionals develop interventions to improve cognitive outcomes with better understanding of the relationship among cognition, mood, and behavioral performance in individuals with MCI.
Activities of Daily Living ; Cognition ; Delivery of Health Care ; Depression ; Executive Function ; Humans ; Linear Models ; Memory Disorders ; Memory ; Mild Cognitive Impairment ; Neurobehavioral Manifestations ; Neuropsychological Tests

This study aimed to investigate the cognition-enhancing effect of Panax ginseng. A randomized, double-blind, placebo-controlled clinical trial was conducted to address the cognition-enhancing effects of Panax ginseng. A total of 90 Korean volunteers with mild cognitive impairment participated in this study. All subjects were allocated randomly into ‘Ginseng’ group or ‘Placebo’ group. All subjects were administered 3g of Panax ginseng powder or starch (placebo) for 6 months. The Korean version of the Mini-Mental Status Examination (K-MMSE), Korean version of Instrumental Activities of Daily Living (K-IADL), and Seoul Neuropsychological Screening Battery (SNSB) were used to assess the changes in cognitive function at the end of the 6 month study period. The subjects of the ‘Ginseng’ group improved significantly on the Rey Complex Figure Test (RCFT) immediate recall (P = 0.0405 and P = 0.0342 in per-protocol (PP) and intention-to-treat (ITT) analysis, respectively) and on the RCFT 20-min delayed recall (P = 0.0396 and P = 0.0355 in PP and ITT analysis, respectively) compared with ‘placebo’ group throughout the 6 months of Panax ginseng administration. There were no serious adverse events. These results suggest that Panax ginseng has a cognition-enhancing effect.
Activities of Daily Living ; Cognition ; Mass Screening ; Memory, Short-Term ; Mild Cognitive Impairment ; Panax ; Seoul ; Starch ; Volunteers