Clinical Characteristics of a Nationwide Hospital-based Registry of Mild-to-Moderate Alzheimer's Disease Patients in Korea: A CREDOS (Clinical Research Center for Dementia of South Korea) Study

With rapid population aging, the socioeconomic burden caused by dementia care is snowballing. Although a few community-based studies of Alzheimer's disease (AD) have been performed in Korea, there has never been a nationwide hospital-based study thereof. We aimed to identify the demographics and clinical characteristics of mild-to-moderate AD patients from the Clinical Research Center for Dementia of Korea (CREDOS) registry. A total of 1,786 patients were consecutively included from September 2005 to June 2010. Each patient underwent comprehensive neurological examination, interview for caregivers, laboratory investigations, neuropsychological tests, and brain MRI. The mean age was 74.0 yr and the female percentage 67.0%. The mean period of education was 7.1 yr and the frequency of early-onset AD (< 65 yr old) was 18.8%. Among the vascular risk factors, hypertension (48.9%) and diabetes mellitus (22.3%) were the most frequent. The mean score of the Korean version of Mini-Mental State Examination (K-MMSE) was 19.2 and the mean sum of box scores of Clinical Dementia Rating (CDR-SB) 5.1. Based on the well-structured, nationwide, and hospital-based registry, this study provides the unique clinical characteristics of AD and emphasizes the importance of vascular factors in AD in Korea

NICE 2023 Zero-shot Image Captioning Challenge

In this report, we introduce NICE project\footnote{\url{https://nice.lgresearch.ai/}} and share the results and outcomes of NICE challenge 2023. This project is designed to challenge the computer vision community to develop robust image captioning models that advance the state-of-the-art both in terms of accuracy and fairness. Through the challenge, the image captioning models were tested using a new evaluation dataset that includes a large variety of visual concepts from many domains. There was no specific training data provided for the challenge, and therefore the challenge entries were required to adapt to new types of image descriptions that had not been seen during training. This report includes information on the newly proposed NICE dataset, evaluation methods, challenge results, and technical details of top-ranking entries. We expect that the outcomes of the challenge will contribute to the improvement of AI models on various vision-language tasks.Comment: Tech report, project page https://nice.lgresearch.ai

Impaired Design Fluency Is a Marker of Pathological Cognitive Aging; Results from the Korean Longitudinal Study on Health and Aging

ObjectiveaaWe investigated neuropsychological markers that can be used to discriminate pathological cognitive aging from normal cognitive aging. MethodsaaWe administered frontal lobe function tests including the Wisconsin Card Sorting Test (WCST), digit span test, lexical fluency test, fixed condition design fluency test, and Trail Making Test B (TMT-B) to 92 individuals with pathological cognitive aging (PCA) and 222 individuals with normal cognitive aging (NCA). We examined the main effects of participants ’ diagnoses (PCA, NCA) and age (65-69 years old, 70-74 years old and 75 years old or over) on their test performance using multivariate analysis of variance. ResultsaaThe main effects of both the diagnosis (F=2.860, p=0.002) and the age group (F=2.484, p&lt;0.001) were significant. The PCA group showed lower performance on the backward digit span test (F=14.306, p&lt;0.001), fixed condition design fluency test (F=8.347, p=0.004) and also exhibited perseverative errors in the WCST (F=4.19, p=0.042) compared with the NCA group. The main effect of the diagnosis on the backward digit span test and the fixed condition design fluency test remained significant after Bonferroni correction

Frontal dysfunction underlies depressive syndrome in Alzheimer disease: a FDG-PET study

OBJECTIVE: This study aimed to investigate the regional cerebral dysfunction associated with depressive syndrome in patients with Alzheimer disease (AD). METHOD: Twelve patients with AD with depressive syndrome (ADD) and 12 age-, gender-, and severity-matched patients with AD without depressive syndrome (ADND) underwent FDG-PET scanning. The regional cerebral glucose metabolism in the two groups was compared using a voxel-based method. RESULTS: The ADD group showed lower glucose metabolism in the right superior frontal gyrus than the ADND group. CONCLUSIONS: These results indicate that frontal dysfunction, known to be associated with primary or other secondary depressive syndromes, underlies the depressive syndrome of patients with AD patients as well

Development of a screening algorithm for Alzheimer's disease using categorical verbal fluency.

We developed a weighted composite score of the categorical verbal fluency test (CVFT) that can more easily and widely screen Alzheimer's disease (AD) than the mini-mental status examination (MMSE). We administered the CVFT using animal category and MMSE to 423 community-dwelling mild probable AD patients and their age- and gender-matched cognitively normal controls. To enhance the diagnostic accuracy for AD of the CVFT, we obtained a weighted composite score from subindex scores of the CVFT using a logistic regression model: logit (case)  = 1.160+0.474× gender +0.003× age +0.226× education level - 0.089× first-half score - 0.516× switching score -0.303× clustering score +0.534× perseveration score. The area under the receiver operating curve (AUC) for AD of this composite score AD was 0.903 (95% CI = 0.883 - 0.923), and was larger than that of the age-, gender- and education-adjusted total score of the CVFT (p<0.001). In 100 bootstrapped re-samples, the composite score consistently showed better diagnostic accuracy, sensitivity and specificity for AD than the total score. Although AUC for AD of the CVFT composite score was slightly smaller than that of the MMSE (0.930, p = 0.006), the CVFT composite score may be a good alternative to the MMSE for screening AD since it is much briefer, cheaper, and more easily applicable over phone or internet than the MMSE

Association of Low Emotional and Tangible Support With Risk of Dementia Among Adults 60 Years and Older in South Korea

IMPORTANCE The association between social support and dementia risk has been debated. Most previous prospective studies have not differentiated the subtypes of social support. OBJECTIVE To examine whether the association between social support and risk of dementia differs by subtype of social support and by sex. DESIGN, SETTING, AND PARTICIPANTS This nationwide prospective cohort study included randomly sampled South Korean adults 60 years or older. The study was launched November 1, 2010, with follow-up every 2 years until November 30, 2020. The 5852 participants who completed the assessment for social support and were not diagnosed as having dementia, severe psychiatric disorders including major depressive disorder, or major neurological disorders at the baseline assessment were included in the analysis. EXPOSURES Geriatric psychiatrists administered the structured diagnostic interviews and physical examinations to every participant based on the Korean version of the Consortium to Establish a Registry for Alzheimer Disease (CERAD-K) Assessment Packet Clinical Assessment Battery. MAIN OUTCOMES AND MEASURES Baseline levels of emotional and tangible support using the Medical Outcomes Survey Social Support Survey. RESULTS Among the 5852 participants (mean [SD] age, 69.8 [6.6] years; 3315 women [56.6%]; mean [SD] follow-up duration, 5.9 [2.4] years), 237 (4.0%) had incident all-cause dementia and 160 (2.7%) had incident Alzheimer disease (AD) subtype of dementia. Compared with women who reported having emotional support, those with low emotional support had almost a 2-fold higher incidence of all-cause dementia (18.4 [95% CI, 13.6-23.2] vs 10.7 [95% CI, 9.0-12.5] per 1000 person-years) and AD (14.4 [95% CI, 10.2-18.6] vs 7.8 [95% CI, 6.3-9.3] per 1000 person-years). Adjusted Cox proportional hazard analysis revealed that low emotional support was associated with increased risk of all-cause dementia (hazard ratio, 1.61 [95% CI, 1.10-2.36]; P = .02) and AD (hazard ratio, 1.66 [95% CI, 1.07-2.57]; P = .02) only in women. Low tangible support was not associated with a risk of all-cause dementia or AD regardless of sex. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that older women with low emotional support constitute a population at risk for dementia. The level of emotional support should be included in risk assessments of dementia.N

Bootstrap validation^a of the diagnostic accuracy for Alzheimer' disease of the Mini Mental Status Examination (MMSE), Categorical Fluency Test total score (CVFT-T) and composite score (CVFT-C).

<p>^a 100 runs; in each run, 60% samples were randomly selected for validations using bootstrap sampling estimation.</p><p>AUC, area under the receiver operator curver; SE, standard error; 95% CI, 95% confidence interval.</p

Logistic regression model for predicting Alzheimer's disease using the Categorical Verbal Fluency Test (CVFT).

<p>B, beta coefficient; SE, standard error; Wald, Wald statistics; OR, odds ratio; CI, confidence interval.</p