White matter changes associated with psychotic symptoms in Alzheimer's disease patients

This study explored the relationship between white matter changes seen on magnetic resonance imaging (MRI) and neuropsychiatric symptoms of Alzheimer's disease patients. Fifty-five probable Alzheimer's disease patients were assessed with Behavioral Rating Scale for Dementia (BRSD) and MRI. White matter changes in the bilateral frontal or parieto-occipital region and left basal ganglia significantly corresponded with the score of the Psychotic Symptoms subscale of BRSD. Secondary analyses revealed that white matter changes were not associated with paranoid delusion and hallucination, but only with delusional misidentification. Our results suggest that white matter changes in Alzheimer's disease patients probably contribute to the development of specific psychotic symptoms, namely delusional misidentification

Normative study of the Stroop Color and Word Test in an educationally diverse elderly population

OBJECTIVE: The purpose of this study was to explore the effects of demographic variables on Stroop Color and Word Test (SCWT) performance in an educationally diverse elderly population and to provide normative information. METHODS: SCWT was administered to 564 community-dwelling volunteers aged 60-90 years with an educational history of from zero to 25 years of full-time education. People with serious neurological, medical and psychiatric disorders (including dementia) were excluded. RESULTS: Age, education and gender were found to be significantly associated with performance on all three pages of the SCWT. Based on the results obtained, SCWT norms were stratified by age (four overlapping tables), education (three strata), and gender. CONCLUSIONS: In the present study, normative information on SCWT was obtained from an educationally diverse elderly population. SCWT would appear to be more useful in poorly educated elderly, and could be used in future cross-cultural comparisons of geriatric populations

A normative study of the Trail Making Test in Korean elders

OBJECTIVE: The purpose of this study was to explore the effects of age, education and gender on the performance of the Trail Making Test (TMT) and provide normative information in Korean elders. METHODS: The TMT was administered to 997 community-dwelling volunteers aged 60-90. People with serious neurological, medical and psychiatric disorders, including dementia, were excluded. RESULTS: Education and age had significant effects on both parts of the TMT. Gender also had an effect on part A of the TMT (Trail A). Based on these results, the norms of Trail A stratified by age (four overlapping tables), education (four strata) and gender, and the norms of part B of TMT (Trail B) stratified by age (four overlapping tables) and education (three strata). CONCLUSIONS: Age and educational level had a considerable influence on both Trail A and B. Our normative information on the Trail A will be useful in the elders with poor educational attainment and can be utilized for cross-cultural comparison of the Trail A performance. The fact that a large number of elders fail to complete Trail B indicates a limited applicability of Trail B in elderly population, particularly with poor educational background

Neural correlates of the Clock Drawing Test performance in Alzheimer's disease: a FDG-PET study

BACKGROUND/AIM: This study aimed to identify the functional neuroanatomical correlates of impaired clock drawing test (CDT) performance in patients with Alzheimer's disease (AD). METHOD: The CDT was administered to 71 patients with AD, and regional cerebral glucose metabolism (rCMglc) was measured by positron emission tomography (PET). Correlations between CDT scores and rCMglc were examined on a voxel-by-voxel basis. RESULTS: Significant positive correlations were found between CDT performance and rCMglc in the right inferior parietal lobule and right posterior cingulate cortex. CONCLUSION: These results provide the first PET evidence that poor CDT performance in patients with AD is closely related to the functional decline in the right hemisphere, especially the right parietal cortex

Prevalence of major depressive disorder and minor depressive disorder in an elderly Korean population: Results from the Korean Longitudinal Study on Health and Aging (KLoSHA)

Objective: We investigated the prevalence, risk factors and impact of major depressive disorder (MDD) and minor depressive disorder (MnDD) in a randomly selected community-dwelling Korean elderly population. Method: This study was conducted as a part of the Korean Longitudinal Study on Health and Aging (KLoSHA). A study population of 1118 Korean elders was randomly sampled from residents of Seongnam, Korea aged 65 years or older. Standardized face-to-face interviews and neurological and physical examinations were conducted on 714 respondents using the Korean version of Mini International Neuropsychiatric Interview. MOD was diagnosed according to the DSM-IV criteria, and MnDD according to research criteria proposed in Appendix B of the DSM-IV criteria. Results: Age-, gender- and education-standardized prevalence rates in Korean elders aged 65 years or older were estimated as 5.37% (95% CI = 3.72-7.03) for MOD, 5.52% (95% CI = 3.84-7.19) for MnDD, and 10.89% (95% CI = 8.60-13.17) for overall late-life depression (LLD). A prior MOD episode (OR = 3.07,95% CI = 1.38-6.82 in MDD, OR = 3.44,95% CI = 1.49-7.94 in MnDD), female gender (OR = 3.55, 95% CI = 1.53-8.24 in MDD, OR = 2.68, 95% CI = 1.19-6.04 in MnDD) and history of stroke or TIA (OR = 3.45, 95% CI = 1.62-7.35 in MDD. OR = 2.95, 95% CI = 1.34-6.52 in MnDD) were associated with the risks of both MDD and MnDD. Lack of formal education (OR = 2.75, 95% CI = 1.30-5.85) and low income (OR = 2.83, 95% CI = 1.02-7.88) were associated with the risk of MDD only. Quality of life (QOL) of the MOD and MnDD patients was worse than that of non-depressed elders (P<0.001, ANOVA). Conclusion: MnDD was as prevalent as MOD in Korean elders and impacted QOL as MDD did. MnDD patients may increase in the future with accelerated population aging and westernization of lifestyle in Korea. (C) 2010 Elsevier B.V. All rights reserved.This work was supported by the Independent Research Grant (IRG) from Pfizer Global Pharmaceuticals (grant no. 06-05-039), the Grant for Developing Seongnam Health Promotion Program for the Elderly from Seongnam City Government in Korea (grant no. 800-20050211) and the Grant of the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (grant no.: A070001).Mossaheb N, 2009, J CLIN PSYCHIAT, V70, P500Han L, 2008, AM J GERIAT PSYCHIAT, V16, P742Cho MJ, 2007, J NERV MENT DIS, V195, P203, DOI 10.1097/01.nmd.0000243826.40732.45PARK JH, 2007, PSYCHIAT INVEST, V4, P84*UN DEP EC SOC AFF, 2007, WORLD POP PROSP 2006Djernes JK, 2006, ACTA PSYCHIAT SCAND, V113, P372, DOI 10.1111/j.1600-0447.2006.00770.x*UN, 2006, WORLD POP PROSPYOUU SW, 2006, ANXIETY MOOD, V2, P50Chen RL, 2005, ARCH INTERN MED, V165, P2019, DOI 10.1001/archinte.165.17.2019Driscoll HC, 2005, INT J GERIATR PSYCH, V20, P661, DOI 10.1002/gps.1334YI JS, 2005, J KOREAN NEUROPSYCHI, V44, P456*KNSO, 2005, REP POP HOUS CENSMojtabai R, 2004, PSYCHOL MED, V34, P623Battaglia A, 2004, INT CLIN PSYCHOPHARM, V19, P135, DOI 10.1097/01.yic.0000122860.35081.5fBAE JN, 2004, J PSYCHOSOM RES, V57, P297Lee DY, 2004, J INT NEUROPSYCH SOC, V10, P72Kessler RC, 2003, JAMA-J AM MED ASSOC, V289, P3095Cole MG, 2003, AM J PSYCHIAT, V160, P1147Sonnenberg CM, 2003, INT J GERIATR PSYCH, V18, P99, DOI 10.1002/gps.771*WHO, 2003, WORLD HLTH REP 2003NAM BH, 2003, J KOREAN SOC HLTH ST, V28, P3Lavretsky H, 2002, AM J GERIAT PSYCHIAT, V10, P239Lee JH, 2002, J GERONTOL B-PSYCHOL, V57, pP47Brodaty H, 2001, J AFFECT DISORDERS, V66, P225Van den Berg MD, 2001, J AFFECT DISORDERS, V65, P19Chong MY, 2001, BRIT J PSYCHIAT, V178, P29Thomas AJ, 2001, J NEUROL NEUROSUR PS, V70, P83Dubois B, 2000, NEUROLOGY, V55, P1621Steffens DC, 2000, ARCH GEN PSYCHIAT, V57, P601SUH GH, 2000, J KOREAN NEUROPSYCHI, V39, P809Rollman BL, 1999, J AM GERIATR SOC, V47, P757Beekman ATF, 1999, BRIT J PSYCHIAT, V174, P307CHO MJ, 1999, J KOREAN NEUROPSYCHI, V38, P48Newman SC, 1998, PSYCHOL MED, V28, P1339Beekman ATF, 1997, PSYCHOL MED, V27, P1397Lebowitz BD, 1997, JAMA-J AM MED ASSOC, V278, P1186Liu CY, 1997, PSYCHOL MED, V27, P943MURRAY JL, 1996, GLOBAL BURDEN DISBeekman ATF, 1995, J AFFECT DISORDERS, V36, P65PAHKALA K, 1995, SOC PSYCH PSYCH EPID, V30, P99KRISHNAN KRR, 1995, AM J PSYCHIAT, V152, P785KOMAHASHI T, 1994, JPN J PSYCHIAT NEUR, V48, P517JUDD LL, 1994, J CLIN PSYCHIAT, V55, P18*AM PSYCH ASS TASK, 1994, DIAGN STAT MAN MENTCHO MJ, 1993, J KOREAN NEUROPSYCHI, V32, P381WELLS KB, 1992, ARCH GEN PSYCHIAT, V49, P788MILLER MD, 1992, PSYCHIAT RES, V41, P237SHERBOURNE CD, 1991, SOC SCI MED, V32, P705HOROWITZ A, 1991, J GERONTOL SOC WORK, V17, P371989, AM J EPIDEMIOL, V129, P687BLAZER D, 1989, HOSP PRACT OFF ED, V24, P79VENTRY IM, 1982, EAR HEARING, V3, P128MURPHY E, 1982, BRIT J PSYCHIAT, V141, P135HATANO S, 1976, B WORLD HEALTH ORGAN, V54, P541LINN BS, 1968, J AM GERIATR SOC, V16, P622HAMILTON M, 1967, BRIT J SOC CLIN PSYC, V6, P278

Performance on the Benton Visual Retention Test in an educationally diverse elderly population

In this study, we investigated the effects of demographic variables on the performances of Administrations A and C of the Benton Visual Retention Test (BVRT) in a geriatric population with a wide range of educational achievement. We administered the test to 554 nondemented elders aged 60-90 years with an educational history of from zero to 25 years. Age and education significantly influenced Administrations A and C, although gender had no main effect. We observed significant Education x Gender interactions for Administrations A and C, Age x Gender interactions for Administration A, and Age x Education interactions for Administration C. Our results suggest that both nonverbal memory and constructional ability are influenced by age and education. Although there is no overall gender effect, men seem to outperform women in a poorly educated (for Administrations A and C) or relatively older (for Administration A) elderly population

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

Prevalence of Mild Cognitive Impairment and Its Subtypes Are Influenced by the Application of Diagnostic Criteria: Results from the Korean Longitudinal Study on Health and Aging (KLoSHA)

Aims: We investigated the influence of varying applications of diagnostic criteria on the prevalence of mild cognitive impairment (MCI) in community-dwelling Korean elders. Methods: A study population of 1,118 Korean elders was randomly sampled from the residents aged 65 years or older living in Seongnam, Korea. Standardized face-to-face interviews, with neurological and physical examinations, were conducted with 714 respondents. Cognitive function was evaluated using the Korean version of the CERAD Neuropsychological Assessment Battery, digit span test, and lexical fluency test. Activities of daily living were evaluated using the Blessed Dementia Scale in the CERAD Clinical Assessment Battery (Korean version). Using variable sets of operational diagnostic criteria, the prevalence of MCI was estimated. Results: Age- and gender-standardized prevalence estimates according to the Petersen criteria were 28.6% (95% CI = 25.3-31.9) for overall MCI, 17.0% (95% CI = 14.3-19.8) for amnestic MCI, and 11.5% (95% CI = 9.2-13.9) for non-amnestic MCI. However, the estimated prevalence of MCI varied widely (8.3-27.6%) according to the applied operational diagnostic criteria. The proportion of MCI subtypes also varied considerably according to the number and types of applied neuropsychological tests. Conclusions: Variable implementation of MCI diagnostic criteria may significantly complicate the homogeneity of this condition.Choo IH, 2009, INT J GERIATR PSYCH, V24, P306, DOI 10.1002/gps.2107Wancata J, 2007, AM J GERIAT PSYCHIAT, V15, P1034Das SK, 2007, NEUROLOGY, V68, P2019PARK JH, 2007, PSYCHIAT INVEST, V4, P84Busse A, 2006, NEUROLOGY, V67, P2176Perneczky R, 2006, AGE AGEING, V35, P240, DOI 10.1109/ageing/afj054Gauthier S, 2006, LANCET, V367, P1262Artero S, 2006, DEMENT GERIATR COGN, V22, P465, DOI 10.1159/000096287YOUU SW, 2006, ANXIETY MOOD, V2, P50Manly JJ, 2005, ARCH NEUROL-CHICAGO, V62, P1739Petersen RC, 2005, NEW ENGL J MED, V352, P2379, DOI 10.1056/NEJMoa050151YOUN JC, 2005, PSYCHIAT INVEST, V2, P28Kazui H, 2005, DEMENT GERIATR COGN, V19, P331, DOI 10.1159/000084559Takemura F, 2005, ADV ROBOTICS, V19, P331, DOI 10.1163/1568553053583698Petersen RC, 2004, J INTERN MED, V256, P183Winblad B, 2004, J INTERN MED, V256, P240BAE JN, 2004, J PSYCHOSOM RES, V57, P297Meguro K, 2004, ALZ DIS ASSOC DIS, V18, P3Lee DY, 2004, J INT NEUROPSYCH SOC, V10, P72Fisk JD, 2003, NEUROLOGY, V61, P1179Lopez OL, 2003, ARCH NEUROL-CHICAGO, V60, P1385Busse A, 2003, BRIT J PSYCHIAT, V182, P449DeCarli C, 2003, LANCET NEUROL, V2, P15IKEDA M, 2003, SEISHIN SHINKEIGAKU, V105, P381QIU CJ, 2003, ZHONGHUA LIU XING BI, V24, P1104Hanninen T, 2002, ACTA NEUROL SCAND, V106, P148Lee JH, 2002, J GERONTOL B-PSYCHOL, V57, pP47Petersen RC, 2001, ARCH NEUROL-CHICAGO, V58, P1985Morris JC, 2001, ARCH NEUROL-CHICAGO, V58, P397Ritchie K, 2001, NEUROLOGY, V56, P37Petersen RC, 1999, ARCH NEUROL-CHICAGO, V56, P303Sheehan DV, 1998, J CLIN PSYCHIAT, V59, P22Sheehan DV, 1998, J CLIN PSYCHIAT, V59, P34PETERSEN RC, 1997, INT PSYCHOGERIATR S, V9, P65Ruff RM, 1996, ARCH CLIN NEUROPSYCH, V11, P329*AM PSYCH ASS, 1994, DIAGN STAT MAN MENTWECHSLER D, 1987, WECHSLER MEMORY SCALHUGHES CP, 1982, BRIT J PSYCHIAT, V140, P566FLEISS JL, 1981, STAT METHODS RATES P

Prevalence and neuropsychiatric comorbidities of alcohol use disorders in an elderly Korean population

Objectives We investigated the prevalence and comorbidities of problem drinking in community-dwelling elders living in Korea. Methods Structured face-to-face diagnostic interviews were administered to the 714 Korean elders randomly sampled from Seongnam, Korea. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and the Alcohol Use Disorders Identification Test (AUDIT) scores, the participants were categorized into one of six diagnostic groups: lifetime abstainer, ex-drinker, social drinking, at-risk drinking, alcohol abuse, and alcohol dependence. Results Prevalence rates of social drinking, at-risk drinking, alcohol abuse, and alcohol dependence were estimated to be 13.60%, 5.42%, 2.28%, and 2.92%, respectively. Problem drinking was associated with increased risks of smoking (OR=3.52), whereas social drinking was associated with decreased risks of stroke (OR=0.27) and depression (OR=0.49). Conclusions Problem drinking was common particularly in men and associated with smoking. Social drinking was associated with the lower risks of stroke and depression. Copyright (C) 2009 John Wiley & Sons, Ltd.This work was supported by an Independent Research Grant (IRG) from Pfizer Global Pharmaceuticals (grant no. 06–05–039) and a Grant for Developing Seongnam Health Promotion Program for the Elderly from Seongnam City Government in Korea (grant no. 800–20050211).Park JT, 2008, J KOREAN MED SCI, V23, P199, DOI 10.3346/jkms.2008.23.2.199Duranceaux NCE, 2008, J STUD ALCOHOL DRUGS, V69, P227Hasin DS, 2007, ARCH GEN PSYCHIAT, V64, P830Gossop M, 2007, ADDICT BIOL, V12, P190, DOI 10.1111/j.1369-1600.2007.00066.xCho MJ, 2007, J NERV MENT DIS, V195, P203, DOI 10.1097/01.nmd.0000243826.40732.45Eng MY, 2007, ALCOHOL RES HEALTH, V30, P22Huth C, 2007, J STUD ALCOHOL DRUGS, V68, P6PARK J, 2007, PSYCHIAT INVEST, V4, P80YOUU SW, 2006, ANXIETY MOOD, V2, P50Lukassen J, 2005, SOC SCI MED, V61, P1658, DOI 10.1016/j.soscimed.2005.03.019Ait-Daoud N, 2005, ALCOHOL CLIN EXP RES, V29, P1541, DOI 10.1097/01.alc.0000174692.20933.49Aira M, 2005, INT J GERIATR PSYCH, V20, P680, DOI 10.1002/gps.1340Cook TAR, 2005, J STUD ALCOHOL, V66, P196Room R, 2005, LANCET, V365, P519Hahm BJ, 2005, SOC PSYCH PSYCH EPID, V40, P114, DOI 10.1007/s00127-005-0854-9Kim O, 2004, ADDICT BEHAV, V29, P1595, DOI 10.1016/j.addbeh.2004.02.037Bond GE, 2004, J AGING HEALTH, V16, P615, DOI 10.1177/0898264304268587Winblad B, 2004, J INTERN MED, V256, P240Lee DY, 2004, J INT NEUROPSYCH SOC, V10, P72Reynolds K, 2003, JAMA-J AM MED ASSOC, V289, P579, DOI 10.1001/jama.289.5.579Moore AA, 2003, J AM GERIATR SOC, V51, P44Sun F, 2002, BEHAV GENET, V32, P229Lee JH, 2002, J GERONTOL B-PSYCHOL, V57, pP47Wang JL, 2002, DEPRESS ANXIETY, V15, P42, DOI 10.1002/da.1084Thomas VS, 2001, J AM GERIATR SOC, V49, P415Dubois B, 2000, NEUROLOGY, V55, P1621Johnson I, 2000, INT J GERIATR PSYCH, V15, P575Dixit AR, 2000, AM J PSYCHIAT, V157, P751Rodgers B, 2000, PSYCHOL MED, V30, P421LEE BO, 2000, J KOREAN ACAD ADDICT, V4, P83Mulinga JD, 1999, INT J GERIATR PSYCH, V14, P564Moore AA, 1999, J AM GERIATR SOC, V47, P412Caetano R, 1999, DRUG ALCOHOL DEPEN, V54, P45CHO MJ, 1999, J KOREAN NEUROPSYCHI, V38, P48Thaller V, 1998, COLLEGIUM ANTROPOL, V22, P603Ruchlin HS, 1997, PREV MED, V26, P651GIRLING DM, 1995, J AFFECT DISORDERS, V34, P319OHARE T, 1995, ADDICT BEHAV, V20, P261ISAACSON JH, 1994, J GEN INTERN MED, V9, P550*AM PSYCH ASS TASK, 1994, DIAGN STAT MAN MENTADAMS WL, 1993, JAMA-J AM MED ASSOC, V270, P1222ROMAN GC, 1993, NEUROLOGY, V43, P250DUFOUR MC, 1992, CLIN GERIATR MED, V8, P127BIEN TH, 1990, INT J ADDICT, V25, P1429WILLIAMS OD, 1989, AM J EPIDEMIOL, V129, P687WECHSLER D, 1987, WECHSLER MEMORY SCALSTALL R, 1986, ANTHR EPIDEMIOLOGY IMCKHANN G, 1984, NEUROLOGY, V34, P939KLATSKY AL, 1983, ALCOHOL CLIN EXP RES, V7, P372HATANO S, 1976, B WORLD HEALTH ORGAN, V54, P541