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Seoul, South Korea

Kim J.W.,Hallym University | Lee D.Y.,Seoul National University | Seo E.H.,Seoul National University | Sohn B.K.,Seoul National University | And 8 more authors.
Psychiatry Investigation | Year: 2014

Objective This study aimed to investigate whether the supplementation of Verbal Fluency: Animal category test (VF) performance can improve the screening ability of Mini-Mental State Examination (MMSE) for mild cognitive impairment (MCI), dementia and their major subtypes. Methods Six hundred fifty-five cognitively normal (CN), 366 MCI [282 amnestic MCI (aMCI); 84 non-amnestic MCI (naMCI)] and 494 dementia [346 Alzheimer's disease (AD); and 148 non-Alzheimer's disease dementia (NAD)] individuals living in the community were included (all aged 50 years and older) in the study. Results The VF-supplemented MMSE (MMSE+VF) score had a significantly better screening ability for MCI, dementia and overall cognitive impairment (MCI plus dementia) than the MMSE raw score alone. MMSE+VF showed a significantly better ability than MMSE for both MCI subtypes, i.e., aMCI and naMCI. In the case of dementia subtypes, MMSE+VF was better than the MMSE alone for NAD screening, but not for AD screening. Conclusion The results support the usefulness of VF-supplementation to improve the screening performance of MMSE for MCI and NAD. © 2014 Korean Neuropsychiatric Association. Source


Kim J.W.,Hallym University | Lee D.Y.,Seoul National University | Seo E.H.,Seoul National University | Sohn B.K.,Seoul National University | And 6 more authors.
Journal of Korean Medical Science | Year: 2013

This study aimed to investigate whether the demographic variable-adjustment and supplementation of Frontal Assessment Battery (FAB) score can improve the screening ability of Mini-Mental State Examination (MMSE) for dementia and its subtypes. Five hundred forty-one non-demented comparison (NC) and 474 dementia (320 Alzheimer's disease [AD]; 139 non-Alzheimer's disease dementia [NAD]; and 15 mixed AD-NAD dementia) individuals living in the community were included. Education-adjusted MMSE (MMSE-edu) score showed significantly better screening accuracy for overall dementia, AD, and NAD than MMSE raw score. FAB-supplemented MMSE (MMSE-FAB) score had significantly better screening ability for NAD, but not for overall dementia and AD, than MMSE raw score alone. Additional supplementation of FAB to MMSE-edu further increased the ability for overall dementia or NAD screening, but not for AD screening. Further education adjustment of MMSE-FAB also improved its ability for overall dementia, AD, and NAD screening. These results strongly support the usefulness of education-adjustment and supplementation of frontal function assessment to improve screening performance of MMSE for dementia and its subtypes, NAD in particular. © 2013 The Korean Academy of Medical Sciences. Source


Kim J.W.,Seoul National University | Lee D.Y.,Seoul National University | Choo I.H.,Seoul National University | Seo E.H.,Seoul National University | And 3 more authors.
American Journal of Geriatric Psychiatry | Year: 2011

OBJECTIVES:: To identify regional alterations of white matter integrity associated with apathy in Alzheimer disease (AD). Design: Cross-sectional study. Setting: University Dementia Clinic. Participants: Fifty-one very mild or mild probable AD subjects. INTERVENTION:: Volumetric magnetic resonance imaging with diffusion tensor imaging. MEASUREMENTS:: Volume of interest analyses were performed to compare regional fractional anisotropy (FA) between apathy and apathy-free group, and to test linear relationship between regional FA and apathy severity. Apathy was assessed by the Neuropsychiatric Inventory. Results: Apathy group showed significantly lower FA values than apathy-free group in the left anterior cingulum (A-C), regardless of concomitant depression and psychotropic medications. Left A-C FA values also had significant linear relationship with apathy-composite scores as a measure of apathy severity, even after controlling gray matter density of the ipsilateral anterior cingulate cortex. Conclusions: Our findings support that communication failure between the anterior cingulate cortex and other brain structures via the A-C contributes to the development and aggravation of apathy in AD, additionally supporting the general notion of disconnection syndrome for clinical manifestation of AD. © 2011 American Association for Geriatric Psychiatry. Source


Seo E.H.,Seoul National University | Lee D.Y.,Seoul National University | Lee J.H.,Kangwon National University | Choo I.H.,Seoul National University | And 9 more authors.
American Journal of Geriatric Psychiatry | Year: 2010

Objectives: This study aimed to validate the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer Disease neuropsychological battery (CERAD-NP) for a large elderly population including mild cognitive impairment (MCI) and dementia patients with various etiologic backgrounds. The authors also investigated whether the addition of frontal-executive function score can improve the discrimination accuracy of the total scores for dementia and MCI. Design, Setting, and Participants: One thousand three hundred thirty-six normal comparison (NC), 583 dementia (420 AD, 111 non-AD dementia, and 52 mixed AD with non-AD dementia), and 250 MCI (223 amnestic and 27 nonamnestic MCI) individuals living in the community were included (all aged 60 years and older). Results: Both TS-I and TS-II were highly correlated with other global cognitive and functional scales. Both total scores showed, though modest, superior NC versus MCI discrimination ability to Mini-Mental State Examination (MMSE). Their discrimination ability for NC versus dementia was excellent and significantly better, especially in discriminating very mild dementia, than MMSE. The addition of frontal-executive test score to TS-I or TS-II did not make a significant improvement in dementia or MCI discrimination ability. Both of them also showed higher test-retest and interrater reliability than MMSE or any individual neuropsychological tests in the CERAD-NP. Conclusion: These results strongly support the validity and usefulness of CERAD total scores for early detection and progression monitoring of MCI and dementia in clinical and research settings. © 2010 American Association for Geriatric Psychiatry. Source


Han J.Y.,Seoul National University | Seo E.H.,Chosun University | Yi D.,Seoul National University | Sohn B.K.,Boramae Medical Center | And 12 more authors.
International Psychogeriatrics | Year: 2014

Background: This study aimed to investigate the influences of age, education, and gender on the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological assessment battery (CERAD-NP) and to provide normative information based on an analysis for a large number of elderly persons with a wide range of educational levels. Methods: In the study, 1,987 community-dwelling healthy volunteers (620 males and 1,367 females; 50-90 years of age; and zero to 25 years of education) were included. People with serious neurological, medical, and psychiatric disorders (including dementia) were excluded. All participants underwent the CERAD-NP assessment. TS-I was generated by summing raw scores from the CERAD-NP subtests, excluding Mini-Mental State Examination and Constructional Praxis (CP) recall subtests. TS-II was calculated by adding CP recall score to TS-I. Results: Both TS-I and TS-II were significantly influenced by demographic variables. Education accounted for the greatest proportion of score variance. Interaction effect between age and gender was found. Based on the results obtained, normative data of the CERAD-NP total scores were stratified by age (six overlapping tables), education (four strata), and gender. Conclusions: The normative information will be very useful for better interpretation of the CERAD-NP total scores in various clinical and research settings and for comparing individuals' performance of the battery across countries. © International Psychogeriatric Association 2014. Source

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