Impact of White Matter Lesions on Depression in the Patients with Alzheimer’s Disease

JungJae Lee,EunYoung Lee,SeokBum Lee,JoonHyuk Park,TaeHui Kim,HyunGhang Jeong,JaeHyoung Kim,JiWon Han,KiWoong Kim 대한신경정신의학회 2015 PSYCHIATRY INVESTIGATION Vol.12 No.4

Objective-Comorbid depression is common in patients with Alzheimer’s disease (AD). An increase in white matter lesions (WMLs) has been associated with depression in both elderly individuals with normal cognition and patients with Alzheimer’s disease. We investigated whether the severity and location of WMLs influence the association between WMLs and comorbid depression in AD. Methods-We enrolled 93 AD patients from Seoul National University Bundang Hospital. We administered both the Mini International Neuropsychiatric Inventory (MINI) and the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet (CERAD-K) clinical and neuropsychological battery. Subjects also underwent brain magnetic resonance imaging (MRI). We diagnosed AD according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association. We diagnosed depressive disorders according to the DSM-IV diagnostic criteria, and evaluated the severity of depressive symptoms using the Korean version of the Geriatric Depression Scale (GDS-K). We quantified the WML volumes from the brain MRI using a fully automated segmentation algorithm. Results-The log of the WML volume in the frontal lobe was significantly associated with depressive disorders (odds ratio=1.905, 95% CI=1.027–3.533, p=0.041), but not with the severity of depressive symptoms as measured by the GDS-K. Conclusion-The WML volume in the frontal lobe conferred a risk of comorbid depressive disorders in AD, which implies that comorbid depression in AD may be attributed to vascular causes.

Impacts of Poor Social Support on General Health Status in Community-Dwelling Korean Elderly: The Results from the Korean Longitudinal Study on Health and Aging

JaeKyung Shin,KiWoong Kim,JoonHyuk Park,JungJae Lee,Yoonseok Huh,SeokBum Lee,EunAe Choi,DongYoung Lee,JongInn Woo 대한신경정신의학회 2008 PSYCHIATRY INVESTIGATION Vol.5 No.3

Objective-We investigated the influence of social support on health, quality of life (QOL), and the risk of depression in elderly Korean people. Methods-This study was conducted as a part of the Korean Longitudinal Study on Health and Aging (KLoSHA). A total of 787 nondemented community-dwelling elderly aged 65 years or older were recruited and underwent clinical evaluations for dementia and psychiatric disorders conformed to Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Clinical Assessment Battery (CERAD-K) and the Korean version of the Mini-International Neuropsychiatric Interview (MINI), respectively. Social support was assessed using the Medical Outcome Study Social Support Survey (MOS-SSS). Poor social support (PSS) was defined as having a MOS-SSS score below the 25th percentile of the entire sample. General health status was comprehensively evaluated using the modified Cumulative Illness Rating Scale (CIRS), the Korean version of the Geriatric Depression Scale (GDS-K), Mini-Mental Status Examination (MMSE-KC), Korean Activities of Daily Living (KADL), and Korean Instrumental Activities of Daily Living (KIADL). Healthrelated QOL was evaluated using the Short Form 36 (SF-36). Results-Low educational attainment and living alone were associated with PSS. Geriatric depression was more prevalent in the PSS group (OR=3.05, 95% CI=1.77-5.27) than in the normal social support (NSS) group. Among the various forms of social support, positive social interaction was significantly associated with risk of geriatric depression (OR=2.25, 95% CI=1.07-4.73). Although health-related QOL was lower in the PSS group than in the NSS group, the ADL and IADL scores of the subjects in the PSS group were better than those of the subjects in the NSS group. In the subjects with geriatric depression, PSS was associated with more severe depression, higher medical morbidity, and poor QOL. Conclusion-PSS had a negative influence on the general health status and QOL among community-dwelling elderly and was an independent risk factor of geriatric depression.

A Normative Study of the Disability Assessment for Dementia in Community-Dwelling Elderly Koreans

JinHyeong Jhoo,YeonKyung Chi,HyoJung Choi,JiWon Han,TaeHui Kim,JungJae Lee,SeokBum Lee,JoonHyuk Park,JongChul Youn,JeongLan Kim,SeungHo Ryu,DongYoung Lee,Ki Woong Kim 대한신경정신의학회 2014 PSYCHIATRY INVESTIGATION Vol.11 No.4

Objective-We investigated demographic influences on Korean version of Disability Assessment for Dementia (DAD-K) performance and developed normative data for DAD-K. Methods-The DAD-K was administered to 2362 normal controls (NCs), 296 patients with mild cognitive impairment (MCI) and 293 patients with Alzheimer’s disease (AD). MANOVA and ROC curve analysis were used to compare DAD-K performance and the diagnostic accuracy of DAD-K, respectively. The demographic influence on DAD-K scores was analyzed by multiple linear regression and ANOVA. Normative DAD-K data were calculated using natural logarithmic transformation. Results-All DAD-K scores were significantly different among groups (p<0.001). Post hoc analysis showed that instrumental activities of daily living (IADL), executive function and DAD-K total scores began to decline significantly in the very mild stage of AD, whereas the basic activities of daily living (BADL) scores began to decline in the mild stage of AD. The area under the ROC curve differentiating MCI or AD from NC was 0.737 and that differentiating AD from MCI or NC was 0.911. IADL and planning and organization scores were influenced by age and education and performance and DAD-K total scores were influenced by education. Conclusion-The demographic influences on DAD-K scores are not conspicuous and are mainly limited to the IADL and planning and organization scores. Unitary or minimally stratified norms for a specific population were developed for DAD-K application. Our results suggest that the DAD-K is useful for differentiating NC or MCI from AD but not as powerful for differentiating NC from MCI.

LAB 컬러 모델을 이용한 조명에 강건한 이물 검사 방법

김영환(YeongHwan Kim),이석범(SeokBum Lee),최경주(KyungJoo Choi) 한국통신학회 2016 한국통신학회 학술대회논문집 Vol.2016 No.11

CERAD-K의 단어목록기억검사를 통해 알아본 알츠하이머형 치매, 혈관성 치매, 노년기 우울, 정상 집단의 계열위치효과 비교 연구

박정란 ( Jeongran Park ),이석범 ( Seokbum Lee ) 대한한방신경정신과학회 2017 동의신경정신과학회지 Vol.28 No.4

Objectives: The purpose of this study is to obtain the differential variable and learning effect of the serial position effect, targeting individuals aged 60 years and over. A total of 89 individuals were categorized into the following groups: Alzheimer’s group, vascular dementia group, elderly depression group, and normal group. Methods: Considering the size of the groups used for comparison, of the total 89 participants, 28 were in the Alzheimer’s group, 24 in the vascular dementia group, 16 in the elderly depression group, and 21 were randomly chosen for the normal group. In the CERAD-K word list memory test, 10 words were shown to the subjects. We then asked them to freely recall the words. After changing the order of the words three times, the same process was followed. Results: First, a significant difference was observed among the groups in terms of word recalling rate. The analysis conducted afterward showed that, as predicted, the depressed group showed significantly better performance in recalling the words. Second, the vascular dementia patients and the Alzheimer’s patients showed, as predicted, better recall of the largest recency region of words shown. Third, the normal group and the elderly depressed group showed a high-performance rate, proving that the reiterative method can contribute to the recalling process. Thus, we demonstrated that the Alzheimer’s group showed the deterioration of short memory recalling skills and the elderly depressed showed deteriorated output performance skill.

An Overview of the Korean Longitudinal Study on Health and Aging

JoonHyuk Park,Soo Lim,JaeYoung Lim,KwangIl Kim,MoonKu Han,InYoung Yoon,JongMin Kim,YoonSeok Chang,ChongBum Chang,HoJun Chin,EunAe Choi,SeokBum Lee,YoungJoo Park,NamJong Paik,TaeKyun Kim,Hak C. Jang,Ki 대한신경정신의학회 2007 PSYCHIATRY INVESTIGATION Vol.4 No.2

Objective-The Korean Longitudinal Study on Health and Aging (KLoSHA) was developed 1) to estimate the prevalence, incidence and progression of common geriatric diseases; 2) to determine the risk factors for common geriatric diseases and to develop preventive strategies by managing potentially modifiable determinants; 3) to investigate the influence of common geriatric diseases on the quality of life and general health status; 4) to evaluate the levels of health and functional status of Korean elderly persons. Methods-The KLoSHA was designed as a population-based prospective cohort study on health, aging and common geriatric diseases of Korean elders aged 65 years and over. The baseline study of the KLoSHA was conducted from September 2005 through September 2006 in Seongnam. Follow-up studies will be performed at 4-year intervals without an endpoint. Results-At the baseline study, 992 subjects (714 randomly sampled elderly subjects aged 65 years or over, 278 volunteers aged 85 years or over) were enrolled and completed the study. Prevalences and risk factors of common geriatric disorders in Korean elders were estimated, and the normative data of neuropsychological measures, general health parameters, and laboratory tests were drawn. Conclusion-The KLoSHA may not only provide comprehensive epidemiological data on the health status and common geriatric disorders of Korean elders, but also may stimulate comprehensive multidisciplinary and interdisciplinary researches on aging and geriatric disorders and contribute to policy formulation and planning of health management programs and social services in Korea.