Korean Instrumental Activities Of Daily Living Research Articles

The Effect of Depression in Instrumental Activities of Daily Living in Mild Cognitive Impairment: The mediating role of cognitive dysfuction

AbstractBackgroundGeriatric depression can affect on decline of various cognitive functions including executive function and can lead to disabilities in instrumental activities of daily living (IADL). Decline in IADL was related to conversion to dementia even though there was no decline in screening tests such as MMSE. Therefore it is important to manage the factors affecting IADL. We examined the relationship between depression, cognitive dysfunction and IADL in mild cognitive impairment (MCI) to reveal the effect of depression on IADL.MethodWe recruited 132 patients with MCI who visited the Department of Neurology at Pusan National University Yangsan Hospital from March 2019 to June 2022. Using the Short‐Geriatric Depression Scale (S‐GDS: cuf‐off 8), these patients were divided into 64 depressed groups (mean age 75±6.7) and 68 non‐depressed groups (mean age: 71±8.1). To evaluate cognitive function, the Seoul Neuropsychological Screening Battery, which consists of five domains: attention, language functions, visuospatial functions, memory, and executive functions, was conducted. K‐IADL (Korean Instrumental Activities of Daily Living) was conducted to evaluate IADL. We investigated the mediation effect of cognitive functions between depression and IADL using mediation analysis.ResultDepression and K‐IADL showed positive correlation (B = 0.023, p < 0.001). Mediation analysis of cognitive function between depression and IADL showed significant effect of executive function (B = ‐0.001, p = 0.019) and visuospatial function (B = ‐0.001, p = 0.045). Memory, language and attention domains had no significant mediation effect between depression and ADL.ConclusionIn our study, depression related to decline in IADL, and not only the effects of depression but also mediation effects of executive and visuospatial dysfunction could affect IADL. In terms of IADL maintenance, it is necessary to actively manage the depressed mood of MCI patients.

The effect of all-cause hospitalization on cognitive decline in older adults: a longitudinal study using databases of the National Health Insurance Service and the memory clinics of a self-run hospital

BackgroundCognitive decline is common in older adults and imposes a burden on public health. Especially for older adults, hospitalization can be related to decreased physical fitness. This study aimed to investigate the quantitative association between hospitalization and cognitive decline.MethodsThis was a retrospective cohort study. We performed a longitudinal study by using the combined database from the Korean National Health Insurance Service (NHIS) and memory clinic data of its self-run hospital. We identified whether hospitalized, the number of hospitalizations, and the total hospitalization days through the claim information from the NHIS database. We also identified whether hospitalization was accompanied by delirium or surgery with general anesthesia for subgroup analysis. Primary outcome was the clinical dementia rating-sum of boxes (CDR-SB) score. Secondary outcomes were mini-mental state examination (MMSE) score, clinical dementia rating (CDR) grade, and Korean-instrumental activities of daily living (KIADL) score. Multivariable mixed models were established.ResultsOf the 1810 participants, 1200 experienced hospitalization at least once during the observation period. The increase in CDR-SB was significantly greater in the hospitalized group (β = 1.5083, P < .001). The same results were seen in the total number of hospitalizations (β = 0.0208, P < .001) or the total hospitalization days (β = 0.0022, P < .001) increased. In the group that experienced hospitalization, cognitive decline was also significant in terms of CDR grade (β = 0.1773, P < .001), MMSE score (β = − 1.2327, P < .001), and KIADL score (β = 0.2983, P < .001). Although delirium (β = 0.2983, P < .001) and nonsurgical hospitalization (β = 0.2983, P < .001) were associated with faster cognitive decline, hospitalization without delirium and with surgery were also related to faster cognitive decline than in the no hospitalization group.ConclusionCognitive decline was quantitatively related to all-cause hospitalization in older adults. Moreover, hospitalizations without delirium and surgery were also related to cognitive decline. It is vital to prevent various conditions that need hospitalization to avoid and manage cognitive dysfunction.

Does the virtual shopping training improve executive function and instrumental activities of daily living of patients with mild cognitive impairment?

To date, ecological validity of virtual shopping training for patients with mild cognitive impairment (MCI) has not been confirmed yet. Main objective of this study was to investigate effects of virtual shopping training on executive function and instrumental activities of daily living (IADL) in patients with MCI. 32 patients with MCI were randomly assigned to the experimental group that received virtual shopping training or the waitlist control group for a total of 16 sessions. To examine effects of virtual shopping training on executive function and IADL, Korean version of the Executive Function Performance Test (EFPT-K) and Korean Instrumental Activities of Daily living (K-IADL) were conducted. After the 16 sessions, the experimental group showed greater improvement in the EFPT-K (p<0.001) and the K-IADL (p<0.001) compared to the control group. These results suggest that virtual shopping training might be clinically beneficial to enhance executive function and IADL in patients with MCI.

Predicting the Severity of Parkinson's Disease Dementia by Assessing the Neuropsychiatric Symptoms with an SVM Regression Model.

In this study, we measured the convergence rate using the mean-squared error (MSE) of the standardized neuropsychological test to determine the severity of Parkinson’s disease dementia (PDD), which is based on support vector machine (SVM) regression (SVR) and present baseline data in order to develop a model to predict the severity of PDD. We analyzed 328 individuals with PDD who were 60 years or older. To identify the SVR with the best prediction power, we compared the classification performance (convergence rate) of eight SVR models (Eps-SVR and Nu-SVR with four kernel functions (a radial basis function (RBF), linear algorithm, polynomial algorithm, and sigmoid)). Among the eight models, the MSE of Nu-SVR-RBF was the lowest (0.078), with the highest convergence rate, whereas the MSE of Eps-SVR-sigmoid was 0.110, with the lowest convergence rate. The results of this study imply that this approach could be useful for measuring the severity of dementia by comprehensively examining axial atypical features, the Korean instrumental activities of daily living (K-IADL), changes in rapid eye movement sleep behavior disorder (RBD), etc. for optimal intervention and caring of the elderly living alone or patients with PDD residing in medically vulnerable areas.

Validation of a New Screening Tool for Dementia: The Simple Observation Checklist for Activities of Daily Living

Background and PurposeScreening tests for dementia such as the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment are widely used, but there are drawbacks to their efficient use. There remains a need for a brief and easy method of assessing the activities of daily living (ADL) that can be administered to elderly individuals by healthcare workers. We have therefore developed a new scale named the Simple Observation Checklist for Activities of Daily Living (SOC-ADL).MethodsWe developed the SOC-ADL scale as a team of experts engaged in caring for individuals with dementia. This scale comprises eight items and was designed based on the Korean instrumental activities of daily living (K-IADL) scale and the Barthel activities of daily living scale (Barthel Index). The new scale was validated by enrolling 176 patients with cognitive dysfunction across 6 centers. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed. We assessed its concurrent validity by performing comparisons with the Korean-MMSE, Clinical Dementia Rating, Clinical Dementia Rating-Sum of Boxes, K-IADL, and Barthel Index, and its criterion validity by performing comparisons between mild cognitive impairment (MCI) and dementia. We also used Cronbach's alpha to assess the interitem reliability. The appropriate cutoff values were determined by analyzing receiver operating characteristic curves, including the areas underneath them.ResultsEFA extracted one factor and CFA revealed that all of the model fits exceeded the minimum acceptable criteria. The SOC-ADL scores were strongly correlated with those of the other tools for dementia and could be used to differentiate MCI from dementia. Cronbach's alpha values indicated that the results were reliable. The optimal cutoff value of the SOC-ADL for discriminating dementia from MCI was 3 points, which provided a sensitivity and specificity of 74.5% and 75.7%, respectively.ConclusionsOur results demonstrate that the SOC-ADL is a valid and reliable tool for differentiating dementia from MCI based on an assessment of ADL. This new tool can be used for screening ADL in elderly subjects who have difficulty communicating, and to increase the efficiency of dementia screening at the population level.

Is a program to improve grocery-shopping skills clinically effective in improving executive function and instrumental activities of daily living of patients with schizophrenia?

To date, cognitive intervention to improve executive function for patients with schizophrenia has not been ecologically validated. Our main objective was to investigate the effectiveness of grocery shopping skill program on executive function and instrumental activities of daily living (IADL) of patients with schizophrenia. Among 20 patients with schizophrenia who received conventional rehabilitation, 10 patients were allocated to an experimental group and they additionally performed the program to improve grocery shopping skill in a real situation for eight sessions. The rest of participants were assigned to the wait-list group. To identify the effects on executive function, the Korean version of the Executive Function Performance Test (EFPT-K) was used. IADL was evaluated using the Korean Instrumental Activities of Daily Living (K-IADL). After the sessions, the EFPT-K (p < .001) and K-IADL (p < .05) were significantly improved in the experimental group. These results indicate that the program to improve grocery shopping skills might be clinically beneficial to enhance executive function and IADL of patients with schizophrenia.

COWAT Performance of Persons with Alzheimer Dementia, Vascular Dementia, and Parkinson Disease Dementia According to Stage of Cognitive Impairment.

The Controlled Oral Word Association Test (COWAT) evaluates frontal lobe and executive function. Therefore, it can be helpful in differentiating cognitive deficits. However, there are no studies comparing the COWAT performance according to the type and stage of cognitive impairment. To compare performance among persons with Alzheimer dementia (AD), vascular dementia (VaD), and Parkinson disease dementia (PDD) on the COWAT according to stage of cognitive impairment. Retrospective chart review. University hospital rehabilitation psychology center. We reviewed the medical records of 246 persons diagnosed with mild cognitive impairment (MCI) or dementia using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Korean-Instrumental Activities of Daily Living (K-IADL). Patients were divided into a control group, Alzheimer groups (amnestic mild cognitive impairment [aMCI] + AD), Vascular groups (vascular mild cognitive impairment [VaMCI] + VaD), and Parkinson groups (Parkinson disease-mild cognitive impairment [PD-MCI] + PDD). Total scores (ie, total number of words produced in 60 seconds on the semantic and phonemic fluency tests of the COWAT) were analyzed. Secondary analysis included calculating percentage scores of words produced during each of the four, 15-second segments from the total number of words produced in each trial. All MCI groups scored significantly lower than the control group on both semantic and phonemic fluency tests. Among the dementia groups, the VaD (mean ± SD, 5.6 ± 5.1) and PDD (5.5 ± 5.5) groups' scores were significantly lower and worse than that of the AD (11.0 ± 8.8) group on the phonemic test (P < .001). The difference in percentage scores was most marked between the PD-MCI (17.0 ± 2.2) and PDD (1.2 ± 3.1) groups, followed by the VaMCI (13.3 ± 1.9) and VaD (5.6 ± 1.8) groups on the latter phonemic test (P = .007). The COWAT is a sensitive test of frontal-lobe and executive function impairment in persons with MCI. Decreased verbal output in the last 15 seconds of phonemic fluency test is significantly decreased and impaired in persons with VaMCI and PD-MCI compared to persons with aMCI as they progress to dementia. III.

Analysis of characteristics affecting instrumental activities of daily living in Parkinson's disease patients without dementia.

Patients with Parkinson's disease (PD) are liable to experience impairment in their activities of daily living (ADL), which include ambulating, eating, dressing, bathing, and personal hygiene. The aim of this study is to assess which clinical characteristics contribute significantly to instrumental ADL (IADL) in PD patients without dementia. We included 106 PD patients in our study, and each patient's motor and non-motor status and basic and instrumental ADL were assessed using the appropriate scales. Of the 106 PD patients, 31 (29.2%) had abnormal Korean IADL (K-IADL) scores. These patients were older and had higher scores in terms of the modified Hoehn and Yahr (mHY) staging scale, Unified Parkinson's Disease Rating Scale (UPDRS) parts II and III, UPDRS part IV motor fluctuation, Beck Depression Inventory (BDI), and total Non-Motor Symptoms assessment scale for PD (NMSS), as well as lower scores in the Mini-Mental State Examination (MMSE). Pearson's correlation analysis showed significant associations between the scores of K-IADL and each of the following characteristics of the patients: age, mHY stage, UPDRS parts II and III, UPDRS part IV motor fluctuation, BDI, total NMSS, and MMSE. Multivariate linear regression analysis showed that the significant clinical characteristics associated with the K-IADL scores were determined to be the UPDRS part II, MMSE, and BDI scores. The results of our study revealed that the cognitive, depression, and motor symptoms were the significant predictors of IADL in PD patients without dementia.

Validation of the Korean-Everyday Cognition (K-ECog).

BackgroundIn the early diagnosis of dementia, an important factor is the evaluation of activities of daily living. The Everyday Cognition (ECog) scale was developed to measure functional changes that are the everyday correlates of specific neuropsychological impairments. This study aimed to examine the validity of the Korean version of Everyday Cognition (K-ECog).MethodsThe participants were 268 cognitively normal older adults (NA), 151 amnestic mild cognitive impairment (aMCI), and 77 dementia of the Alzheimer's type (DAT). The Korean-Mini Mental State Examination (K-MMSE), Korean-Montreal Cognitive Assessment (K-MoCA), and Short form of the Geriatric Depression Scale (SGDS) were administered to all the participants. The K-ECog and Korean-Instrumental Activities of Daily Living (K-IADL) were rated by their informants.ResultsInternal consistency (Cronbach's α) of K-ECog global function was 0.93, and its test-retest reliability (Pearson's r) was 0.73. K-ECog was significantly correlated with K-IADL (0.66), K-MMSE (−0.38), and K-MoCA (−0.26). Confirmatory factor analysis of K-ECog yielded seven factor model that the original ECog proposed. K-ECog global score and six domain scores were significantly different across the NA, aMCI, and DAT groups. Receiver operating characteristic curve analyses showed that K-ECog effectively differentiated aMCI and DAT patients from NA, suggesting that K-ECog is as sensitive for detecting functional impairments as K-IADL. The proposed optimal cut-off score to differentiate aMCI from NA was 1.41.ConclusionK-ECog is proven reliable and valid for clinical use. K-ECog can be used to distinguish very early stages of impaired ADL and cognitive impairment in the community.

Re-standardization of the Korean-Instrumental Activities of Daily Living (K-IADL): Clinical Usefulness for Various Neurodegenerative Diseases.

Background and PurposeEvaluating instrumental activities of daily living (IADL) is an important part of procedure to diagnose dementia. The Korean-Instrumental Activities of Daily Living (K-IADL) has been used extensively in Korea. However, its cut-off score has not been reformulated since 2002. The purpose of this study was to yield a new optimal cut-off score for the K-IADL and confirm the validity of this new cut-off score with various dementia groups.MethodsWe retrospectively collected a total of 2,347 patients' K-IADL data from 6 general hospitals in Korea. These patients had mild cognitive impairment (MCI) or dementia with various etiologies for cognitive impairment. We also recruited a normal control group (n=254) from the community. Korean-Mini Mental State Examination, Short version of the Geriatric Depression Scale, Clinical Dementia Rating, and Global Deterioration Scale were administered to all participants. Caregivers completed K-IADL and Barthel Index.ResultsK-IADL scores were significantly different among dementia subgroups, but not significantly different among MCI subgroups. Based on internal consistency, correlations with other scales, and factor analysis, K-IADL showed excellent reliability and validity. The new optimal cut-off score to diagnose dementia was 0.40, which gave a sensitivity of 0.901 and a specificity of 0.916. Positive predictive value for dementia using the new cut-off score was 94.2% for Alzheimer's disease, 100% for vascular dementia, and 84% for Parkinson's disease.ConclusionsOur results illustrate that the new K-IADL cut-off score of 0.40 is reliable and valid for screening impairments of daily functioning resulting from various etiologies.

RELATIONSHIP BETWEEN SLEEP DISTURBANCE AND COGNITIVE DYSFUNCTION IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT

The relationship between sleep disturbance and cognitive dysfunction in patients with mild cognitive impairment (MCI) has been reported, but relatively few studies have explored the relationship. This study attempted to investigate the association between sleep disturbance and cognitive dysfunction in MCI patients. Seventy eight MCI patients were assessed with a comprehensive neuropsychological test battery (Seoul Neuropsychological Screening Battery-2, SNSB-2). To assess behavioral and psychological symptoms, including sleep disturbance, Neuropsychiatric Inventory (NPI) was used. Thirty one (39.7%) out of seventy eight MCI patients showed sleep disturbance. There were no significant differences in age, sex, level of education, Korean-Instrumental Activities of Daily Living (K-IADL) score and Korean version of Short Form of Geriatric Depression Scale (SGDS-K) score, all subscales of Neuropsychiatric Inventory (NPI) except sleep disturbance between the group with sleep disturbance and the group without sleep disturbance. Korean version of Mini-Mental State Exam (K-MMSE) score was significantly lower in the group with sleep disturbance than the group without sleep disturbance (p=0.046). After adjusted for K-MMSE scores by ANCOVA, the group with sleep disturbance had significantly lower performance scores in Calculation-sub, Ideomotor apraxia than the group without sleep disturbance (p=0.029, p=0.019). Additionally, non-amnestic MCI group with sleep disturbance had significantly lower performance scores in Calculation-sub, Rey Complex Figure Test-immediate recall than non-amnestic MCI group without sleep disturbance(p=0.036, p=0.026). The group with sleep disturbance showed cognitive dysfunction in language and related function as compared to the group without sleep disturbance in patients with MCI.

A follow-up study of the association between mobile phone use and symptoms of ill health.

The duration and frequency of mobile phone calls, and their relationship with various health effects, have been investigated in our previous cross-sectional study. This 2-year period follow-up study aimed to assess the changes in these variables of same subjects. The study population comprised 532 non-patient adult subjects sampled from the Korean Genome Epidemiology Study. The subjects underwent a medical examination at a hospital in 2012/2013 and revisited the same hospital in 2014/2015 to have the same examination for the characteristics of mobile phone use performed. In addition, to evaluate the effects on health, the Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale, Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey were analyzed. For all these tests, the higher the score, the greater the effect on health. Variances between scores in all the indices in the baseline and follow-up surveys were calculated, and correlations of each index were analyzed. The average duration per call and HIT-6 score of the subjects decreased significantly compared with those recorded two years ago. The results showed a slight but significant correlation between call duration changes and HIT-6 score changes for female subjects, but not for males. HIT-6 scores in the follow-up survey significantly decreased compared to those in the baseline survey, but long-time call users (subjects whose call duration was ≥5 minutes in both the baseline and follow-up surveys) had no statistically significant reduction in HIT-6 scores. This study suggests that increased call duration is a greater risk factor for increases in headache than any other type of adverse health effect, and that this effect can be chronic.

A cross-sectional study of the association between mobile phone use and symptoms of ill health.

ObjectivesThis study analyzed the associations between mobile phone call frequency and duration with non-specific symptoms.MethodsThis study was conducted with a population group including 532 non-patient adults established by the Korean Genome and Epidemiology Study. The pattern of phone call using a mobile phone was investigated through face-to-face interview. Structured methods applied to quantitatively assess health effects are Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey where a higher score represents a higher greater health effect.ResultsThe average daily phone call frequency showed a significant correlation with the PSS score in female subjects. Increases in the average duration of one phone call were significantly correlated with increases in the severity of headaches in both sexes. The mean (standard deviation) HIT-6 score in the subgroup of subjects whose average duration of one phone call was five minutes or longer was 45.98 (8.15), as compared with 42.48 (7.20) in those whose average duration of one phone call was <5 minutes. The severity of headaches was divided into three levels according to the HIT-6 score (little or no impact/moderate impact/substantial or severe impact), and a logistic regression analysis was performed to investigate the association between an increased phone call duration and the headache severity. When the average duration of one phone call was five minutes or longer, the odds ratio (ORs) and the 95% confidence intervals (CIs) for the moderate impact group were 2.22 and 1.18 to 4.19, respectively. The OR and 95% CI for the substantial or severe impact group were 4.44 and 2.11 to 8.90, respectively.ConclusionsMobile phone call duration was not significantly associated with stress, sleep, cognitive function, or depression, but was associated with the severity of headaches.

Slower gait speed predicts decline in Instrumental Activities of Daily Living in community-dwelling elderly: 3-year prospective finding from Living Profiles of Older People Survey in Korea

Background/PurposeSlower gait speed is a good predictor of falls, dependency, disability, and mortality. However, the cutoff point of the gait speed to best predict the bad outcomes is controversial. The purpose of this study was to determine the cutoff point of gait speed that best predicts Instrumental Activities of Daily Living (IADL) dependency. MethodsThe study targeted 8000 people aged ≥ 65 years who had been enrolled in 2008 and followed up in 2011 for the Living Profiles of Older People Survey in Korea. The population was divided into an independent group and a dependent group with 2011 Korean Instrumental Activities of Daily Living (K-IADL) scores of 10 and ≥ 11, respectively. The gait speed was measured as the time taken to walk 2.5 m at a usual pace without any help, and the best result of two trials was chosen for analysis. ResultsThe area under the curve was highest (0.642) at gait speed of 0.6 m/s, with a sensitivity and specificity of 68.44% and 55.09%, respectively. The dependency hazard ratio of IADL was statistically significant in the group with gait speed less than 0.6 m/s, 1.974 (95% confidence interval, 1.646–2.367). The dependency hazard ratio of IADL was also statistically significant in the same group after adjusting for all relevant variables, 1.613 (95% confidence interval, 1.332–1.955). ConclusionThe gait speed of 0.6 m/s may be considered as the new standard of a screening tool to predict IADL dependency in Korean people aged ≥ 65 years.

환자선택적 과제지향훈련이 뇌졸중 환자의 일상생활동작 수행, 삶의 질, 우울감에 미치는 영향

This study included 40 stroke subjects, randomly assigned to either an experimental group or a control group. Both the experimental group and the control group included 20 stroke patients. Patients from the experimental group selected and performed task-oriented training. In the exercise program, the patient chose two categories from six categories and trained for 30 minutes a day, three times a week, for four weeks. Patients from the control group performed conventional task-oriented training. †Corresponding Author : shinws@dju.krThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Outcomes were measured using the Korean version of a modified Barthel Index (K-MBI), the Korean Instrumental Activities of Daily Living (K-IADL), the Stroke-specific Quality of Life (SS-QOL), the Short Form 8 (SF-8), and the Beck Depression Inventory (BDI), both before and after training.

뇌졸중 노인의 기능장애 정도, 일상생활 수행능력, 우울과 삶의 질 간의 관계

The purpose of this study was to know dysfunctions degree, daily living activity, depression and quality of life among stroke elderly person; and to know what kind of factors affecting to quality of life of the stroke elderly person; after that provide a fundamental data to nursing arbitration plan about increase height quality of life of the stroke elderly person. The study subjects were collected 119 people, over than 60 age, who were diagnosed with stoke in D hospital, living in B city. The data was collected by using personal interviews and questionnaire, from Nov 2008 to Jan 2009. The questionnaire were Pre-Stroke MRDS(Modified Rankin Disability Scale), Barthel-ADL(Activities of Daily Living), K-IADL(Korean-Instrumental Activities of Daily Living), GDS-15(Geriatric Depression Scale-15-question form) methods. The pre-stroke MRDS was appeared a functional obstacle. The mean score of activity of daily living was 18.24 which showed the subjects were mildly disabled, the score of instrumental activities of daily living was 7.94 which showed the mildly abled, and score of depressiveness was 7.41 which showed the subjects were mildly depression. There was a significantly correlation among MRDS, ADL, IADL, depressiveness and quality of life. Through these study result, important to check the old subjects' depressiveness, cognitive functions, daily living abilities, dysfunctions degree to main tain their quality of life.

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

ObjectiveWe investigated the influence of social support on health, quality of life (QOL), and the risk of depression in elderly Korean people.MethodsThis 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). Health-related QOL was evaluated using the Short Form 36 (SF-36).ResultsLow 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.ConclusionPSS had a negative influence on the general health status and QOL among community-dwelling elderly and was an independent risk factor of geriatric depression.

Does arm length indicate cognitive and functional reserve?

This study aimed to examine whether arm length and height were associated with cognitive and functional abilities. Screening interviews were conducted in 235 community dwelling individuals aged 65 and over. The assessment scales included the Korean version of modified Mini-Mental State Examination (K-mMMSE) for cognition, and the Korean Instrumental Activities of Daily Living (K-IADL) for functional ability. All the participants were examined clinically and a diagnosis of dementia was ascertained. Anthropometric measurements included total arm span and height. Both arm length and height correlated significantly with the cognitive and functional scales. In the multivariate regression models, their associations were significant, independent of age, sex, education, and other variables. Shorter arm length was also significantly associated with dementia; while, height lost significance after an adjustment for the potential confounders. Arm length and height could indicate cognitive and functional ability. Arm length, which was known to be less prone to degenerative processes, might be more stable as an indicator for cognitive and functional reserve capacity than height.