Mini-Mental State Examination For Dementia Screening Research Articles

Relationship between Physical Activity, Handgrip Strength, Depressive Symptoms, and Cognitive Impairment in Korean older adults

AbstractBackgroundPhysical activity, muscle strength, depressive symptoms, and cognitive function are intertwined in later life. This study aimed to investigate the association physical activity (PA), relative handgrip strength (RHGS), depressive symptoms, and cognitive impairment in Korean older adults.MethodThis study consisting of 512 community‐dwelling Korean older adults (417 female, 95 male) aged 65 years and older (74.8±5.4 years) in S‐city, Gyeonggi‐do. PA and handgrip strength were assessed with the Global Physical Activity Questionnaire and using a dynamometer (GRIP‐D; Takei Ltd, Niigata, Japan). Depressive symptoms were evaluated using the Korean form of the Center for Epidemiologic Studies Depression (CES‐D) Scale. Cognitive impairment was assessed with the Mini‐Mental State Examination for Dementia Screening (MMSE‐DS) of Korean version. The PROCESS V3.4 macro for SPSS based on the bootstrap method was used to determine the mediating effects of PA and RHGS on the relationship between depressive symptoms and cognitive impairment.ResultMultiple logistic regression showed that insufficient PA was associated with high odds of a cognitive impairment ((OR = 2.972, 95%CI = 1.749‐5.052, p = .002) compared with sufficient PA (OR = 1). Weak RHGS (OR = 3.540, 95%CI = 2.156‐5.814, p<.001) was associated with high odds of the cognitive impairment compared with normal RHGS (OR = 1). Depressive symptoms (OR = 2.676, 95%CI = 1.594‐4.492, p<.001) were associated with higher odds of the cognitive impairment compared with normal depression status (OR = 1). Particularly, depressive symptoms were found to have both direct and indirect effects on cognitive impairment. As predicted, PA and RHGS partially mediated the relationship between depressive symptoms and cognitive impairment (PA: B = –0.017, 95%CI = –0.028 ‐ –0.009, p<.001; RHGS: B = –0.005, 95%CI = –0.007 ‐ –0.003, p<.001). In addition, serial mediation analysis indicates that the association between depressive symptoms and cognitive impairment was partially mediated by PA and RHGS in a sequential manner (B = –0.004, 95%CI = –0.006 ‐ –0.002, p<.001).ConclusionAccording to the results of the serial multiple mediation model, the elderly should be encouraged to continue their physical activity in daily life, which not only improves and maintaining muscular strength but also reduces the negative impact of depressive symptoms on cognitive impairment.

Deep Learning of Speech Data for Early Detection of Alzheimer's Disease in the Elderly.

Alzheimer's disease (AD) is the most common form of dementia, which makes the lives of patients and their families difficult for various reasons. Therefore, early detection of AD is crucial to alleviating the symptoms through medication and treatment. Given that AD strongly induces language disorders, this study aims to detect AD rapidly by analyzing the language characteristics. The mini-mental state examination for dementia screening (MMSE-DS), which is most commonly used in South Korean public health centers, is used to obtain negative answers based on the questionnaire. Among the acquired voices, significant questionnaires and answers are selected and converted into mel-frequency cepstral coefficient (MFCC)-based spectrogram images. After accumulating the significant answers, validated data augmentation was achieved using the Densenet121 model. Five deep learning models, Inception v3, VGG19, Xception, Resnet50, and Densenet121, were used to train and confirm the results. Considering the amount of data, the results of the five-fold cross-validation are more significant than those of the hold-out method. Densenet121 exhibits a sensitivity of 0.9550, a specificity of 0.8333, and an accuracy of 0.9000 in a five-fold cross-validation to separate AD patients from the control group. The potential for remote health care can be increased by simplifying the AD screening process. Furthermore, by facilitating remote health care, the proposed method can enhance the accessibility of AD screening and increase the rate of early AD detection.

Effectiveness and Safety of the Korean Medicine Senior Health Promotion Program Using Herbal Medicine and Acupuncture for Mild Cognitive Impairment: A Retrospective Study of 500 Patients in Seoul, Korea.

Background The management of mild cognitive impairment (MCI) is becoming increasingly important. The Korean Medicine Senior Health Promotion Program (KSHPP) was developed in 2016, and it has been in use to date. This study aimed to assess the effectiveness of KSHPP using herbal medicine and acupuncture for treating MCI and the safety of herbal medicine using liver and renal function tests. Methods We retrospectively reviewed the medical records of the participants with MCI. We assessed the Korean version of the Montreal Cognitive Assessment (MoCA-K), the Mini-Mental State Examination-Dementia Screening (MMSE-DS), and the Geriatric Depression Scale Short Form-Korea version (GDSSF-K) scores before and after KSHPP to determine its effectiveness. To evaluate its safety, the liver and renal function tests were conducted before and after herbal treatment. Results We enrolled 1002 participants, and 500 participants satisfied the inclusion criteria. Of 500 patients, 364 (72.8%) were depressed and 136 (27.2%) were not. The mean MoCA-K score significantly increased by 2.77 for the entire sample and 3.22 for the depressed sample (all P < 0.0001). The mean MMSE-DS score significantly increased by 2.19 for the entire sample and 2.51 for the depressed sample (all P < 0.0001); the mean GDSSF-K score significantly decreased by 1.73 for the entire sample and 2.68 for the depressed sample (all P < 0.0001). Conclusions Our findings suggest that Korean medicine interventions can improve cognitive function and depression symptoms in patients with MCI. In addition, the results of the liver and renal function tests were analyzed as surrogate outcomes to assess the safety of herbal medicine. Based on these results, we expect that Korean medicine interventions can promote the cognitive and mental health of seniors. However, as there were several study limitations, particularly study design, practice effect, and short follow-up, these results must be interpreted with caution. We need a further long-term study with a rigorous design to retain confidence in the effectiveness and safety of KSHPP.

Cognitive function of the elderly without dementia in Korea: Cross‐sectional study

AbstractBackgroundThe decline of cognitive function is common in the elderly. However, it should not be overlooked as it could be a risk factor for mild cognitive impairment or dementia in the future. The purpose of this study was to evaluate the cognitive function of the elderly without dementia in Korea.MethodsThe subjects were 274 elderly (78 males and 196 females) without dementia living in some areas of Korea. The cognitive function of the subjects was evaluated using the Mini‐Mental State Examination for Dementia Screening (MMSE‐DS), and compared by gender, age, educational period. In addition, the proportion of subjects below the criteria score based on demographic information of MMSE‐DS was evaluated, which indicates the possibility of developing mild cognitive impairment or dementia in the future. All data were collected through the face‐to‐face examination from 2015 to 2020, and statistical analysis was performed using SPSS 26.0.ResultsThe total MMSE‐DS score of subjects was good at 24.9 points, but scores of female elderly were significantly lower than those of male elderly in total score, place orientation, attention, and language (p&lt;0.05). The scores of the elderly aged over 80 were significantly lower than those of the elderly aged 65‐69 and 70‐79 in total score, time orientation, place orientation, and language (p&lt;0.001). The total score of the uneducated elderly was significantly lower than that of the elderly who graduated from elementary, middle, and high school (p&lt;0.001). The proportions of subjects below the criteria score of MMSE‐DS were 16.4% in all subjects, 20.5% in male elderly, and 14.8% in female elderly. The proportions were 12.9 to 20.6% by age and by education period. The total MMSE‐DS score of the subjects was shown to be positive correlations with age and education period (p&lt;0.001).ConclusionsThese results showed that cognitive function were lower in female elderly, the elderly aged over 80, and uneducated elderly, and proportions of the elderly with a high risk of dementia were 10 to 20% of the all subjects. Therefore, it is necessary to prepare measures such as regular mental health screening for early detection and preventive management of dementia in the elderly.

Reference interval and the role of plasma oligomeric beta amyloid in screening of risk groups for cognitive dysfunction at health checkups

BackgroundAlzheimer's disease (AD) has a prolonged preclinical stage characterized by cognitive dysfunction. Simple, reliable, and noninvasive biomarkers reflecting the pathogenesis of AD are needed for screening cognitive dysfunction in primary health care. The aims of this study were to determine (1) the potential utility of the Multimer Detection System‐Oligomeric Amyloid‐β (MDS‐OAβ) value in cognitive assessments and (2) the reference interval (RI) of plasma MDS‐OAβ values in the general population.MethodsThis prospective study consecutively recruited 1,594 participants who underwent health checkups including cognitive function examination at 16 health‐promotion centers in Korea between December 2020 and January 2021. The inBloodTM OAβ test (PeopleBio, Gyeonggi‐do, Republic of Korea) was utilized to quantify MDS‐OAβ values in plasma. The reference subjects were obtained among those with normal general cognition on cognitive screening tools. RIs were established according to the CLSI C28‐A3 guidelines.ResultsThe median MDS‐OAβ value was higher in subjects with Korean Dementia Screening Questionnaire‐Cognition (KDSQ‐C) scores ≥8 than in those with KDSQ‐C scores of 6–7 (P = 0.013). The median MDS‐OAβ value was higher in subjects with Mini‐Mental State Examination for Dementia Screening (MMSE‐DS) scores of 21–26 than in those with MMSE‐DS scores ≥27 (P = 0.011). The RI (one‐side upper 95th percentile) of the MDS‐OAβ value was 0.80 ng/mL (95% confidence interval = 0.78–0.82) in those aged ≥50 years.ConclusionsThe plasma MDS‐OAβ value reflects cognitive function as assessed using the KDSQ‐C and MMSE‐DS. RIs obtained from a large and cognitively healthy community‐based sample are presented.

EFFECT OF LOWER LIMB EXERCISE ON POSTURE STABILITY AND BRAIN ACTIVITY DURING WHOLE BODY VIBRATION FOR THE ELDERLY

This study aimed to investigate the effect of lower limb exercise on electroencephalogram (EEG) activity and posture stability during whole body vibration (WBV) for healthy elderly people. Subjects were composed of 20 elderly people who were over 60 years old and had no disease. They were subjected to WBV of 30[Formula: see text]Hz and strength intensity of 20 (total 5 sets, 20[Formula: see text]s/set, rest time: 20[Formula: see text]s, except for the final set). The subjects were grouped into two groups. One group of 11 subjects was WBVSt (WBV of upright stance) and the other group of nine subjects was WBVSq (WBV of squat posture). In the WBVSt group, the subjects were requested to maintain a standing position, whereas those in the WBVSq group were asked to perform 60∘-knee flexion squat at 2[Formula: see text]s intervals during WBV stimulation. In this study, the electromyography (EMG) was measured on the right and left erector spinae, rectus femoris, vastus lateralis, vastus medialis, tibialis anterior to evaluate lower limb muscle activity and postural stability during timed up and go (TUG) test before and after WBV. The EEG was measured on frontal (F3, F4, F7, F8), central (Cz, C3, C4), temporal (T3, T4, T5, T6), parietal (P3, P4), and occipital (O1, O2) lobes to evaluate brain activity during the check of mini-mental state examination for dementia screening (MMSE-DS) before and after WBV. The results of this study showed improved postural stability and muscle activation for the healthy elderly during lower limb and WVB exercises. The WBVSq group showed higher changes in TUG-test ([Formula: see text]) and iEMG analysis by EMG ([Formula: see text]) compared with the WBVSt group. However, there was no significant change in MMSE-DS ([Formula: see text]). Because of the increase in relative SMR power by EEG, the central (C4), frontal (F7) and parietal (P3, P4) lobes were activated in WBVSt group ([Formula: see text]); however, all regions, except the parietal lobe, were activated in WBVSq group ([Formula: see text]). Lower limb exercise with WBV stimulation improved postural stability, lower limb muscle, and brain activation for the elderly. These results may be helpful to the protocol of exercise using WBV for the healthy elderly.

More Teeth and Posterior Balanced Occlusion Are a Key Determinant for Cognitive Function in the Elderly.

Age-related decline in cognitive function is a major challenge in geriatric healthcare. A possible explanation is that the tooth loss or low chewing ability is at cause of cognitive impairment or dementia. The study aimed to investigate the potential relationship between chewing ability and cognitive function in the elderly. A total of 563 participants aged 65 years or over residing in urban and rural areas of South Korea were surveyed. The chewing ability was measured by objectively measurable indications such as the number of remaining teeth, denture status, color-changeable gum, and occlusal balance using T-Scan III®. The cognitive function was measured by the Korean version of Mini-Mental State Examination-Dementia Screening (MMSE-DS) and a score of 24 or more (out of 30) indicates a normal cognition, below 23 indicates cognitive impairment. The association between socio-demographic factors, chewing ability factors, and cognitive function demonstrated statistically significant results. When comparing the denture status and chewing ability, the proportion of need denture group had fewer remaining teeth and anterior balanced occlusion. The average number of remaining teeth in anterior balanced occlusion with cognitive impairment was 11.2 compared to posterior balanced occlusion with the normal cognition 19.2. A multiple linear regression analysis declared a significant correlation between number of remaining teeth, denture status, occlusal balance, and cognitive function. Results of the present study revealed objectively measurable indications are suitable for chewing ability assessment and correlated with cognitive function.

Cognitive Intervention with Musical Stimuli Using Digital Devices on Mild Cognitive Impairment: A Pilot Study

The effect of music therapy on cognitive function has been widely reported; however, its clinical implications remain controversial. Performing therapeutic musical activities in groups using individualized instruments can help overcome the issues of engagement and compliance. We aimed to evaluate the effect of a cognitive intervention with musical stimuli using digital devices on mild cognitive impairment (MCI). In this prospective study, 24 patients with MCI (intervention group, 12; and control group, 12) were enrolled. We developed an electronic device with musical instruments and the Song-based Cognitive Stimulation Therapy protocol (SongCST). Patients in the intervention group underwent a 10-week cognitive intervention involving musical stimuli generated by our device. Effect of the intervention on cognitive function was evaluated by the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Montreal Cognitive Assessment-Korean (MOCA-K), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB). In the intervention group, MMSE-DS and MOCA-K scores improved significantly after the 10-week intervention. The changes in MOCA-K and CDR-SB scores were significantly different between the intervention and control groups. Our study showed that music therapy with digital devices has a positive effect on the executive function and overall disease severity in patients with MCI. Our study can facilitate individualization of music therapy using digital devices in groups.

Home-Visiting Cognitive Intervention for the Community-Dwelling Elderly Living Alone.

Background and PurposeThe elderly living alone feel lonelier and more isolated than do those live with others, and they are at higher risk for cognitive decline and depression. This study aimed to assess whether a home-visiting cognitive intervention (HCI) can have positive effects on cognitive improvement for the elderly who living alone.MethodsHCI was conducted from April 2016 to November 2019. Every elder who lived alone and 2 matched partners met for 8 weeks once a week. The partners visited participants' home and did the HCI which composed of cognitive training and cognitive stimulation activities. The Mini-Mental State Examination-dementia screening (MMSE), Geriatric Depression Scale (GDS), the Korean version of instrumental activities of daily living (K-IADL), and the Social Support Scale (SSS) were evaluated before and after HCI to compare the effect of HCI.ResultsA total of 258 participants showed significant improvements in MMSE, GDS, K-IADL, and SSS. The MMSE and GDS scores were significantly improved after HCI in both the normal cognition (NC, n=210) and cognitive impairment (CI, n=48) groups. The cognitive effect of HCI for CI was higher than for NC. Among the NC, the magnitude of cognitive improvement was greater in the higher educated group (above 7 years) than in the other groups.ConclusionsActive cognitive interventions could provide possible benefits to improve cognition, emotion, and functional abilities. Regular cognitive-care services like HCI are necessary to reduce dementia risk for the elderly who live alone in the community.

Effects of Multicomponent Exercise on Cognitive Function in Elderly Korean Individuals.

Background and PurposeThe aim of this study was to investigate the effects of multicomponent exercise on cognitive function, depression, and quality of life in elderly individuals.MethodsThis study prospectively recruited 605 participants, and constructed an exercise pyramid comprising even distributions of daily physical activities, aerobic exercise, muscle-strengthening exercise, flexibility exercise, balance exercise, and activities that subjects could perform while sitting down. The exercise program was divided into six stages according to the participant's level of frailty. The 12-week exercise program intervention was conducted once yearly.ResultsThe exercise regimen was followed by 402 of the 605 enrolled participants, giving a dropout rate of 33.6%. The 27-month exercise program was completed by 60 participants. The scores for the Mini Mental State Examination for dementia screening (MMSE-DS), short form of the Geriatric Depression Scale, World Health Organization Quality of Life Assessment (WHOQOL-BREF), International Physical Activity Questionnaire (IPAQ), fear of falling, handgrip strength, and walking speed were improved after the exercise intervention. The analysis of frailty revealed that participants in the frail group showed greater improvements for the MMSE-DS, WHOQOL-BREF, IPAQ, fear of falling, handgrip strength, and walking speed.ConclusionsIndividually customized, multicomponent exercise programs lead to improved levels of cognitive function, depression, and quality of life, especially among those who are more frail.

Effectiveness of integrative medicine program for dementia prevention on cognitive function and depression of elderly in a public health center

BackgroundThis study investigated the effectiveness of an integrative medicine program (IMP) for dementia prevention on cognitive function, depression and quality of life (QOL) of elderly in a public health center. MethodsThis study employed a before-after study design to assess effectiveness of the IMP for dementia prevention for community dwelling elderly over 60 without diagnosis of dementia. Cognitive function was measured using the Mini Mental State Examination for Dementia screening (MMSE-DS), digit span test (DST) and trail making test (TMT). The Geriatric Depression Scale Short Form- Korean version (GDSSF-K) and EQ-5D were used to evaluate depression and health-related quality of life. The IMP composed of acupuncture, moxibustion, physical activities, meditation, laughter therapy and music therapy was held once a week over 8 weeks. A paired t-test was used to compare the pre and post-test results. ResultsAfter screening 93 people, a total of 48 were included in the analysis. Evaluation of the cognitive function revealed that TMT-A (p=0.028) and TMT-B (p=0.0013) were significantly reduced, but MMSE-DS (p=0.309) and DST (DSF: p=0.855, DSB: p=0.176) were not statistically significant. Depression (p<0.01) and preventive behavior for dementia (p<0.0001) of the participants were improved after the IMP. ConclusionThe IMP for dementia prevention may have beneficial effects on cognitive function and depression of elderly. However, a well-designed follow-up study is needed to confirm this conclusion.

The Utility of Subset of Subjective Memory Complaint Questionnaire and Mini-Mental State Examination for Dementia Screening

Objective：Purpose of this study was to assess the potential added values of Subjective Memory Complaint Questionnaire (SMCQ) combined with Mini-Mental State Examination (MMSE) in developing a brief screening battery to improve the early detection rate of dementia in community setting. Methods：Non-depressed community-dwelling Korean elderly aged 65 years and older who 945 randomly selected and 734 voluntarily involved were recruited. Dementia was diagnosed using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. Diagnostic ability of 10 point SMCQ subscale for everyday memory (SMCQ-E) for dementia was eval- uated. Additive values of SMCQ-E combined with MMSE for dementia screening and the economic benefits of SMCQ-E and its combination with MMSE were also evaluated. Results：Overall area under the curve values of SMCQ-E were 0.605 (0.565-0.646) for nonrandom sample and 0.836 (0.783-0.890) for random sample. When SMCQ-E was combined with MMSE using ‘AND’ rule, accuracy, specificity, positive predictive values and positive likelihood ratio were increased than those of MMSE. While SMCQ-E was combined the MMSE using ‘OR’ rule, sensitivity and negative predictive values were increased and negative likelihood ratio were decreased than those of SMCQ-E and MMSE. When SMCQ-E and MMSE combined with AND rule, total cost for dementia screening was reduced to about 80% compared to MMSE single use model. Conclusion：Results of this study showed that brief SMCQ-E and its combination with MMSE could be used to dementia screening with cost effective manner.

Associated factors for cognitive impairment in the rural highly elderly.

BackgroundAmong the symptoms commonly faced by an increasingly aged population, dementia, preceded by cognitive impairment, most threatens their quality of life. Dementia is a well‐recognized burden, not only for individuals who face the disease and for their families, but also for entire nation.AimsThe purpose of this study was to identify associated factors for cognitive impairment in a very elderly population via a screening study design in Sokcho, a rural area in South Korea.MethodsTrained nurses screened patients from 75–84 years of age for dementia using the Mini‐Mental State Examination for Dementia Screening (MMSE‐DS) and conducted interviews to determine their socioeconomic status, education level, and living conditions (i.e., with or without family).ResultsIn total, 4,369 subjects (1,646 males, 2,723 females) were enrolled in this study. Reported MMSE‐DS scores decreased with increasing age and to a greater degree in less educated subjects (p < 0.001). Subjects requiring medical assistance or living alone exhibited lower MMSE‐DS scores compared to those who did not require medical assistance or who lived alone (p < 0.001).ConclusionWe found that less education, lower socioeconomic status, and living alone were associated factors for cognitive impairment based on this study of an elderly population.

Taekwondo Enhances Cognitive Function as a Result of Increased Neurotrophic Growth Factors in Elderly Women.

The purpose of this study was to investigate the effects of regular taekwondo (TKD) training on physical fitness, neurotrophic growth factors, cerebral blood flow (CBF) velocity, and cognitive function in elderly women. Thirty-seven women aged 65 or older were randomly assigned to either TKD (n = 19) or control (n = 18) group. TKD training was performed at 50–80% maximum heart rate (HRmax) for 60 min, five times per week for 16 weeks. All participants underwent the following examinations before and after the intervention: Senior Fitness Test; serum levels of neurotrophic growth factors, including brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1); systolic, diastolic, and mean blood flow velocity and pulsatility index of the middle cerebral artery using Doppler ultrasonography; Mini-Mental State Examination for dementia screening (MMSE-DS); and Stroop Color and Word Test (word, color, and color-word). In the TKD group, lower body strength and flexibility, aerobic endurance levels, BDNF, VEGF, and IGF-1 serum levels as well as the color-word test scores were significantly increased after as compared to before the intervention (p < 0.05). No statistically significant differences were found in cerebral blood flow velocities and the MMSE-DS score (p > 0.05). These findings suggest that regular TKD training may be effective in improving not only fitness but also cognitive function in elderly women. The latter effect may be due to increased neurotrophic growth factor levels.

The Effect of Multi-tasking Exercise Intervention on Cognitive Function in Elderly and Cognitive Impairment Patients: a Pilot Multicenter Study.

Background and PurposeThe purpose of this study was to investigate the impact of multi-tasking exercise on cognitive and motor function in patients with mild cognitive impairment (MCI) and cognitive normal elderly (CNE).MethodsA total of 144 subjects were recruited from 14 regional dementia centers in Busan Metropolitan City. With the exception of 77 subjects unsuitable for the study, 67 subjects participated in the intervention. The Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Subject Memory Complain Questionnaire (SMCQ), and the Korean version of the Short-Form Geriatric Depression Scale (SGDS-K) were used to determine changes in cognitive function and depressive symptoms pre-post intervention in patients with MCI and CNE, respectively. To observe changes in motor function, 5-chair sit to stand and 5-meter walking speed on the lower body strength and walking ability were also measured in both groups.ResultsFor the MCI group, changes in cognitive and depressive symptoms on the tasks of MMSE-DS (p=0.006), SMCQ (p=0.000), SGDS-K (p=0.000) and the result of the motor function analysis on the items of 5-chair sit to stand (p=0.000), normal speed (p=0.004) and maximal speed (p=0.002) of 5-meter walking speed (p<0.005). In the CNE group, all the items except MMSE-DS (p=0.068) and SGDS-K (p=0.095) showed statistically significant improvement.ConclusionsMulti-tasking exercise intervention, including exercise and cognitive tasks, may possibly improve the cognitive and motor function in patients with MCI and CNE.

Cognitive impairment is associated with elevated serum homocysteine levels among older adults.

The aim of this study was to examine the associations between the risk of cognitive impairment and the serum levels of folate, vitamin B12, and homocysteine (Hcy). Subjects were persons aged 60-79years who participated in the Yangpyeong Cohort study between 2011 and 2012. Cognitive impairment and normal subjects consisted of 100 pairs of old adults matched by age, sex, and education levels. Cognitive function was evaluated with the Korean version of the Mini-Mental State Examination for Dementia Screening (MMSE-DS). Pearson's partial correlation coefficients and conditional multiple logistic regression analysis were applied to determine the associations between cognitive function and the serum levels of folate, vitamin B12, and Hcy. Compared with the matched normal group, the cognitive impairment group had higher proportions of folate deficiency (< 3ng/mL) and hyperhomocysteinemia (≥ 15µmol/L). Serum Hcy concentrations were inversely associated with serum folate (r = - 0.234, p = 0.001) and MMSE-DS score (r = - 0.150, p = 0.037) after adjusting for age, sex, and education. The high Hcy group showed a higher prevalence of cognitive impairment (4th vs. 1st quartile, OR 3.30, 95% CI 1.12-9.72, p for trend = 0.014) after adjusting for exercise. The present findings suggest a putative protective role of high serum folate and normal Hcy against cognitive impairment among older adults.

Relationship between chewing ability and cognitive impairment in the rural elderly

ObjectiveRelationship between masticatory function and cognitive impairment had been suggested but still understudied. We investigated the association between chewing ability and cognitive impairment among the elderly living in a rural region. MethodsA total of 295 elderly individuals aged ≥70 years in a rural city of Korea participated in a cross-sectional study. Trained nurses conducted interviews and assessed chewing ability using gum that changed color based on chewing performance. Cognitive impairment was assessed using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) of Korean vesrsion. Socio-demographic characteristics, activities of daily living (ADL), Mini-Nutritional Assessment (MNA) were also assessed using questionnaires as potential confounders. ResultsThe mean age of the participants was 81.4 (ranged 70–102) years and 67.8% of them were female. Participants with low chewing ability were significantly older, dependent, and had lower MNA and MMSE-DS scores. The elderly with middle or low chewing ability had significantly higher risk for having cognitive impairment than those with higher chewing ability. ConclusionOur findings suggest that poor chewing ability is associated with cognitive impairment or dementia in the elderly living in rural area.

The Effect of Dangguijagyag-san on Mild Cognitive Impairment.

The aim of this study was to evaluate the safety and the effect of dangguijagyag-san (DJS) on mild cognitive impairment (MCI). This study examined the administration of DJS ([Formula: see text]; angelica and peony formula) and was conducted at Uijeongbu Health Center in Gyeonggi-do, Korea, in 2013. Ninety-five of 118 patients diagnosed with MCI were followed up for 1 year after the study ended, and their medical records were analyzed. The patients included 36 men (37.9%) and 59 women (62.1%). When the results from before the study began were compared with the results 1 year after the study ended, the overall average score according to the Korean-Montreal Cognitive Assessment (K-MOCA) showed a statistically significant increase, from 15.46 ± 5.30 to 18.54 ± 5.11, respectively. Both male and female patients recorded a significant increase in K-MOCA scores for all sections, including the visuospatial/executive section, the naming section, the attention section, the language section, the abstraction section, the delayed recall section, and the orientation section. Scores assessed by the Mini-Mental State Examination for Dementia Screening (MMSE-DS) showed a statistically significant increase, from 21.84 ± 3.59 before the study to 24.43 ± 3.13 after the study, but decreased slightly to 23.04 ± 3.36 at the 1-year follow-up. However, MMSE-DS scores measured before the study began increased significantly when compared with scores measured 1 year after the study ended. DGJYS improved the cognitive skills of patients diagnosed with MCI, and no adverse effects were observed. In the future, the efficacy of DGJYS must be objectively verified by using a randomized controlled trial.

Food and nutrient intake status of Korean elderly by degree of cognitive function

Purpose: This study was conducted to examine the relationship among cognitive function, nutrition screening initiative (NSI) score, and food intake status. Methods: A total of 409 subjects aged over 60 years were recruited from the Yongin dementia prevention and control center. Mini Mental State Examination Dementia Screening (MMSE-DS) method was used to assess the cognitive function of the subjects. Information on health related behaviors and food intake was collected by face to face interview using a structured questionnaire. The questionnaires included the NSI DETERMINE checklist, food intake sheets by 24 hr recall method and by semi-quantified food frequency questionnaire. Results: Subjects were divided into low cognitive or normal groups according to the MMSE-DS result. The prevalence of low cognitive function in the subjects was 25.7%. The low cognitive group exercised less and had higher nutritional health risk than the normal group. The low cognitive group had lower consumption of polyunsaturated fatty acid and higher tendency of thiamin, riboflavin, and iron deficiency. The low cognitive group had less frequency of eating mackerel, pepper, tangerine, and watermelon and higher frequency of eating white rice and cookies than the normal group. Conclusion: The results of this study imply that the cognitive function of elderly is related to exercise behavior, nutritional health risk, and food and nutrient intake status.

Fruit and Vegetable Consumption is Inversely Related to Mild Cognitive Impairment among Older Adults

Objective:This study was conducted to investigate the association between fruit and/or vegetable consumption with the risk of mild cognitive impairment (MCI) in Korean older adults.Methods:Subjects were 729 (307 men and 422 women) older adults aged 60 years and older participating in the Yangpyeong Cohort Study between 2011 and 2012. Dietary intake was estimated by using a food frequency questionnaire. Cognitive function was evaluated by Korean version of Mini‐Mental State Examination for Dementia Screening (MMSE‐DS). Multiple logistic regression analysis was applied to determine the associations between ‘Fruit', ‘Vegetable' and ‘Fruit and Vegetable' consumptions and the risk of MCI.Results:Age, depression score, proportions of current drinker and smoker decreased across the quintiles of ‘Fruit', ‘Vegetable' and ‘Fruit and Vegetable', but body mass index (BMI), total energy intake, fish consumption, proportion of higher education level and dietary supplement user increased across the quintiles of ‘Fruit', ‘Vegetable' and ‘Fruit and Vegetable'. ‘Fruit' (5th v. 1st quartile, OR = 0.46, 95% CI = 0.24‐0.88, p for trend = 0.081) and ‘Fruit and Vegetable' (5th v. 1st quartile, OR = 0.42, 95% CI = 0.21‐0.84, p for trend = 0.029) intakes were inversely related to the risk of MCI after adjusting for potential confounder.ConclusionsThe present findings suggest that high intakes of fruits and vegetables, but not vegetable, may have a beneficial effect on the prevention of MCI.