Biomedical subjects

Jae-Min Kim

Publications and source records attributed to Jae-Min Kim.

35 records · Page 2Linked to original sources

PubMed2004

Assessment of association between mitochondrial aldehyde dehydrogenase polymorphism and Alzheimer's disease in an older Korean population.

BACKGROUND: The mutant allele of mitochondrial aldehyde dehydrogenase (ALDH2(*)2) was found to be associated with Alzheimer's disease (AD) in a Japanese sample, interacting with the apolipoprotein E epsilon 4 allele (Apo E4). OBJECTIVE: In a community Korean population we sought to investigate associations between ALDH2 genotypes and the following outcomes: cognitive impairment, previous cognitive decline, dementia and AD. METHODS: Six hundred ninety community residents aged 65 or over were assessed for demographic characteristics, drinking behaviour, cognitive function, clinical diagnoses of dementia and AD, physical health status, and genotype (ALDH2 and Apo E). RESULTS: There were no significant associations between the ALDH2(*)2 and any cognitive outcome, before or after adjustment for alcohol-related characteristics. These findings were consistent both in the non-drinkers and drinkers. Interaction between ALDH2 and Apo E was only found for one outcome (previous cognitive decline) at borderline levels of significance (P=0.058). CONCLUSIONS: Overall, these findings in a community population did not support a substantial role for ALDH2 genotype in the aetiology of dementia.

Acetaldehyde↗

PubMed2004

Vascular disease/risk and late-life depression in a Korean community population.

BACKGROUND: Associations between vascular risk factors and late-life depression are controversial. AIMS: To investigate the association between measures of vascular disease/risk and depression and confounding and effect modification by APOE genotype and cognitive function. METHOD: In a Korean community population aged 65+ (n=732), diagnosis of depression (Geriatric Mental State Schedule) and information on vascular status, disability, APOE genotype and cognitive function were obtained. RESULTS: Previous stroke and lower high-density lipoprotein cholesterol level (but neither hypertension nor diabetes) were significantly associated with depression (independently of disability and cognitive function). These associations were stronger in participants with borderline cognitive impairment, although not to a significant extent. CONCLUSIONS: Except for previous stroke and an atherogenic lipid profile, associations between depression and other common risk factors for cerebrovascular disease were not evident.

Aged↗

PubMed2003

Diagnosing dementia in a developing nation: an evaluation of the GMS-AGECAT algorithm in an older Korean population.

BACKGROUND: Numbers of older people are increasing rapidly in many developing nations and there is a pressing need for epidemiological studies of psychiatric morbidity, particularly dementia. Valid methods for case identification are an important first step. The Geriatric Mental State (GMS) is a widely used diagnostic instrument but has received little formal evaluation in developing nations. The objective of this study was to investigate the screening properties of GMS organic disorder with respect to clinically diagnosed dementia in an older Korean population, about half of whom have received no formal education. METHODS: 746 people aged 65+ in Kwangju, South Korea who were participants in a community survey of psychiatic morbidity, completed a GMS interview (with diagnoses assigned through the AGECAT computerised algorithm) and, independently, received a clinical assessment for dementia. RESULTS: GMS organic disorder was diagnosed in 262 participants (35%) and DSM-IV dementia in 110 (15%). Increased age, female gender and lower education independently predicted disagreement between the two diagnoses. In these groups, GMS sensitivity to a clinical diagnosis of dementia remained high but specificity was markedly reduced. CONCLUSIONS: Dementia may be overestimated in developing nations if the GMS-AGECAT diagnosis of organic disorder is used alone. The validity of other diagnoses, such as affective disorder, may also be affected if the hierarchical diagnostic algorithm is used (i.e. where the diagnosis of organic disorder affects the likelihood of other diagnoses).

Aged↗

PubMed2003

Differences in the behavioral and psychological symptoms between Alzheimer's disease and vascular dementia: are the different pharmacologic treatment strategies justifiable?

BACKGROUND: This study aimed (1) to compare the behavioral and psychological symptoms of dementia (BPSD) between patients with Alzheimer's disease (AD) and vascular dementia (VaD); (2) to investigate the differences in the correlates of BPSD between them; and (3) to suggest potential different pharmacological strategies in treating BPSD of either etiology. METHODS: In a study group of 135 patients with dementia (99 AD, 36 VaD), information on age, gender, education, age at onset and duration of dementia was collected. The severity of dementia was measured by the following assessment scales: Korean version of Mini-Mental State Examination (MMSE-K) for cognitive function; Blessed Dementia Scale (BDS) for functional activities of daily living (ADL); Barthel Index (BI) for physical ADL; and Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Scale (HAM-D) and Hamilton Anxiety Scale (HAM-A) for BPSD. The independent variables between the patients with AD and VaD were compared, and then the correlations of BPSD with other variables were estimated. RESULTS: HAM-D and HAM-A scores were higher in patients with VaD than in those with AD, while other variables demonstrated no statistical differences. BPRS score correlated with scores on MMSE-K, BDS and BI in AD, but only with BDS in VaD. The HAM-D score correlated with scores on BDS and BI in AD, but only with BDS in VaD. The HAM-A score was correlated with score on BDS in AD not in VaD. CONCLUSIONS: BPSD were more severe in the patients with VaD. However, BPSD correlated more prominently with cognitive or ADL impairments in patients with AD. Different treatment approaches to BPSD may be required according to the clinical differentiation of dementia type.

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PubMed2003

Risperidone use in Korean patients with Alzheimer's disease: optimal dosage and effect on behavioural and psychological symptoms, cognitive function and activities of daily living.

BACKGROUND: This study aimed to investigate the effect of risperidone on the behavioural and psychological symptoms (BPS), cognitive function and activities of daily living (ADL) of Alzheimer's disease (AD). The optimal dose of risperidone in Korean patients with AD was determined with respect to both efficacy and safety profiles. METHODS: This was an 8 week prospective, open-labelled study with risperidone. The following efficacy measures were implemented: Behaviour Pathology in Alzheimer's Disease Rating Scale, Korean version for BPS; Korean version of mini-mental state examination for cognitive function; Barthel activities of daily living and blessed dementia rating scale for ADL; and global deterioration scale for global assessment of severity. Adverse events were recorded using the UKU side effect rating scale. RESULTS: Forty-eight patients completed the study. Risperidone was effective in reducing the BPS without affecting the cognitive and ADL domains of AD symptomatology. Risperidone dosages of 0.25 or 0.5 mg/day were most frequently administered and demonstrated the most favourable outcomes by efficacy and safety measures. Risperidone treatment was generally well tolerated, although extrapyramidal symptoms were noted in a dose-dependent manner. CONCLUSIONS: These results suggest that low dosages of risperidone are effective and favourable in reduction of the BPS for Korean patients with AD.

Activities of Daily Living↗

PubMed2003

Education and the association between vascular risk factors and cognitive function: a cross-sectional study in older Koreans with cognitive impairment.

BACKGROUND/OBJECTIVE: The association between hypertension, diabetes, and worse cognitive function has been reported to be stronger in groups with low levels of education. Using data from a cross-sectional community survey of Korean elders, we sought to investigate this within a sample with relative cognitive impairment. METHODS: The sample consisted of 341 participants with Mini-Mental State Examination (MMSE) (Korean version) scores of 24/30 or below. Previous diagnoses were ascertained and participants were examined for resting blood pressure and nonfasting blood glucose and cholesterol. RESULTS: After adjustment for age, occupation, physical dependence, and cholesterol levels, worse cognitive function (MMSE score <21) within the sample was associated with raised systolic blood pressure, raised glucose levels, and a previous diagnosis of diabetes. These associations were significant only in participants with no formal education. In this group the adjusted odds ratios for worse cognitive function were 1.18 (95% confidence interval [CI] 1.04-1.34) for each 10 mmHg increase in systolic blood pressure and 3.47 (1.14-10.6) for a previous diagnosis of diabetes. Odds ratios for the group with previous education were 0.99 (0.81-1.21) and 1.82 (0.48-6.92), respectively. CONCLUSION: The association between risk factors for cerebrovascular disease and cognitive impairment appears to be particularly strong in people with lower educational attainment.

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PubMed2003

Subjective memory impairment, cognitive function and depression--a community study in older Koreans.

Correlates of subjective memory impairment (SMI) were investigated using data from a community study of 1,204 individuals aged 65 or over in an urban and rural area of South Korea. SMI and depression were ascertained from the Geriatric Mental State Schedule and cognitive function from the Korean version of the Mini-Mental State Examination (MMSE-K). 686 participants had also completed the MMSE-K two years earlier. SMI was present in 22% of the sample and was associated with depression and lower MMSE-K scores. Depression and SMI were most strongly associated in the presence of cognitive impairment. SMI was weakly associated with previous cognitive decline and was not associated with APOE e4. SMI and cognitive impairment were most strongly associated in urban residents, particularly rural-to-urban migrants.

Aged↗

PubMed2002

Predictors of institutionalization in patients with dementia in Korea.

BACKGROUND: Many studies have sought to determine the predictors of institutionalization of patients with dementia. Such studies, performed in developed western societies, have come to various conclusions which may not be supported in an East Asian culture such as that found in Korea. OBJECTIVES: This study aimed to determine the factors that predict institutionalization of patients in Korea diagnosed with dementia. METHODS: Seventy-nine cases (37 institutionalized, 42 community-dwelling) in the Kwangju area were evaluated for patient characteristics, severity of dementia symptoms, caregiver characteristics, burden and distress. Logistic regression was performed to determine predictors of actual institutionalization. RESULTS: Six predictors of institutionalization were identified. Of these, three were patient-related factors: higher score on the Clinical Dementia Rating, higher score on the Brief Psychiatric Rating Scale, and shorter duration of dementia. The other three were caregiver-related factors: younger age, higher education (formal schooling), and higher cost of home care. CONCLUSIONS: As seen in previous western studies, institutionalization of dementia sufferers was influenced by both patient and caregiver factors. But, the specific predictors and their relative influences might be explained best by the particular social, cultural and economic situation in Korea. This study was the first of its kind in Korea and, as such, could serve as a reference for future intra-cultural and cross-cultural comparisons.

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PubMed2002

Previous stroke but not vascular risk factors are associated with depression in a cognitively impaired older Korean population.

BACKGROUND: Depression is frequently associated with dementia and mild cognitive impairment. Cerebrovascular disease may be an important aetiological factor for depression in the context of cognitive impairment but has received little investigation in population-based research. OBJECTIVES: To investigate the association between vascular disease/risk and depression in an older Korean population with cognitive impairment. METHODS: The sample consisted of 341 persons, drawn from a community study in Kwangju, South Korea, all aged 65 or over and with scores of 24 or below on the Korean version of the Mini-Mental State Examination. Depression (Hamilton Rating Scale for Depression), vascular disease/risk (interview, examination and blood tests), and disablement were ascertained. RESULTS: Previous stroke was associated with depression (Odds Ratio 3.4, 95% Confidence Intervals 1.6-7.4). This association was weaker in the presence of more severe cognitive impairment and higher levels of dependency. No associations were found between depression and any other measures of vascular risk. CONCLUSIONS: In the absence of previous stroke, a role of vascular disease/risk was not supported in the aetiology late-life depression.

Aged↗

PubMed2002

Prevalence and correlates of late-life depression compared between urban and rural populations in Korea.

BACKGROUND: The aetiology of late-life depression has received relatively little research in developing countries. Urban and rural populations have rarely been sampled in the same study. OBJECTIVES: To investigate demographic factors associated with depression and depressive symptoms in an urban and rural sample of older Korean people. METHODS: A community survey of residents aged 65 or over was conducted in an urban and a rural area within Kwangju, South Korea. The Korean Form of the Geriatric Depression Scale (KGDS) was administered. Associations with demographic, socio-economic factors and cognitive function (MMSE) were investigated for depression categorised according to a previously validated cut-off. RESULTS: The sample comprised 485 urban-dwelling and 649 rural-dwelling participants. No difference was found between urban and rural samples for prevalence rates of depression. However associations with independent variables varied between the areas. In the urban sample, increased age, low education, manual occupation and current rented accommodation were independently associated with depression. Only low education was associated with depression in the rural sample. The interaction with sample area was strongest for age (p < 0.01) and persisted after further adjustment for cognitive function. CONCLUSIONS: Adverse socio-economic status was strongly associated with depression and appeared to operate across the life-course. While no evidence was found for urban-rural differences in prevalence rates of depression, factors associated with depression differed between these populations.

Aged↗

PubMed2002

Alcoholism in older Korean men: prevalence, aetiology, and comorbidity with cognitive impairment and dementia in urban and rural communities.

BACKGROUND: Alcoholism in the elderly has received little research, particularly outside 'Western' cultures. OBJECTIVES: This study aimed to investigate the prevalence and aetiology of alcoholism, and its comorbidity with cognitive impairment and dementia in an older Korean population. METHODS: 1134 urban and rural community residents aged 65 or over were surveyed in Kwangju, South Korea. Alcoholism was identified by a culturally validated screening scale. RESULTS: Alcoholism was present in 16% of men and 2% of women. In men (n = 457), alcoholism was positively associated with manual occupation and negatively with religions encouraging temperance. In the urban sample, alcoholism was associated with higher education and with dementia. In the rural sample, it was associated with lower education and less strongly with dementia. CONCLUSIONS: The prevalence of alcoholism was high in this population. Associated factors and urban/rural differences reflect traditional attitudes toward drinking.

Aged↗

PubMed2002

Correlates of dropout, efficacy, and adverse events in treatment with acetylcholinesterase inhibitors in Korean patients with Alzheimer's disease.

The correlates of dropout, efficacy, and adverse events in the treatment of Alzheimer's disease (AD) with acetylcholinesterase inhibitors (ChEI) are unclear. To investigate these issues, a 26-week prospective, randomized, open-labeled trial with donepezil or rivastigmine was undertaken. Sixty-four Korean patients with AD were recruited, and data on sociodemographic and clinical characteristics and several assessment scales were collected. Characteristics of available caregivers were also gathered. Information on adverse events and dropout was recorded. Thirty-five (55%) patients dropped out during treatment with ChEI, for reasons mainly related to financial burden of caregivers. Of the 29 patients who completed the 26-week trial, 16 (55%) were responsive to ChEI. Lower scores on the Clinical Dementia Rating and Blessed Dementia Scale at baseline were associated with the efficacy of ChEI. Of the total participants, 26 (41%) experienced adverse events, although these seemed to be mild and appeared to be associated with the psychological state of patients or coadministration of psychotropic drugs. In conclusion, ChEI seemed to be effective and well tolerated in the treatment of Korean patients with AD, but the use of this drug was limited mainly by the financial burden of caregivers.

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PubMed2002

Apolipoprotein E among Korean Alzheimer's disease patients in community-dwelling and hospitalized elderly samples.

This study evaluated the association of the apolipoprotein E epsilon4 allele (epsilon4) with Alzheimer's disease (AD) and investigated the relationships of epsilon4 with clinical characteristics of AD in both community-dwelling and hospitalized Korean elderly populations. The apolipoprotein E genotypes were compared between a group of 52 community-dwelling patients with AD (C-AD), a group of 52 hospitalized patients with AD (H-AD) and a group of 52 healthy controls matched to C-AD. Clinical characteristics and scores on several assessment scales were compared between C-AD and H-AD as well as between two subgroups within each AD group: those with epsilon4 and those without epsilon4. For H-AD, the assessment scales were administered again 6 months later, and the temporal course of AD was compared between the subgroups. The frequency of epsilon4 was significantly higher in both AD groups than in controls. Between C-AD and H-AD, no differences were found in epsilon4 frequency, while symptoms of dementia were significantly severer in H-AD than in C-AD. Within each AD group, no differences were observed in terms of clinical characteristics and scores on the assessment scales between the subgroups. Furthermore, the subgroups of H-AD showed no difference in the rate of progression. In conclusion, there was a significant association of epsilon4 with AD. However, no relationships were found between epsilon4 and clinical characteristics in either C-AD or H-AD. Furthermore, the rate of progression did not vary with respect to the presence or absence of epsilon4 in H-AD. The severer symptoms observed in the hospitalized sample than in those at large might be explained by factors other than the impact of epsilon4.

Aged↗

PubMed2002

Junctional scotoma in giant cerebral aneurysm.

A brain lesion located at the lateral side of the sella turcica can produce a junctional scotoma by compressing the ipsilateral optic nerve and the contralateral inferonasal nerve fiber. This study reports a female patient with a junctional scotoma caused by a cerebral aneurysm. At the initial visit, she complained of visual disturbance in both eyes and the right optic disc was atrophied. The visual field showed right blindness and left superotemporal quadrantopsia. A brain CT indicated an approximately 3 cm sized brain mass located superolateral to the sella turcica. The brain MRI showed the lesion to be more like an aneurysm than a pituitary adenoma. Therefore, 4 vessels angiography was done, and this lesion was confirmed to be a sellar variant of an aneurysm located at the right carotid siphon. Like a tumor of the optic chiasm, a cerebral aneurysm can cause visual disturbance and visual field defects. Therefore, an early differential diagnosis is important because the prognosis and treatment of an aneurysm differ.

Aged↗

PubMedDate not supplied

Mirtazapine treatment for pathological laughing and crying after stroke.

Selective serotonin reuptake inhibitors (SSRIs) have been recognized as the treatment of choice for pathological laughing and crying (PLC), which is a common, distressing condition that follows stroke. There have been few reports about other treatment options for PLC. Here, the authors report rapid responses to mirtazapine in two patients with poststroke PLC who failed to respond to SSRIs or bupropion. In the first case, a 63-year-old woman with severe long-standing crying spells that had persisted for 3 months responded well to low-dose mirtazapine within a few days; she could not tolerate citalopram or sertraline. In the second case, both the laughing and crying spells of a 64-year-old woman were improved within a few days of mirtazapine administration, after they had not responded to bupropion. This is one of the first reports to suggest that mirtazapine may be an alternative to SSRIs for treating poststroke PLC.

Antidepressive Agents↗

PubMedDate not supplied

Bupropion may improve restless legs syndrome: a report of three cases.

Restless legs syndrome (RLS) is a common disorder for which agents that enhance dopaminergic activity, including dopamine agonists and levodopa, are the treatment of choice. However, long-term use of dopaminergic drugs can cause unwanted effects such as rebound, tolerance, and augmentation. Bupropion, an inhibitor of dopamine and noradrenalin reuptake, is an antidepressant that modulates dopaminergic systems. The authors report that a low dose of bupropion rapidly and completely ameliorated RLS symptoms in 3 depressed patients within a few days of the initiation of treatment. To their knowledge, this is the first report to show that bupropion may be an effective alternative for treating RLS. Consequently, bupropion may be useful for the treatment of patients with both depression and RLS.

Adult↗

PubMedDate not supplied

Association between attitude toward medication and neurocognitive function in schizophrenia.

OBJECTIVES: A patient's attitude toward medication is important for medication adherence, which is a key determinant of outcome in schizophrenia. This study examined the association between attitude toward antipsychotic medication and clinical status, particularly neurocognitive function, in patients with schizophrenia. METHOD: Ninety-two patients meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for schizophrenia participated in this study. The attitudes of the subjects toward medication were evaluated using the Drug Attitude Inventory (DAI). Clinical characteristics, including psychiatric symptoms and side effects of medication were evaluated. Neurocognitive function was measured using the Mini Mental State Examination and a computerized battery consisting of the Digit Span Test, Verbal Learning Test, Continuous Performance Test, Wisconsin Card Sorting Test, Finger Tapping Test, and Trail Making Test, parts A and B. The associations between attitude toward medication and neurocognitive function and clinical characteristics were analyzed. RESULTS: The scores on the DAI were not significantly correlated with the clinical characteristics, such as psychopathology, subjective well-being, or neuroleptic-induced extrapyramidal side effects. Instead, the scores on the DAI were significantly correlated with the learning index and delayed free recall on the Verbal Learning Test, the number of categories completed on the Wisconsin Card Sorting Test, and omission and commission errors on the Continuous Performance Test; the scores were not significantly correlated with measures on the Mini Mental State Examination, Digit Span Test, Finger Tapping Test, or Trail Making Test. CONCLUSIONS: Our findings indicate that a patient's attitude toward medication is associated with neurocognitive function. Specifically, verbal learning memory, executive functioning, and sustained attention were associated with attitude toward medication.

Adolescent↗