Biomedical subjects

Victor W C Lui

Publications and source records attributed to Victor W C Lui.

5 recordsLinked to original sources

PubMed2007

Depression and apathy affect functioning in community active subjects with questionable dementia and mild Alzheimer's disease.

BACKGROUND: The relationships between apathy, depression and functional impairment in questionable dementia (QD) and Alzheimer's disease (AD) are complex. This study aimed to explore the interactions between severity of apathy, depression and functional performance; and to investigate the effects of apathy alone, depression alone and coexistence of apathy and depression on the functional performance in subjects with QD and AD. METHODS: One hundred ninety-five subjects with QD and 96 subjects with mild AD were recruited. Apathy and depression were rated using the Neuropsychiatric Inventory and functional disability was measured using the Disability Assessment for Dementia (DAD). RESULTS: Severity of apathy and depression symptoms were associated with poorer functional performance in QD and apathy was associated with poorer functional performance in AD. In QD, subjects with apathy, depression, or coexistence of apathy and depression had poorer functional performance than those with neither apathy nor depression. The coexistence of apathy and depression did not produce more severe functional disability than apathy alone or depression alone. In AD, subjects with apathy had poorer functional performance than those without apathy. Depression in the absence of apathy was not associated with more severe functional disability. CONCLUSION: Apathy and depression symptoms are common in the early course of AD. Apathy and depression had different effects on functional performances in the subjects with QD from those with AD.

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PubMed2006

Association between cognitive function, behavioral syndromes and two-year clinical outcome in Chinese subjects with late-onset Alzheimer's disease.

OBJECTIVE: To examine associations between behavioral and psychological symptoms of dementia (BPSD), cognitive function and clinical deterioration over 2 years. METHODS: One hundred and four Chinese subjects with late-onset Alzheimer's Disease (AD) who presented to psychogeriatric clinics were followed for an average of 22.5 months. BPSD subgroups were categorized by latent class analysis using the Neuropsychiatric Inventory. Comprehensive cognitive profiles were performed with the Mattis Dementia Scale, the Hong Kong List Learning Test (HKLLT) and the Category Verbal Fluency Test. Interactions between cognitive function and behavioral syndromes were evaluated. Potential predictors for clinical deterioration were computed with logistic regression analysis. RESULTS: Three latent classes of subjects with similar behavioral syndromes were identified: Low BPSD (44%), Affective (32%) and Psychosis (24%) groups. Association between cognitive functions and BPSD was not significant. At follow-up, a higher proportion of subjects in the Affective (70%) and Low BPSD (49%) groups remained stable at the same Clinical Dementia Rating. Baseline scores in the "recognition" test of the HKLLT and age were significant predictors for "deceased" status at 2-year follow-up. CONCLUSION: The lack of association between behavioral syndromes and cognitive function suggests that these relatively independent dimensions of dementia should be examined individually for different prognostic significance.

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PubMed2005

Subjective memory complaints in Chinese subjects with mild cognitive impairment and early Alzheimer's disease.

BACKGROUND: Mild cognitive impairment (MCI) represents a transitional state between normal aging and dementia. However, there is inconsistent opinion as to the validity of subjective memory complaints as a criterion for diagnosis. OBJECTIVE: This study aimed to examine the potential significance of applying a short memory questionnaire in the assessment of Chinese subjects with MCI and early dementia. METHODS: Three hundred and six ambulatory Chinese subjects were recruited. Each participant completed a short memory questionnaire. They were also assessed with the Chinese versions of the mini-mental state examination (CMMSE), Alzheimer's disease assessment scale-cognitive subscale (ADAS-Cog), category verbal fluency test (CVFT) and span tests. Severity of cognitive impairment was evaluated using the Clinical Dementia Rating (CDR); subjects with CDR 0.5 were further classified into MCI not demented (MCIND) and MCI possible incipient dementia (MCIID) depending on the subscale scores of CDR. RESULTS: An increasing frequency of memory complaints with increasing CDR was observed (Kruskal Wallis test, chi square = 21.29, df 3, p < 0.001). With a cutoff of 3 or more memory complaints, the memory questionnaire demonstrated a sensitivity of 65.3% and 70.4% in identifying subjects with incipient and early dementia respectively. Significant associations between memory complaints and most cognitive test performance were found (Spearman's correlations, p < 0.01). Logistic regression analysis revealed that educational level, the memory questionnaire, ADAS-Cog total and delayed recall scores were significant predictors of MCIID status. CONCLUSIONS: The findings suggested that a short memory questionnaire is useful in the screening of MCI, particularly in subjects who already present with subtle functioning disturbances. Subjective memory complaints were significant correlated with objective performance of memory functions, reflecting the usefulness of memory complaints in the assessment of MCI.

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PubMed2004

Executive function impairment in community elderly subjects with questionable dementia.

BACKGROUND: The neurocognitive profile of community-dwelling Chinese subjects with 'questionable' dementia was studied. METHODS: One hundred and fifty-four ambulatory Chinese subjects were recruited from local social centers for the elderly. Each subject was examined using the Clinical Dementia Rating (CDR), the Cantonese version of the Mini-Mental State Examination (CMMSE), the Chinese version of the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), the Category Verbal Fluency Test (CVFT), digit and visual span tests, and the Cambridge Neurological Inventory. The neurocognitive profile of nondemented subjects (CDR 0) was compared with that of subjects with 'questionable' dementia (CDR 0.5). RESULTS: Subjects with 'questionable' dementia were older, and had lower educational levels and global cognitive assessment scores than the controls (CMMSE and ADAS-Cog; t tests, p < 0.001). In addition, they also had significantly lower scores in delayed recall, reverse span, verbal fluency tests and worse performance in complex motor tasks related to executive function (Mann-Whitney tests, p < 0.001). Logistic regression analysis revealed that ADAS-Cog, CVFT, and reverse visual span were significant predictors for the CDR of 'questionable' dementia. CONCLUSION: Aside from memory impairment, executive function deficits were also present in subjects with 'questionable' dementia. To identify groups cognitively at risk for dementia, concomitant assessments of memory and executive function are suggested.

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PubMedDate not supplied

Apolipoprotein epsilon-4 allele and the two-year progression of cognitive function in Chinese subjects with late-onset Alzheimer's disease.

BACKGROUND: Although the significance of apolipoprotein E4 (Apo E4) in Alzheimer's disease (AD) has been well established in Caucasian populations, its role in determining the rate of cognitive decline in other ethnic groups has yet to be determined. This study examined the two-year progression of cognitive decline and its association with Apo E4 allelic status in a group of Chinese elderly subjects with AD. METHOD: One hundred and four Chinese subjects with mild and moderate AD as assessed by the Clinical Dementia Rating (CDR 1 and 2) were followed up at a mean (SD) duration of 22.53 (5.21) months. The rate of cognitive decline and its association with Apo E4 allelic status was evaluated RESULTS: At follow-up, 74 (73 percent) subjects were reassessed. Forty-nine remained stable at the same CDR and 25 had deteriorated. The mean (SD) deterioration in the Mini-Mental State Examination (MMSE) was 2.52 (4.38) and in the Mattis Dementia Rating Scale (DRS) was 9.03 (14.98) (paired t-test, p < 0. 001). There was no significant difference in the baseline MMSE and DRS scores between the "stable", "deteriorated", or "deceased" groups. Mildly demented subjects with the Apo E4 allele were more likely to have deteriorated to a more severe CDR than subjects without the Apo E4 allele (Pearson chi2 = 5.72, df 1, p = 0.017, Odds ratio = 6.3, CI 1.3 to 30.53). CONCLUSION: The presence of the Apo E4 allele may influence the rate of cognitive deterioration, particularly in subjects with mild AD.

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