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Suh SW, Han JW, Han JH, Bae JB, Moon W, Kim HS, Oh DJ, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Byun S, Seo J, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. Sex differences in subjective age-associated changes in sleep: a prospective elderly cohort study. Aging (Albany NY) 2020; 12:21942-21958. [PMID: 33170149 PMCID: PMC7695390 DOI: 10.18632/aging.104016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/22/2020] [Indexed: 01/16/2023]
Abstract
Subjective age-associated changes in sleep (AACS) and sex differences in AACS have never been prospectively investigated in elderly populations. We compared the AACS every 2 years over a total of 6 years between 4,686 community-dwelling healthy men and women aged 60 years or older who participated in the Korean Longitudinal Study on Cognitive Aging and Dementia. Sleep parameters including sleep duration, latency, and efficiency, mid-sleep time, daytime dysfunction, and overall subjective sleep quality were measured using the Pittsburgh Sleep Quality Index at baseline and at each follow-up. The effects of time and sex on subjective sleep parameters were analyzed using linear mixed-effects models. During the 6 years of follow-up, we observed that overall, sleep latency increased, while daytime dysfunction and sleep quality worsened. Significant sex differences in AACS was found, with women showing shortened sleep duration, delayed mid-sleep time, and decreased sleep efficiency over 6 years. Sleep quality worsened in both groups but a more pronounced change was observed in women. Clinicians should be cautious in determining when to treat declared sleep disturbances in this population.
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Bae JB, Lipnicki DM, Han JW, Sachdev PS, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Llibre-Rodriguez JJ, Llibre-Guerra JJ, Valhuerdi-Cepero AJ, Ritchie K, Ancelin ML, Carriere I, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Dardiotis E, Meguro K, Kasai M, Nakamura K, Riedel-Heller S, Roehr S, Pabst A, van Boxtel M, Köhler S, Ding D, Zhao Q, Liang X, Scazufca M, Lobo A, De-la-Cámara C, Lobo E, Kim KW. Does parity matter in women's risk of dementia? A COSMIC collaboration cohort study. BMC Med 2020; 18:210. [PMID: 32753059 PMCID: PMC7406389 DOI: 10.1186/s12916-020-01671-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Dementia shows sex difference in its epidemiology. Childbirth, a distinctive experience of women, is associated with the risk for various diseases. However, its association with the risk of dementia in women has rarely been studied. METHODS We harmonized and pooled baseline data from 11 population-based cohorts from 11 countries over 3 continents, including 14,792 women aged 60 years or older. We investigated the association between parity and the risk of dementia using logistic regression models that adjusted for age, educational level, hypertension, diabetes mellitus, and cohort, with additional analyses by region and dementia subtype. RESULTS Across all cohorts, grand multiparous (5 or more childbirths) women had a 47% greater risk of dementia than primiparous (1 childbirth) women (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.10-1.94), while nulliparous (no childbirth) women and women with 2 to 4 childbirths showed a comparable dementia risk to primiparous women. However, there were differences associated with region and dementia subtype. Compared to women with 1 to 4 childbirths, grand multiparous women showed a higher risk of dementia in Europe (OR = 2.99, 95% CI = 1.38-6.47) and Latin America (OR = 1.49, 95% CI = 1.04-2.12), while nulliparous women showed a higher dementia risk in Asia (OR = 2.15, 95% CI = 1.33-3.47). Grand multiparity was associated with 6.9-fold higher risk of vascular dementia in Europe (OR = 6.86, 95% CI = 1.81-26.08), whereas nulliparity was associated with a higher risk of Alzheimer disease (OR = 1.91, 95% CI 1.07-3.39) and non-Alzheimer non-vascular dementia (OR = 3.47, 95% CI = 1.44-8.35) in Asia. CONCLUSION Parity is associated with women's risk of dementia, though this is not uniform across regions and dementia subtypes.
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Grants
- RF1 AG057531 NIA NIH HHS
- Wellcome Trust
- National Health and Medical Research Council of Australia
- the National Institute On Aging of the National Institutes of Health
- philanthropic contributions to The Dementia Momentum Fund
- the Wellcome Trust Foundation
- the Cuban Ministry of Public Health
- Novartis
- National Research Agency
- The Swedish Research Council
- Swedish Research Council for Health, Working Life and Wellfare
- the Swedish state under the agreement between the Swedish government and the county councils
- Alzheimerfonden, Hjärnfonden, The Alzheimer's Association Stephanie B. Overstreet Scholars
- The Alzheimer's Association Zenith Award
- the Alzheimer’s Association
- the ESPA-EU program Excellence Grant
- the Ministry for Health and Social Solidarity
- the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea
- Ministry of Health, Labour and Welfare
- the Interdisciplinary Centre for Clinical Research at the University of Leipzig
- the Maastricht University Medical Center
- the School for Mental Health and Neuroscience and the Dutch Ministry for Education, Culture and Science
- Shanghai Brain-Intelligence Project
- Natural Science Foundation and Major Basic Research Program of Shanghai
- National Natural Science Foundation of China
- Scientific Research Plan Project of Shanghai Science and Technology Committee
- Shanghai Municipal Science and Technology Major Project
- Fudan University
- the Wellcome Trust Foundation and FAPESP
- the Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- the Fondo Europeo de Desarrollo Regional (FEDER) of the European Union and Gobierno de Aragón, Group #19.
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Kim JS, Bae JB, Han K, Hong JW, Han JH, Kim TH, Kwak KP, Kim K, Kim BJ, Kim SG, Kim JL, Kim TH, Moon SW, Park JY, Park JH, Byun S, Suh SW, Seo JY, So Y, Ryu SH, Youn JC, Lee KH, Lee DY, Lee DW, Lee SB, Lee JJ, Lee JR, Jeong H, Jeong HG, Jhoo JH, Han JW, Kim KW. Driving-Related Adverse Events in the Elderly Men: A Population-Based Prospective Cohort Study. Psychiatry Investig 2020; 17:744-750. [PMID: 32683838 PMCID: PMC7449837 DOI: 10.30773/pi.2019.0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 03/18/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study estimated the incidence of driving-related adverse events and examined the association of cognitive function with the risk of future driving-related adverse events in the elderly Korean male population. METHODS We analyzed 1,172 male drivers aged 60 years or older in the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD). Using the data from Korean National Police Agency, we classified the participants into three groups: safe driving (drove for 2 years after baseline without a traffic accident or repeated violations), driving cessation (stopped driving), and risky driving (one or more traffic accidents or repeated violations). We estimated the incidences of driving cessation and risky driving, and examined the effect of cognitive function on their risks. RESULTS The incidence of driving cessation and risky driving in the Korean male drivers aged 60 years or older was 19.3 and 69.9 per 1,000 person-years respectively and increased in the late 80s. Drivers with better baseline Word List Memory Test scores showed less risky driving (OR=0.94, p=0.039). CONCLUSION Driving-related adverse events increased in late 80s, and better memory function was protective against these events.
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Kwon W, Kim H, Han Y, Hwang YJ, Kim SG, Kwon HJ, Vinuela E, Járufe N, Roa JC, Han IW, Heo JS, Choi SH, Choi DW, Ahn KS, Kang KJ, Lee W, Jeong CY, Hong SC, Troncoso AT, Losada HM, Han SS, Park SJ, Kim SW, Yanagimoto H, Endo I, Kubota K, Wakai T, Ajiki T, Adsay NV, Jang JY. Role of tumour location and surgical extent on prognosis in T2 gallbladder cancer: an international multicentre study. Br J Surg 2020; 107:1334-1343. [PMID: 32452559 DOI: 10.1002/bjs.11618] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In gallbladder cancer, stage T2 is subdivided by tumour location into lesions on the peritoneal side (T2a) or hepatic side (T2b). For tumours on the peritoneal side (T2a), it has been suggested that liver resection may be omitted without compromising the prognosis. However, data to validate this argument are lacking. This study aimed to investigate the prognostic value of tumour location in T2 gallbladder cancer, and to clarify the adequate extent of surgical resection. METHODS Clinical data from patients who underwent surgery for gallbladder cancer were collected from 14 hospitals in Korea, Japan, Chile and the USA. Survival and risk factor analyses were conducted. RESULTS Data from 937 patients were available for evaluation. The overall 5-year disease-free survival rate was 70·6 per cent, 74·5 per cent for those with T2a and 65·5 per cent among those with T2b tumours (P = 0·028). Regarding liver resection, extended cholecystectomy was associated with a better 5-year disease-free survival rate than simple cholecystectomy (73·0 versus 61·5 per cent; P = 0·012). The 5-year disease-free survival rate was marginally better for extended than simple cholecystectomy in both T2a (76·5 versus 66·1 per cent; P = 0·094) and T2b (68·2 versus 56·2 per cent; P = 0·084) disease. Five-year disease-free survival rates were similar for extended cholecystectomies including liver wedge resection versus segment IVb/V segmentectomy (74·1 versus 71·5 per cent; P = 0·720). In multivariable analysis, independent risk factors for recurrence were presence of symptoms (hazard ratio (HR) 1·52; P = 0·002), R1 resection (HR 1·96; P = 0·004) and N1/N2 status (N1: HR 3·40, P < 0·001; N2: HR 9·56, P < 0·001). Among recurrences, 70·8 per cent were metastatic. CONCLUSION Tumour location was not an independent prognostic factor in T2 gallbladder cancer. Extended cholecystectomy was marginally superior to simple cholecystectomy. A radical operation should include liver resection and adequate node dissection.
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Lee J, Lee SI, Kim SG, Lee J, Jung HY. A Case of Cerebral Amyloid Angiopathy Presented with Cognitive Decline and Hoarding Behavior. Psychiatry Investig 2020; 17:382-384. [PMID: 32320593 PMCID: PMC7176570 DOI: 10.30773/pi.2019.0328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/16/2020] [Indexed: 12/02/2022] Open
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Oh DJ, Han JW, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. Epidemiological characteristics of subsyndromal depression in late life. Aust N Z J Psychiatry 2020; 54:150-158. [PMID: 31595770 DOI: 10.1177/0004867419879242] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Subsyndromal depression is prevalent and associated with poor outcomes in late life, but its epidemiological characteristics have barely been investigated. The aim of this prospective cohort study is to compare the prevalence, incidence and risk factors of subsyndromal depression with those of syndromal depression including major and minor depressive disorders in community-dwelling elderly individuals. METHODS In a nationwide community-based study of randomly sampled Korean elderly population aged 60 years or older (N = 6640), depression was assessed with standardized diagnostic interviews. At baseline and at 2-year and 4-year follow-ups, the authors diagnosed subsyndromal depression by the operational criteria and syndromal depression by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnostic criteria. Multivariate logistic regression analyses were conducted to identify the risk factors for incident depression. RESULTS The age- and gender-adjusted prevalence rate of subsyndromal depression was 9.24% (95% confidence interval = [8.54, 9.93]), which was 2.4-fold higher than that of syndromal depression. The incidence rate of subsyndromal depression was 21.70 per 1000 person-years (95% confidence interval = [19.29, 24.12]), which was fivefold higher than that of syndromal depression. The prevalence to incidence ratio of subsyndromal depression was about half that of syndromal depression. The risk for subsyndromal depression was associated with female gender, low socioeconomic status, poor social support and poor sleep quality, while that of syndromal depression was associated with old age and less exercise. CONCLUSION Subsyndromal depression should be validated as a clinical diagnostic entity, at least in late life, since it has epidemiological characteristics different from those of syndromal depression.
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Lee D, Kim BJ, Han JW, Kim TH, Kwak KP, Kim K, Kim SG, Kim JL, Kim TH, Moon SW, Park JY, Park JH, Byun S, Suh SW, Seo JY, So Y, Ryu SH, Youn JC, Lee KH, Lee DY, Lee DW, Lee SB, Lee JJ, Lee JR, Jeong H, Jeong HG, Jhoo JH, Han K, Hong JW, Bae JB, Kim KW. Low Diastolic Blood Pressure and Cognitive Decline in Korean Elderly People: The Korean Longitudinal Study on Cognitive Aging and Dementia. Psychiatry Investig 2020; 17:21-28. [PMID: 31995969 PMCID: PMC6992855 DOI: 10.30773/pi.2019.0105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/26/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Cardiovascular diseases are representative risk factors for the onset of cognitive decline. The purpose of this study was to confirm the relationship between diastolic blood pressure and cognitive function in elderly people in Korea. METHODS Data from subjects who were enrolled in the prospective Korean Longitudinal Study on Cognitive Aging and Dementia were used in this study. Data from 701 subjects whose diastolic blood pressure range did not change (≤79 mm Hg or ≥80 mm Hg) over 2 years were analyzed. To analyze the differences in cognitive function between the groups at the 2-year follow-up, an analysis of covariance was performed with covariates, which were significantly different between the two groups, and the baseline cognitive function. RESULTS Significant differences were observed between the two groups, and the mean scores on the constructional praxis (η2=0.010) and word list recall tests (η2=0.018) in the diastolic blood pressure ≥80 mm Hg group were higher than those in the diastolic blood pressure ≤79 mm Hg group at the 2-year follow-up. CONCLUSION These results indicate that maintaining a DBP below 79 mm Hg presents a greater risk of cognitive decline in Korean elderly people.
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Suh SW, Han JW, Lee JR, Byun S, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Seo J, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Yoon IY, Kim KW. Short Average Duration of NREM/REM Cycle Is Related to Cognitive Decline in an Elderly Cohort: An Exploratory Investigation. J Alzheimers Dis 2019; 70:1123-1132. [DOI: 10.3233/jad-190399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lee JR, Suh SW, Han JW, Byun S, Kwon SJ, Lee KH, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Lee DW, Youn JC, Lee DY, Lee SB, Lee JJ, Jhoo JH, Kim KW. Anhedonia and Dysphoria Are Differentially Associated with the Risk of Dementia in the Cognitively Normal Elderly Individuals: A Prospective Cohort Study. Psychiatry Investig 2019; 16:575-580. [PMID: 31446685 PMCID: PMC6710416 DOI: 10.30773/pi.2019.06.07] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/07/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We investigated the impact of depressed mood (dysphoria) and loss of interest or pleasure (anhedonia)on the risk of dementia in cognitively-normal elderly individuals. METHODS This study included 2,685 cognitively-normal elderly individuals who completed the baseline and 4-year follow-up assessments of the Korean Longitudinal Study on Cognitive Aging and Dementia. We ascertained the presence of dysphoria and anhedonia using the Mini International Neuropsychiatric Inventory. We defined subjective cognitive decline as the presence of subjective cognitive complaints without objective cognitive impairments. We analyzed the association of dysphoria and anhedonia with the risk of cognitive disorders using multinomial logistic regression analysis adjusted for age, sex, education, Cumulative Illness Rating Scale score, Apolipoprotein E genotype, and neuropsychological test performance. RESULTS During the 4-year follow-up period, anhedonia was associated with an approximately twofold higher risk of mild cognitive impairment (OR=2.09, 95% CI=1.20-3.64, p=0.008) and fivefold higher risk of dementia (OR=5.07, 95% CI=1.44-17.92, p=0.012) but was not associated with the risk of subjective cognitive decline. In contrast, dysphoria was associated with an approximately twofold higher risk of subjective cognitive decline (OR=2.06, 95% CI=1.33-3.19, p=0.001) and 1.7-fold higher risk of mild cognitive impairment (OR=1.75, 95% CI=1.00-3.05, p=0.048) but was not associated with the risk of dementia. CONCLUSION Anhedonia, but not dysphoria, is a risk factor of dementia in cognitively-normal elderly individuals.
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Bae JB, Han JW, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. Impact of Mild Cognitive Impairment on Mortality and Cause of Death in the Elderly. J Alzheimers Dis 2019; 64:607-616. [PMID: 29914024 DOI: 10.3233/jad-171182] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a cognitive state that lies on the continuum between normal aging and dementia, and the prevalence of MCI is higher than dementia. However, the risk for mortality of people with MCI has been far less studied than that of people with dementia, and the population attributable risk percent (PAR%) of death attributable to MCI has not been estimated yet. OBJECTIVE To investigate the impact of MCI on mortality and the cause of death in the elderly, and to estimate the PAR% of deaths attributable to MCI. METHODS Data came from 7,315 elderly subjects aged ≥60 years without dementia from two cohort studies with diagnostic assessments of MCI at baseline. Deaths among participants were confirmed through the nationwide mortality database of Statistics Korea. RESULTS MCI increased the risk of mortality in a multivariate Cox proportional model adjusting for age, sex, education, smoking, alcohol drinking, chronic illness, depression, vascular components, and cohort (hazard ratio = 1.59, 95% confidence interval 1.30, 1.94). PAR% of death attributable to MCI was 10.7% for age 65-74 years, 16.0% for age 75-84 years, and 24.2% for age ≥85 years. In the elderly with MCI, mortality risks from cerebrovascular disease, respiratory disease, and external causes were higher than in the cognitively normal elderly. CONCLUSIONS Our results suggest that the mortality risk of MCI in Asian countries may be comparable to that in Western countries, and MCI can contribute to the death of the elderly as much as dementia.
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Jang S, Han JW, Shin J, Kim TH, Kwak KP, Kim K, Kim BJ, Kim SG, Kim JL, Kim TH, Moon SW, Park JY, Park JH, Byun S, Suh SW, Seo J, So Y, Ryu SH, Youn JC, Lee KH, Lee DY, Lee DW, Lee SB, Lee JJ, Lee JR, Jeong H, Jeong HG, Jhoo JH, Han K, Hong JW, Kim KW. Normal-But-Low Serum Folate Levels and the Risks for Cognitive Impairment. Psychiatry Investig 2019; 16:532-538. [PMID: 31352735 PMCID: PMC6664218 DOI: 10.30773/pi.2019.05.29] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/29/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE This study aimed to examine the association between normal-but-low folate levels and cognitive function in the elderly population using a prospective cohort study. METHODS We analyzed 3,910 participants whose serum folate levels were within the normal reference range (1.5-16.9 ng/mL) at baseline evaluation in the population-based prospective cohort study named the "Korean Longitudinal Study on Cognitive Aging and Dementia." The association between baseline folate quartile categories and baseline cognitive disorders [mild cognitive impairment (MCI) or dementia] was examined using binary logistic regression analysis adjusting for confounding variables. The risks of incident MCI and dementia associated with the decline of serum folate level during a 4-year follow-up period were examined using multinomial logistic regression analysis. RESULTS The lowest quartile group of serum folate (≥1.5, ≤5.9 ng/mL) showed a higher risk of cognitive disorders than did the highest quartile group at baseline evaluation (odds ratio 1.314, p=0.012). Over the 4 years of follow-up, the risk of incident dementia was 2.364 times higher among subjects whose serum folate levels declined from the 2nd-4th quartile group to the 1st quartile than among those for whom it did not (p=0.031). CONCLUSION Normal-but-low serum folate levels were associated with the risk of cognitive disorders in the elderly population, and a decline to normal-but-low serum folate levels was associated with incident dementia. Maintaining serum folate concentration above 5.9 ng/mL may be beneficial for cognitive status.
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Bae JB, Han JW, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. P3-293: THE DIAGNOSTIC CRITERIA OF NEUROCOGNITIVE DISORDERS IN DSM-5 MAY HAVE POTENTIAL TO LOSE AT-RISK CLINICAL POPULATIONS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ahn HK, Lee H, Kim SG, Hyun SH. Pre-treatment 18F-FDG PET-based radiomics predict survival in resected non-small cell lung cancer. Clin Radiol 2019; 74:467-473. [PMID: 30898382 DOI: 10.1016/j.crad.2019.02.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/12/2019] [Indexed: 12/28/2022]
Abstract
AIM To assess the prognostic value of 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)-based radiomics using a machine learning approach in patients with non-small cell lung cancer (NSCLC). MATERIALS AND METHODS Ninety-three patients with stage I-III NSCLC who underwent combined PET/computed tomography (CT) followed by curative resection. A total of 35 unique quantitative radiomic features was extracted from the PET images, which included imaging phenotypes such as pixel intensity, shape, and texture. Radiomic features were ranked based on score according to their correlation with disease recurrence status within a 3-year follow-up. The recurrence risk classification performances of machine learning algorithms (random forest, neural network, naive Bayes, logistic regression, and support vector machine) using the 20 best-ranked features were compared using the areas under the receiver operating characteristic curve (AUC) and validated by the random sampling method. RESULTS Contrast and busyness texture features from neighbourhood grey-level difference matrix were found to be the two best predictors of disease recurrence. The random forest model obtained the best performance (AUC: 0.956, accuracy: 0.901, F1 score: 0.872, precision: 0.905, recall: 0.842), followed by the neural network model (AUC: 0.871, accuracy: 0.780, F1 score: 0.708, precision: 0.755, recall: 0.666). CONCLUSION A PET-based radiomic model was developed and validated for risk classification in NSCLC. The machine learning approach with random forest classifier exhibited good performance in predicting the recurrence risk. Radiomic features may help clinicians to improve the risk stratification for clinical practice.
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Bae JB, Han JW, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. Is Dementia More Fatal Than Previously Estimated? A Population-based Prospective Cohort Study. Aging Dis 2019; 10:1-11. [PMID: 30705763 PMCID: PMC6345342 DOI: 10.14336/ad.2018.0123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/23/2018] [Indexed: 11/01/2022] Open
Abstract
Dementia increases the risk of mortality (ROM) in the elderly and estimates of hazard ratio (HR) of dementia for mortality have ranged from 1.7 to 6.3. However, previous studies may have underestimated ROM of dementia due to length bias, which occurs when failing to include the persons with rapidly progressive diseases, who died before they could be included in the study. This population-based prospective cohort study conducted on 6,752 randomly sampled Koreans, aged 60 years or older (the Korean Longitudinal Study on Cognitive Aging and Dementia). Cognitive disorders were evaluated at baseline and 2-year follow-up using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), and prevalent and incident cases of dementia were identified. The participants' deaths were confirmed through the National Mortality Database of Statistics Korea. We compared the ROM between prevalent and incident dementia, and estimated HR of dementia for mortality using Cox proportional hazards model. Of the 5,097 responders to the 2-year follow-up assessment, 150 participants had dementia from the baseline (prevalent dementia), and 95 participants developed dementia during the 2-year follow-up period (incident dementia). The ROM of participants with incident dementia was about 3 times higher than the ROM of those with prevalent dementia (HR = 3.04, 95% confidence interval [CI] = 1.34-6.91). Compared to cognitively normal participants at both the baseline and 2-year follow-up assessments, the ROM of those with incident dementia approximately 8 times higher (HR = 8.37, 95 % CI = 4.23-16.54). In conclusion, the ROM of dementia using prevalent cases was underestimated due to length bias, and dementia may be much more fatal than previously estimated. In clinical settings, the ROM of dementia warrants the attention of physicians, particularly in recently incident dementia cases.
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Park CHK, Lee JW, Lee SY, Shim SH, Kim SG, Lee J, Kim MH, Paik JW, Cho SJ, Moon JJ, Jeon DW, Kim S, Park JH, You S, Jeon HJ, Ahn YM. Characteristics of the "young-old" and "old-old" community-dwelling suicidal Ideators: A longitudinal 6-month follow-up study. Compr Psychiatry 2019; 89:67-77. [PMID: 30597426 DOI: 10.1016/j.comppsych.2018.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 11/20/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Despite heterogeneity of older people in suicidal behavior, research identifying characteristics by age groups is scarce. We examined baseline features of older community-dwelling suicidal ideators by dichotomized age groups and the 6-month trajectory of their suicidal ideation along with its related psychopathology. Predictors of suicidal ideation within each group were investigated. METHODS Older community-dwelling suicidal ideators enrolled in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were subdivided into the "young-old (65-74 years)" and "old-old (≥75 years)" group. Baseline, 1-, and 6-month assessments were compared. Within each group, multiple regression analysis using rating scales (Patient Health Questionnaire-9, Beck Anxiety Inventory, Alcohol Use Disorders Identification Test, Stress Questionnaire for Korean National Health and Nutrition Examination Survey-Short Form, and Social Relationships Scale) was conducted to identify predictors of suicidal ideation measured with the intensity subscale of the Columbia-Suicide Severity Rating Scale. Two-way repeated-measures analysis of variance (RM-ANOVA) was used to compare changes in suicidal ideation, depression, anxiety between age groups over time, and one-way RM-ANOVA to examine changes within each age group. RESULTS Among 29 "young-old" and 53 "old-old" ideators, the latter were less likely to be receiving psychiatric treatment (odds ratio [OR] = 4.065) and make suicide attempts (OR = 2.874), whereas the former revealed greater levels of anxiety and stress. Baseline depression and stress in the "young-old" group and the "old-old" group, respectively, predicted the intensity of suicidal ideation at both baseline and 1-month assessments. No significant age group x time interactions on suicidal ideation and depression were found. However, within each age group, both suicidal ideation and depression significantly decreased only during the first month with no further improvement. CONCLUSION We speculate cautiously that more attention may need to be paid to the "old-old" ideators in the evaluation of psychiatric issues and for referral to psychiatrists. To decrease suicidal ideation, tailored approaches involving proactive, timely management of depression in the "young-old" and interventions focusing on stress reduction in the "old-old," would be helpful.
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Park CHK, Lee JW, Lee SY, Moon JJ, Jeon DW, Shim SH, Cho SJ, Kim SG, Lee J, Paik JW, Kim MH, Kim S, Park JH, You S, Jeon HJ, Rhee SJ, Ahn YM. The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior: Study rationale, methodology, and baseline sample characteristics of a long-term, large-scale, multi-center, prospective, naturalistic, observational cohort study. Compr Psychiatry 2019; 88:29-38. [PMID: 30468986 DOI: 10.1016/j.comppsych.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study is a prospective, naturalistic, observational cohort study, aiming to identify predictors of suicide attempt and suicide characteristics in the Korean suicidal population. The findings intend to contribute to a thorough understanding of suicidal phenomena and development of suicide prevention guidelines. The present cross-section study examines the study rationale, methodology, and baseline characteristics of the participants. METHODS Participants were enrolled via the hospital and community gateways, establishing the hospital-based cohort (HC) and community-based cohort (CC), respectively. Baseline assessment was conducted on sociodemographic, clinical, diagnostic, and psychopathological aspects. The Columbia-Suicide Severity Rating Scale was used to investigate suicidality. RESULTS A total of 800 suicidal people aged 15 years or older were enrolled from 8 university hospitals and 8 community mental health welfare centers (CMHWCs), among whom 480 (60%) were suicidal ideators and 320 (40%) were attempters. The ideators comprised 207 CC and 273 HC participants, whereas the attempters, 34 CC and 286 HC participants. Despite their lower severity in some measures, including suicidal ideation, compared with their HC counterparts, the CC participants within each group of ideators or attempters presented clinically significant psychopathology. Moreover, alcohol use problems and past suicide attempt were more likely to be found in CC participants. Only 11.1% to 21.6% of the participants in each of the four groups (defined by the cohorts and the ideators/attempters) were on any type of psychiatric treatment. CONCLUSIONS Suicidal visitors to CMHWCs need to be as closely monitored as suicidal patients in university hospitals, especially considering their association with problem drinking and past suicide attempt. A cautious assumption is that the high suicide rate in Korea might be partly attributable to the low proportion of patients receiving psychiatric services.
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Jang H, Bae JB, Dardiotis E, Scarmeas N, Sachdev PS, Lipnicki DM, Han JW, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Yannakoulia M, Kosmidis MH, Hadjigeorgiou GM, Sakka P, Kim KW. Differential effects of completed and incomplete pregnancies on the risk of Alzheimer disease. Neurology 2018; 91:e643-e651. [PMID: 30021919 PMCID: PMC9811944 DOI: 10.1212/wnl.0000000000006000] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 05/17/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To investigate the effects of completed pregnancy with childbirth and incomplete pregnancy without childbirth on the late-life cognition and the risk of Alzheimer disease (AD) in women. METHODS Using the pooled data of 3,549 women provided by 2 population-based cohort studies, we conducted logistic regression analyses to examine retrospectively the associations of completed and incomplete pregnancy with the risks of mild cognitive impairment and AD. For women without dementia, we also conducted analyses of covariance to examine the associations of completed and incomplete pregnancy with Mini-Mental State Examination (MMSE) score. RESULTS Grand multiparous women who experienced ≥5 completed pregnancies showed an ≈1.7-fold higher risk of AD than those who experienced 1 to 4 completed pregnancies (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.04-2.72), while those who had incomplete pregnancies showed half the level of AD risk compared with those who never experienced an incomplete pregnancy (OR 0.43, 95% CI 0.24-0.76 for 1 incomplete pregnancy; OR 0.56, 95% CI 0.34-0.92 for ≥2 incomplete pregnancies). In women without dementia, the grand multiparous had worse MMSE scores than those with 1 to 4 completed pregnancies (p < 0.001), while those who experienced ≥1 incomplete pregnancies had better MMSE scores than those who never experienced an incomplete pregnancy (p = 0.008). CONCLUSIONS Grand multiparity was associated with high risk of AD, while incomplete pregnancy was associated with low risk of AD in late life.
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Han JW, Kim TH, Kwak KP, Kim K, Kim BJ, Kim SG, Kim JL, Kim TH, Moon SW, Park JY, Park JH, Byun S, Suh SW, Seo JY, So Y, Ryu SH, Youn JC, Lee KH, Lee DY, Lee DW, Lee SB, Lee JJ, Lee JR, Jeong H, Jeong HG, Jhoo JH, Han K, Hong JW, Kim KW. Overview of the Korean Longitudinal Study on Cognitive Aging and Dementia. Psychiatry Investig 2018; 15:767-774. [PMID: 30086611 PMCID: PMC6111226 DOI: 10.30773/pi.2018.06.02] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 05/18/2018] [Accepted: 06/02/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Due to an unprecedented rate of population aging, South Korea is facing a dementia epidemic. For this reason, the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD) was launched in 2009 with support from the Korean Health Industry Development Institute to investigate the epidemiology, biopsychosocial risk factors, and outcomes of dementia and dementia-related conditions. METHODS The KLOSCAD is the first nationwide multi-center population-based prospective cohort study. In October 2010, 12,694 individuals were randomly sampled from residents aged 60 years or older who lived in 13 districts across South Korea. In the baseline assessment, which was conducted from November 2010 through October 2012, 6,818 (53.7%) individuals participated. Follow-up assessments have been conducted every two years, with the first follow-up assessment conducted between November 2012 and October 2014, and the second between November 2014 and October 2016. The third is now in progress, and will span from November 2016 to October 2018. Diagnosis of cognitive disorders, neuropsychological battery, behavioral and psychological symptoms of dementia, activities of daily living, physical and neurologic examination and laboratory tests, life styles, quality of life, and identification of death were evaluated in each assessment. RESULTS The cumulative drop-out rate at the second follow-up assessment was 38.7%. Dementia and mild cognitive impairment were 5.0% and 27.0%, respectively. CONCLUSION The KLOSCAD may provide strong scientific evidence for advancing the fight against dementia both in Korea and globally.
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Suh SW, Han JW, Lee JR, Byun S, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Seo JY, Yoon IY, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo J, Kim KW. P2‐619: NON‐REM/REM CYCLES AND COGNITIVE DECLINE: A PROSPECTIVE COHORT STUDY OF COGNITIVELY NORMAL ELDERLY. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Han JW, So Y, Kim TH, Lee DY, Ryu SH, Kim SY, Kim SG, Kim SK, Youn JC, Jhoo JH, Kim JL, Lee SB, Lee JJ, Kwak KP, Moon SW, Kim BJ, Bae JN, Woo JI, Jeong H, Park JH, Kim YJ, Kim KW. Prevalence Rates of Dementia and Mild Cognitive Impairment Are Affected by the Diagnostic Parameter Changes for Neurocognitive Disorders in the DSM-5 in a Korean Population. Dement Geriatr Cogn Disord 2018; 43:193-203. [PMID: 28237992 DOI: 10.1159/000458408] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/19/2022] Open
Abstract
AIM To examine the impact of the revised diagnostic criteria for neurocognitive disorders (NCDs) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) on the prevalence of dementia and mild cognitive impairment (MCI). METHODS A total of 755 participants aged 65 years or older in the Nationwide Survey on Dementia Epidemiology in Korea 2012 were rediagnosed according to the DSM-5 criteria. RESULTS The estimated age-, gender-, education-, and urbanicity-standardized prevalence rates of major and mild NCDs were 8.35 and 11.10%, respectively, and those of dementia and MCI were 8.74 and 31.85%, respectively. Cohen's κ for dementia and major NCD was 0.988, and that for MCI and mild NCD was 0.273. CONCLUSION Diagnostic discrepancies between major/mild NCDs and dementia/MCI might depend on the operationalization of neuropsychological performance criteria.
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Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. Regenerative endodontics: a comprehensive review. Int Endod J 2018; 51:1367-1388. [PMID: 29777616 DOI: 10.1111/iej.12954] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/14/2018] [Indexed: 12/13/2022]
Abstract
The European Society of Endodontology and the American Association for Endodontists have released position statements and clinical considerations for regenerative endodontics. There is increasing literature on this field since the initial reports of Iwaya et al. (Dental Traumatology, 17, 2001, 185) and Banchs & Trope (Journal of Endodontics, 30, 2004, 196). Endogenous stem cells from an induced periapical bleeding and scaffolds using blood clot, platelet rich plasma or platelet-rich fibrin have been utilized in regenerative endodontics. This approach has been described as a 'paradigm shift' and considered the first treatment option for immature teeth with pulp necrosis. There are three treatment outcomes of regenerative endodontics; (i) resolution of clinical signs and symptoms; (ii) further root maturation; and (iii) return of neurogenesis. It is known that results are variable for these objectives, and true regeneration of the pulp/dentine complex is not achieved. Repair derived primarily from the periodontal and osseous tissues has been shown histologically. It is hoped that with the concept of tissue engineering, namely stem cells, scaffolds and signalling molecules, that true pulp regeneration is an achievable goal. This review discusses current knowledge as well as future directions for regenerative endodontics. Patient-centred outcomes such as tooth discolouration and possibly more appointments with the potential for adverse effects needs to be discussed with patients and parents. Based on the classification of Cvek (Endodontics and Dental Traumatology, 8, 1992, 45), it is proposed that regenerative endodontics should be considered for teeth with incomplete root formation although teeth with near or complete root formation may be more suited for conventional endodontic therapy or MTA barrier techniques. However, much is still not known about clinical and biological aspects of regenerative endodontics.
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Lho SK, Kim TH, Kwak KP, Kim K, Kim BJ, Kim SG, Kim JL, Kim TH, Moon SW, Park JY, Park JH, Byun S, Suh SW, Seo JY, So Y, Ryu SH, Youn JC, Lee KH, Lee DY, Lee DW, Lee SB, Lee JJ, Lee JR, Jeong H, Jeong HG, Jhoo JH, Han K, Hong JW, Han JW, Kim KW. Effects of lifetime cumulative ginseng intake on cognitive function in late life. ALZHEIMERS RESEARCH & THERAPY 2018; 10:50. [PMID: 29793529 PMCID: PMC5968575 DOI: 10.1186/s13195-018-0380-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/01/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND We investigated the effects of lifetime cumulative ginseng intake on cognitive function in a community-dwelling population-based prospective cohort of Korean elders. METHODS Community-dwelling elders (N = 6422; mean age = 70.2 ± 6.9 years, education = 8.0 ± 5.3 years, female = 56.8%) from the Korean Longitudinal Study on Cognitive Aging and Dementia were included. Among them, 3918 participants (61.0%) completed the 2-year and 4-year follow-up evaluations. Subjects were categorized according to cumulative ginseng intake at baseline evaluation; no use group, low use (< 5 years) group, and high use (≥ 5 years) group. One-way analysis of covariance (ANCOVA) was conducted to compare the impact of cumulative ginseng intake on baseline Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet neuropsychological battery total score (CERAD total score) and Mini-Mental State Examination (MMSE) score among the three groups while adjusting for potential covariates. A repeated-measures ANCOVA was performed to investigate the impacts on the changes in CERAD total scores and MMSE scores during the 4 years of follow-up. RESULTS The high use group showed higher CERAD total scores compared to the no use group after controlling for age, sex, education years, socioeconomic status, smoking, alcohol intake, presence of hypertension, stroke history, Geriatric Depression Scale, Cumulative Illness Rating Scale, and presence of the APOE e4 allele (F(2, 4762) = 3.978, p = 0.019). The changes of CERAD total score for 2 or 4 years of follow-up did not differ according to the use of ginseng. CONCLUSIONS Cumulative ginseng use for longer than 5 years may be beneficial to cognitive function in late life.
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Kim NH, Choi J, Kim NH, Choi KM, Baik SH, Lee J, Kim SG. Dipeptidyl peptidase-4 inhibitor use and risk of diabetic retinopathy: A population-based study. DIABETES & METABOLISM 2018; 44:361-367. [PMID: 29752167 DOI: 10.1016/j.diabet.2018.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 03/09/2018] [Accepted: 03/11/2018] [Indexed: 10/17/2022]
Abstract
AIMS This study examined whether dipeptidyl peptidase (DPP)-4 inhibitor use is beneficial or harmful to diabetic retinopathy (DR) compared with other glucose-lowering agents in patients with type 2 diabetes (T2D). METHODS From a population-based cohort provided by the National Health Insurance Service in Korea, 67,743 adults with T2D were identified as having been treated with oral glucose-lowering agents between 2008 and 2013. Matching (1:1) was performed for two groups comparing ever-use (cases) and never-use (controls) of DPP-4 inhibitors (n=14,522 in each group). Cox regression analyses were used to assess risk of the following DR events: vitreous haemorrhage; vitrectomy or photocoagulation; intravitreal agent use; and blindness. RESULTS During a median follow-up of 28.4 (14.0-45.2) months, there were 305 (in controls) and 342 (in cases) composite DR events. DPP-4 inhibitor ever-use was not associated with overall risk of composite DR events [adjusted hazard ratio (HR): 1.08, 95% CI: 0.93-1.26] compared with never-use, nor was the risk of each DR outcome increased with DPP-4 inhibitor therapy either. However, DPP-4 inhibitor administration for<12 months was associated with a greater risk of composite DR events (adjusted HR: 1.31, 95% CI: 1.09-1.57) compared with other glucose-lowering agents over the same treatment period. CONCLUSION In comparison to other oral glucose-lowering agents, DPP-4 inhibitor treatment did not increase overall risk of DR. However, DPP-4 inhibitors may be associated with an increased risk of retinopathy events early in the treatment phase.
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Suh SW, Han JW, Lee JR, Byun S, Kwon SJ, Oh SH, Lee KH, Han G, Hong JW, Kwak KP, Kim BJ, Kim SG, Kim JL, Kim TH, Ryu SH, Moon SW, Park JH, Seo J, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. Sleep and cognitive decline: A prospective nondemented elderly cohort study. Ann Neurol 2018; 83:472-482. [PMID: 29394505 DOI: 10.1002/ana.25166] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate sleep disturbances that induce cognitive changes over 4 years in nondemented elderlies. METHODS Data were acquired from a nationwide, population-based, prospective cohort of Korean elderlies (2,238 normal cognition [NC] and 655 mild cognitive impairment [MCI]). At baseline and 4-year follow-up assessments, sleep-related parameters (midsleep time, sleep duration, sleep latency, subjective sleep quality, sleep efficiency, and daytime dysfunction) and cognitive status were measured using the Pittsburgh Sleep Quality Index and Consortium to Establish a Registry for Alzheimer's Disease Assessment, respectively. We used logistic regression models adjusted for covariates including age, sex, education, apolipoprotein E genotype, Geriatric Depression Scale, Cumulative Illness Rating Scale, and physical activity. RESULTS In participants with NC, long sleep latency (>30 minutes), long sleep duration (≥7.95 hours), and late midsleep time (after 3:00 am) at baseline were related to the risk of cognitive decline at 4-year follow-up assessment; odds ratio (OR) was 1.40 for long sleep latency, 1.67 for long sleep duration, and 0.61 for late midsleep time. These relationships remained significant when these variables maintained their status throughout the follow-up period. Newly developed long sleep latency also doubled the risk of cognitive decline. In those with MCI, however, only long sleep latency reduced the chance of reversion to NC (OR = 0.69). INTERPRETATION As early markers of cognitive decline, long sleep latency can be used for elderlies with NC or MCI, whereas long sleep duration and relatively early sleep time might be used for cognitively normal elderlies only. Ann Neurol 2018;83:472-482.
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Kim SW, Jun JW, Giri SS, Chi C, Yun S, Kim HJ, Kim SG, Kang JW, Park SC. First report of carp oedema virus infection of koi (Cyprinus carpio haematopterus) in the Republic of Korea. Transbound Emerg Dis 2017; 65:315-320. [PMID: 29226602 DOI: 10.1111/tbed.12782] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Indexed: 11/29/2022]
Abstract
Twenty-five koi (Cyprinus carpio haematopterus) bought from a wholesale fish market in Korea, showed lethargic behaviour and 100% mortality within 20 days. Carp oedema virus (CEV) was detected by PCR in all 25 koi. Results of detailed histopathological and clinical examinations of 17 koi indicated loss of body balance, severe infiltration of inflammatory cells into the inter-lamellar spaces of the gills and vacuolization and inclusion bodies in gill epithelial cells. Sequence analysis of PCR products of these koi showed up to 99% identity to the previously reported sequences, suggesting that the observed mass mortality resulted from koi sleepy disease (KSD) due to CEV infection. To the best of our knowledge, this study is the first report of KSD in the Republic of Korea. Partial sequences of 4a protein from the virus indicated that the present CEV detected in koi from Korea is more closely related to that from the UK and Poland than from Japan. The present findings indicate that the prevalence and spread of KSD must be closely monitored in both European and Asian countries to avoid potential economic losses to the global koi industry.
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