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Background: Little is known about the clinical characteristics of patients with situational syncope such as defecation syncope (DS) or micturition syncope (MS) compared with those with common vasovagal syncope (VVS). Methods: Among 680 consecutive patients, who underwent a head-up tilt test between January 2006 and November 2010, 282 patients (40.4± 16.7 years; 48.6% men) diagnosed as DS (n = 38), MS (n = 38), or common VVS (n = 208) were included. Results: Ages at diagnosis (38.7± 17.3 vs 48.3± 14.1 vs 42.0± 13.8, P = 0.004) and the first syncope (33.7± 18.4 vs 44.5± 15.3 vs 37.5± 14.6, P = 0.002) were significantly less in patients with common VVS than those with DS or MS, respectively. The patients with MS were more likely to be men (73.7%, P = 0.036), whereas patients with DS were more commonly women (73.7%). No sexual preference was observed in patients with common VVS. Body mass index was significantly lower (P = 0.047) and syncopal episodes were more recurrent (P = 0.049) in patients with common VVS than those with DS or MS. The frequency of drinking alcohol before syncope was significantly higher in patients with MS (39.5%, P < 0.001). Conclusions: DS tended to occur in older women, whereas MS tended to occur in middle-aged men and drinking alcohol was an important precipitating factor for MS. However, common VVS was observed more in a thin and young population, which was more recurrent compared with those situational syncopes. (PACE 2011;1-7) [ABSTRACT FROM AUTHOR]

Abstract: Our study aimed to compare cognitive status and declines in AD with/without small vessel disease (SVD) and SIVD at baseline and 1-year follow-up. Patients with Alzheimer's disease without small vessel disease (AD(−)SVD) (n =148), Alzheimer's disease with small vessel disease (AD(+)SVD) (n =94) and SIVD (n =60) were recruited from database of multiple centers in Korea. Basic demographics and detailed neuropsychological results were compared. AD, regardless of SVD, showed worse memory and better executive function than SIVD at baseline. Mini-Mental State Examination scores and visual memory function declined more in AD than those in SIVD whereas Barthel Activities of Daily Living (B-ADL) scores declined more in SIVD. AD showed different patterns of cognitive impairment compared with SIVD. After 1 year, AD showed more rapid cognitive decline in some domains. Further investigations with longer follow-up duration may be needed to confirm the cumulative effects of SVD in AD and different patterns of decline between AD and SIVD. [Copyright &y& Elsevier]

Abstract: The SCI, the MCI, and the Alzheimer''s disease (AD) are on a spectrum of disease progression; therefore, identification of the earliest signs of cognitive deterioration is becoming a crucial issue. The goal of this study was to examine symptom characteristics and distinguish predictive symptoms in patients with MCI compared with SCI, using caregiver questionnaires. We assessed the Korean Dementia Screening Questionnaire (KDSQ) and Seoul Instrumental activities of Daily Living (S-IADL) of 344 subjects with SCI and 697 with MCI. Multivariate logistic regression analyses were conducted after adjusting for age, sex, and educational status. Common and rare symptoms were similar between the SCI and MCI groups. The most distinguishing features of KDSQ were ‘Finds it hard to go somewhere on his/her own using public transportation’ (odds ratio=OR=4.56, p <0.0001), ‘Has difficulty in operating appliances’ (OR=2.47, p =0.001), and ‘Keeps repeating the same question’ (OR=2.03, p <0.0001). In S-IADL, the most outstanding features were ‘using household appliances’ (OR=3.99, p <0.0001), ‘taking medication’ (OR=2.38, p =0.01), and ‘using public transportation’ (OR=1.94, p =0.04). The dysfunction in ‘using household appliance’ and ‘using public transportation’ reflect the possibility of MCI rather than SCI. Therefore, it is suggested that these symptoms also have a discriminative and predictive power in identifying SCI. [Copyright &y& Elsevier]