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Introduction: False memory, observed as intrusion errors or false positives (FPs), is prevalent in patients with Alzheimer’s disease, but has yet to be thoroughly investigated in patients with amnestic mild cognitive impairment (a-MCI) with Alzheimer’s disease pathology (ADP). We analyzed false versus veridical memory in individuals with a-MCI and measured the utility of false memory for ADP discrimination. Methods: Patients with a-MCI who received neuropsychological testing and amyloid PET were included. Patients were categorized into “with” and “without ADP” groups according to PET results. Memory tests assessed veridical and false memory, and the verity of patient responses was analyzed. A logistic regression model was used to evaluate false memory efficiency in discriminating ADP, and the sensitivity and specificity at the optimal level were estimated using the receiver-operating characteristic curve. Results: Thirty-seven ADP and 46 non-ADP patients were enrolled. The ADP group made more FPs in the recognition tests, and their response verity was significantly lower in every delayed memory test. No group difference, however, was observed in the veridical memory. The logistic regression analysis demonstrated that as the FPs increased, the risk of ADP increased 1.31 and 1.36 times in the verbal and visual recognition tests, respectively. The discriminatory accuracy of the FPs was estimated “low” to “moderate” in the visual and verbal recognition, respectively, with an optimal cutoff above 2.5. Conclusion: Increased false memory was the only feature to discriminate ADP from non-ADP in individuals with a-MCI. Further studies regarding false memory and its mechanism are warranted.

Purpose We determined whether resilience factors such as self-efficacy, stress coping styles, and social support were differentially associated with health-related quality of life (HRQoL) in men and women with epilepsy after controlling for depression, anxiety, and daily-life stress. Methods This was a cross-sectional study of 129 adults with epilepsy. The Quality of Life in Epilepsy Inventory-31 (QOLIE-31), Epilepsy Self-Efficacy Scale, Way of Stress Coping Checklist, Social Support Scale, Beck Depression Inventory (BDI), Beck Anxiety Inventory, and Daily Hassles Scale were used. Stepwise linear regression analyses were performed. Results Except for medication effects, there were no gender differences in the QOLIE-31 and its subscales. The medication effects score was higher in men than in women after controlling for BDI scores. The BDI scores were independently associated with the QOLIE-31 score in men and women. Epilepsy self-efficacy was associated with the QOLIE-31 in men, whereas social support was associated with the QOLIE-31 in women. Coping strategies were associated with the QOLIE-31 in neither men nor women. Seizure frequency, daily-life stress, and anxiety were also negatively associated with the QOLIE-31, but only in men. The coefficients of determination were 0.637 and 0.587 in the men’s and women’s models, respectively. Conclusions The influence of self-efficacy and social support on HRQoL differed between men and women with epilepsy even after controlling for psychological distress. These findings could contribute to the development of successful gender-specific psychosocial interventions to improve HRQoL in men and women with epilepsy.

Background and purpose Semantic memory remains more stable than episodic memory across the lifespan, which makes it potentially useful as a marker for distinguishing pathological aging from normal senescence. To obtain a better understanding of the transitional stage evolving into Alzheimer's dementia (AD), we focused on the amnestic mild cognitive impairment (aMCI) stage stratified based on β-amyloid (Aβ) pathology. Methods We analyzed the raw data from Korean version of the Boston Naming Test (K-BNT) and the Controlled Oral Word Association Test (COWAT). For K-BNT, the frequencies of six error types and accuracy rates were evaluated. For a qualitative assessment of the COWAT, we computed the number of switching, number of clusters, and mean cluster size. Results The data from 217 participants were analyzed (53 normal controls, 66 with Aβ- aMCI, 56 with Aβ+ aMCI, and 42 disease controls). There were fewer semantically related errors and more semantically unrelated errors on the K-BNT in Aβ+ aMCI than in Aβ- aMCI, without a gross difference in the z score. We also found that Aβ+ aMCI showed a more prominent deficit in the number of clusters in the semantic fluency task [especially for animal names (living items)] than Aβ- aMCI. Conclusions In spite of similar clinical manifestations, Aβ+ aMCI was more similar to AD than Aβ- aMCI in terms of semantic memory disruption. Semantic memory may serve as an early indicator of brain Aβ pathology. Therefore, semantic memory dysfunction deserves more consideration in clinical practice. Longitudinal research with the follow-up data is needed.

Background and Objective We developed a Korean version of the Functional Outcomes of Sleep Questionnaire (K-FOSQ) and investigated its reliability and validity in simple snorer or obstructive sleep apnea (OSA) patients. Methods A total 432 participants (70% men, 84% OSA, mean age 50.0 ± 9.8 years) who were simple snorers or had OSA were included. We assessed the internal consistency, test-retest reliability, factor analysis, multitrait scaling analysis, and the concurrent validity of the K-FOSQ. Participants completed a battery of questionnaires including the Epworth Sleepiness Scale (ESS), Short Form-36 Health Survey (SF-36), Medical Outcomes Study-Sleep (MOS-Sleep) Scale, and Beck Depression Inventory (BDI). Results Factor analysis identified five factors, in which only 24 items met the loading criteria. The five factors of K-FOSQ accounted for 73.0% of the variance. Cronbach’s alpha coefficient for all domains exceeded the 0.70 standard for internal consistency. Test-retest reliability was acceptable (r = 0.41–0.93). Item-domain correlations ranged from 0.37 to 0.90. Only one item did not reach the threshold of 0.40. Floor effects were not observed, but ceiling effects were marked on all K-FOSQ subscales except one. All domains of K-FOSQ were significantly correlated with the corresponding scores of all tested instruments. The global K-FOSQ had a strong correlations (r > 0.50) with ESS and Sleep Problem Index-2 of MOS-Sleep, and had medium-sized correlations (r = 0.40–0.50) with BDI and SF-36 total scores. The K-FOSQ global and subscales did discriminate between participants with and without daytime sleepiness, but not between simple snorers and OSA patients. Conclusions The K-FOSQ is a reliable and valid instrument for assessing functional outcome in participants with daytime sleepiness.

Background and Purpose Evaluating instrumental activities of daily living (IADL) is an important part of procedure to diagnose dementia. The Korean-Instrumental Activities of Daily Living (K-IADL) has been used extensively in Korea. However, its cut-off score has not been reformulated since 2002. The purpose of this study was to yield a new optimal cut-off score for the K-IADL and confirm the validity of this new cut-off score with various dementia groups. Methods We retrospectively collected a total of 2,347 patients' K-IADL data from 6 general hospitals in Korea. These patients had mild cognitive impairment (MCI) or dementia with various etiologies for cognitive impairment. We also recruited a normal control group (n=254) from the community. Korean-Mini Mental State Examination, Short version of the Geriatric Depression Scale, Clinical Dementia Rating, and Global Deterioration Scale were administered to all participants. Caregivers completed K-IADL and Barthel Index. Results K-IADL scores were significantly different among dementia subgroups, but not significantly different among MCI subgroups. Based on internal consistency, correlations with other scales, and factor analysis, K-IADL showed excellent reliability and validity. The new optimal cut-off score to diagnose dementia was 0.40, which gave a sensitivity of 0.901 and a specificity of 0.916. Positive predictive value for dementia using the new cut-off score was 94.2% for Alzheimer's disease, 100% for vascular dementia, and 84% for Parkinson's disease. Conclusions Our results illustrate that the new K-IADL cut-off score of 0.40 is reliable and valid for screening impairments of daily functioning resulting from various etiologies.

The purpose of this study was to investigate if multi-domain cognitive training, especially robot-assisted training, alters cortical thickness in the brains of elderly participants. A controlled trial was conducted with 85 volunteers without cognitive impairment who were 60 years old or older. Participants were first randomized into two groups. One group consisted of 48 participants who would receive cognitive training and 37 who would not receive training. The cognitive training group was randomly divided into two groups, 24 who received traditional cognitive training and 24 who received robot-assisted cognitive training. The training for both groups consisted of daily 90-min-session, five days a week for a total of 12 weeks. The primary outcome was the changes in cortical thickness. When compared to the control group, both groups who underwent cognitive training demonstrated attenuation of age related cortical thinning in the frontotemporal association cortices. When the robot and the traditional interventions were directly compared, the robot group showed less cortical thinning in the anterior cingulate cortices. Our results suggest that cognitive training can mitigate age-associated structural brain changes in the elderly. Trial Registration ClnicalTrials.gov NCT01596205

Furthermore, an observational study shows that greater cardiorespiratory fitness is associated with slowed progression of dementia and brain atrophy in patientswithAD.Objectivewas to assess the influence of physical activity and cognition on ADL.Methods: In the present study, data from the " Preserving quality of life, physical health and functional ability in A lzheimer’s d isease: The effect of physical ex ercise (ADEX) study" a randomized controlled multicentre study, was used. Baseline data from 166 patients with AD (age (mean 6SD): 70,9 67,5; gender (f/m): 72/94; Mini-Mental State Examination (MMSE)(mean 6SD): 24,1 63,6) were included.ADL was assessed by the Alzheimer’s Disease Co-operative Study Activities of Daily Living (ADCSADL) scale and physical activity by the Physical Activity Scale for the Elderly (PASE) (caregiver interview).Furthermore, global cognitive function and mental speed/attention was assessed by the MMSE and Symbol Digit Modalities Test (SDMT), respectively. Two linear regression models were performed to investigate the impact of SDMT and PASE on ADCS-ADL. Covariates were PASE, age, gender and MMSE. In the second model, PASE was replaced by SDMT. Results: A significant association between ADL and PASE was found and between ADL and SDMT (B: 0,06; (SE: 6 0,02); b:0,27; and B: 0,06 (SE: 6 0,06); b:0,09, respectively).Conclusions:Bothmental speed/attention (SDMT) and physical activity (PASE) had a significant but modest association with ADL. There was a tendency that low physical activity was associated with impairedADL to a greater extent than mental speed/attention. Future studies should to clarify if improving physical activity may supplement pharmacotherapy in postponing the decline in ADL in patients with AD.