Glutamate. Its applications in food and contribution to health.

ObjectiveaaWe developed a Korean version of Mini-Mental Status Examination (MMSE) optimized for screening dementia (MMSE-DS) and its’ short form (SMMSE-DS). MethodsaaWe constructed the MMSE-DS using the items of the two current Korean versions of MMSE and then construct the SMMSE-DS consisted of 13 items from the MMSEDS based on the diagnostic accuracy of individual items for dementia. We investigated reliability and validity of MMSE-DS and SMMSE-DS on 1,555 subjects (1,222 nondemented controls, 333 dementia patients). We compared the diagnostic accuracy of the SMMSE-DS with that of the three full Korean versions of MMSE, and examined its’ age- and education-specific optimal cutoff scores for dementia. ResultsaaThe internal consistency obtained by Cronbach’s coefficient alpha was 0.826. The inter-rater reliability and test-retest reliability were 0.968 (p<0.001) and 0.825 (p<0.001), respectively. It showed significant correlation with the Clinical Dementia Rating (CDR) (r=-0.698, p<0.05) and the three full Korean versions of MMSE (r=0.839-0.938, p<0.001). The area under the receiver operator curve for dementia of the SMMSE-DS was larger than those of the three full Korean versions of MMSE (p<0.001). Age, education and gender explained 19.4% of the total variance of SMMSE-DS scores. The optimal cutoff scores for dementia of the SMMSE-DS were estimated differently by age and educational attainment of the subjects. ConclusionaaThe SMMSE-DS was found to be accurate, brief and portable instrument for screening dementia in Korean elders, and may be particularly useful for screening dementia in elderly populations with wide variation in educational levels. Psychiatry Investig 2010;7:102-108 Key Wordsaa Mini-Mental Status Examination, Short form, Dementia, Validity, Reliability, Korean.

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Korean version of mini mental status examination for dementia screening and its' short form.

The associations between blood pressure and dementia have been inconclusive. We followed up a total of 668 community-dwelling Japanese individuals without dementia, aged 65 to 79 years, for 17 years and examined the associations of late-life and midlife hypertension with the risk of vascular dementia and Alzheimer disease using the Cox proportional hazards model. During the follow-up, 76 subjects experienced vascular dementia and 123 developed Alzheimer disease. The age- and sex-adjusted incidence of vascular dementia significantly increased with elevated late-life blood pressure levels (normal: 2.3, prehypertension: 8.4, stage 1 hypertension: 12.6, and stage 2 hypertension: 18.9 per 1000 person-years; P(trend)<0.001), whereas no such association was observed for Alzheimer disease (P(trend)=0.88). After adjusting for potential confounding factors, subjects with prehypertension and stage 1 or stage 2 hypertension had 3.0-fold, 4.5-fold, and 5.6-fold greater risk of vascular dementia, respectively, compared with subjects with normal blood pressure. Likewise, there was a positive association of midlife blood pressure levels with the risk of vascular dementia but not with the risk of Alzheimer disease. Compared with those without hypertension in both midlife and late life, subjects with midlife hypertension had an ≈5-fold greater risk of vascular dementia, regardless of late-life blood pressure levels. Our findings suggest that midlife hypertension and late-life hypertension are significant risk factors for the late-life onset of vascular dementia but not for that of Alzheimer disease in a general Japanese population. Midlife hypertension is especially strongly associated with a greater risk of vascular dementia, regardless of late-life blood pressure levels.

Midlife and late-life blood pressure and dementia in Japanese elderly: the Hisayama study

Animal-assisted interventions for elderly patients affected by dementia or psychiatric disorders: A review

A double-blind, parallel-group, placebo-controlled trial was performed on 50- to 80-year-old Japanese men and women diagnosed with mild cognitive impairment in order to examine the efficacy of oral administration of Yamabushitake (Hericium erinaceus), an edible mushroom, for improving cognitive impairment, using a cognitive function scale based on the Revised Hasegawa Dementia Scale (HDS-R). After 2 weeks of preliminary examination, 30 subjects were randomized into two 15-person groups, one of which was given Yamabushitake and the other given a placebo. The subjects of the Yamabushitake group took four 250 mg tablets containing 96% of Yamabushitake dry powder three times a day for 16 weeks. After termination of the intake, the subjects were observed for the next 4 weeks. At weeks 8, 12 and 16 of the trial, the Yamabushitake group showed significantly increased scores on the cognitive function scale compared with the placebo group. The Yamabushitake group's scores increased with the duration of intake, but at week 4 after the termination of the 16 weeks intake, the scores decreased significantly. Laboratory tests showed no adverse effect of Yamabushitake. The results obtained in this study suggest that Yamabushitake is effective in improving mild cognitive impairment.

Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double‐blind placebo‐controlled clinical trial

Revised Hasegawa's dementia scale (HDS-R), consisting of 9 simple questions with a maximum score of 30, was examined in its usefulness for screening age-associated dementia in a total of 157 subijects: 95 demented patients and 62 non-demented persons. The two groups were age-matched. Cronbach's coefficient alpha was as high as 0.90 in HDS-R. In addition, the coefficient of correlation of each question's score to the total score of other questions in the IHDS-R was significantly high, ranging between 0.79 and 0.40. These findings proved that the HDS-R could satisfy the fundamental prerequisite for dementia screening tests: reliability in terms of internal consistency. Clinical applicability of the HDS-R was confirmed by the following two findings. (a) significant differences were noted between the demented and non-demented groups in each question's score, total mean score and mean score by DS-based severity. (b) Dementia could be most exactly discriminated from non-dementia with sensitivity of 0.90 and specificity of 0.82 at a cutoff point of 20/21 . The coefficient of correlation of the HDS-R to the MMSE was as high as 0.94, proving the HDS-R to be valid in terms of compatability with the established dementia screening test. In conclusion, the HDS-R can screen dementia at the highest conceivable accuracy and efficiency. It may also serve to assess the severity of dementia changing with time and the effect of pharmacotherapy and rehabilitation. Keywords: dementia, screening test, HDS-R, sensitivity, specificity INTRODUCTION Since the primary symptoms of dementia are cognitive decline, various intelligence tests such as the WAIS (Weschesler Adult Intelligence Scale) have f used for its assesment. However the WAIS is not generally able for screening for dementia since it takes too long to administer, and has not been adequately standardize for elderly subject with cognitive changes associated with normal aging. For the purpose of screening for dementia, questions dimild be eat answered key normal elderly persons, but individuals with dementa should find them difficult. Ideally, these should ba a standardized, simple and quick test of cognitive function for routine use by the physcian Many simple scales for assessment of dementia have been deVeloped and are currently in use. Of these, the Mini-Mental State Examination (MMSE) of Folstein et al. (1975) and the Dementia RAM Scale of Blessed et al. (1968) are perhaps the most widely used brief instruments for assessing severity. Hasegawa et al. (1974) developed and standardized a brief dementia screening scale, called the Hasegawa's Dementia Stale (HDS) which comprises 11 questions (Hasegawa 1983). The HDS have been the most widely accepted not only for clinical we in hospitals and elderly nursing home, but also epiderrdolcgxcal surveys in Japan (Hasegawa and hnad, 1989). However, a recent review of the HDS required us to reconsider some questions and study a feasibility for worldwide use. In consequence, we decided to delete the following five questions because they were judged to be obsolete or lacking universality: 1. The place of the subject's birth (since it is impossible to confirm without the presence of the subject's family). 2. The year of the termination of World War II in Japan (since it is not appropriate for international use and not even applicable to Japanese population). 3. The number of days in opte years (since it is very easily answered even by patients with dementia). 4. The name of the present prime minister in Japan (since it is not appropriate for intercultural use). 5. How long have you been here (since it needs advance information from person around the subject or lacks uniformity in answers among among individuals). Instead immediate recall of 3 words, delay recall of 3 words, and list-ratirg fluency were added. The HDS was recontructed in this manner and named the revised HDS (HDS-R). …

Kazou Hasegawa

Papers

The Revised Hasegawa's Dementia Scale (HDS-R)-Evaluation of Its Usefulness as a Screening Test for Dementia