• Korean Journal of Biological Psychiatry
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• v.15 no.1
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• pp.29-34
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• 2008

Objectives : This study aimed to test potential modifying effects of education on the association between apolipoprotein E ${\varepsilon}4$ (Apo E4) and cognitive decline. Methods : A community cohort(N=683) aged 65 or over completed the Korean version of Mini-Mental State Examination(MMSE-K) at baseline and two years later(1999-2001). Apo E polymorphisms were genotyped, and classified into that with or without Apo E4. Educational levels were categorized into people with or without education. Covariates included demographic(age, gender), life style(smoking, alcohol drinking), clinical (depression, sleep disorder, vascular risk factors) characteristics. Results : The association between Apo E4 and cognitive decline was significant only in the old persons with no education. The interaction term between education and Apo E4 on cognitive decline was significant(p=0.040). Conclusion : Elders with no education might be more vulnerable to the impact of Apo E4 on cognitive decline, which suggests gene-environment interaction.

• Korean Journal of Biological Psychiatry
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• v.20 no.3
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• pp.104-110
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• 2013

Objectives : The aim of this study was to examine the prospective impact of the apolipoprotein E (APOE) ${\varepsilon}4$ on cognitive performance in the community-dwelling elderly individuals with Alzheimer's disease (AD). Methods : The total number of subjects was 30 (12 men and 18 women) who were diagnosed with AD from a Korean project of "Early Detection of Dementia". People aged 65-85 years were included in the analysis. The eight neuropsychological domains from the Korean version of Consortium to Establish a Registry of Alzheimer's Disease (CERAD-K) were conducted to test subjects. They have been followed at 24-month intervals with the same assessments at each interval. Their cognitive performance at 2 year intervals was compared by the occurrence of the APOE ${\varepsilon}4$. Results : The impact of ${\varepsilon}4$ allele was significant in the Word List Memory Test (WLMT, F = 4.345, df = 1, p = 0.021) and Word List Recall Test (WLRT, F = 5.569, df = 1, p = 0.033). Conclusions : The APOE ${\varepsilon}4$ allele was significantly correlated especially with verbal episodic memory domain in community-dwelling elders diagnosed with AD.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.261-266
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• 2009

Objectives : The aim of this study is to examine the cognitive function change related to aging, the incidence of cognitive impairment, and the association between apolipoprotein E polymorphism and cognitive impairment through a follow-up of the elderly with normal cognitive ability at baseline. Methods : Two hundred and fifteen subjects aged 65 and over were surveyed in February, 1998 (baseline survey), and their cognitive function was assessed again in 2003 1st follow-up) and the once again in 2006 (2nd follow-up). Ninety one subjects completed all surveys up through the 2nd follow-up and their cognitive function scores using MMSE-K (Korean Version of the Mini-Mental State Examination) and the distribution of apolipoprotein E allele were analyzed. Results : The cognitive function scores decreased with aging and the difference between baseline and the 2nd follow-up scores of the study increased with the age group. The incidence rate of cognitive impairment through an 8-year follow-up was 38.5% and higher in older age groups. Age was the only significant factor for incidence of cognitive impairment, but there was no significant association between apolipoprotein E genotype and incidence of cognitive impairment. Conclusions : The cognition of the elderly decreased with aging and the association of apolipoprotein E genotype with incidence of cognitive impairment was not significant in this study. To confirm the association between apolipoprotein E polymorphism and incidence of cognitive impairment further studies will be needed.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.94-100
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• 2020

Objectives Amyloid β positron emission tomography (Aβ PET) is widely used as a diagnostic tool in patients who have symptoms of cognitive impairment, however, this diagnostic examination is too expensive. Thus, predicting the positivity of Aβ PET before patients undergo the examination is essential. We aimed to analyze clinical predictors of patients who underwent Aβ PET retrospectively, and to develop a predicting model of Aβ PET positivity. Methods 468 patients who underwent Aβ PET with cognitive impairment were recruited and their clinical indicators were analyzed retrospectively. We specified the primary outcome as Aβ PET positivity, and included variables such as age, sex, body mass index, diastolic blood pressure, systolic blood pressure, education, dementia family history, Mini Mental Status Examination (MMSE), Clinical Dementia Rating (CDR), Clinical Dementia Rating-Sum of Box (CDR-SB), hypertension (HTN), diabetes mellitus (DM) and presence of apolipoprotein E (ApoE) E4 as potential predictors. We developed three final models of amyloid positivity prediction for total subjects, mild cognitive impairment (MCI) and Alzheimer's disease (AD) dementia using a multivariate stepwise logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was performed and the area under curve (AUC) value was calculated for the ROC curve. Results Aβ PET negative patients were 49.6% (n = 232), and Aβ PET positive patients were 50.4% (n = 236). In the final model of all subjects, older age, female sex, presence of ApoE E4 and lower MMSE are associated with Aβ PET positivity. The AUC value was 0.296. In the final model of MCI subjects (n = 244), older age and presence of ApoE E4 are associated with Aβ PET positivity. The AUC value was 0.725. In the final model of AD subjects (n = 173), lower MMSE scores, the presence of ApoE E4 and history of HTN are associated with Aβ PET positivity. The AUC value was 0.681. Conclusions The cerebral amyloid positivity model, which was based on commonly available clinical indicators, can be useful for prediction of amyloid PET positivity in MCI or AD patients.

• Korean Journal of Biological Psychiatry
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• v.13 no.2
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• pp.103-109
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• 2006

Objective : Associations of vascular risk/disease or apolipoprotein E ${\varepsilon}4$(APOE4) with geriatric depression has been unclear at a population level. This study aimed to evaluate whether there would be interactions of vascular risk/disease and APOE4 on depression in a Korean elderly population. Methods : 732 community residents aged 65 or over were assessed for depression(GMS), information on vascular risk/disease(reported stroke, transient ishemic attack, heart disease, hypertension, diabetes, smoking), examinations for vascular risk/disease(blood pressure, blood tests for glucose and lipid profiles, body size), APOE genotypes, demographic characteristics(age, gender, education), physical health, and cognitive function(MMSE). Results : Previous stroke and lower level of high density lipoprotein(HDL) cholesterol were significantly associated with geriatric depression independent of demographic characteristics, physical illnesses, and cognitive function. These associations were statistically significant only in those with APOE4, although the interaction terms didn't reach to statistical significance. Conclusion : Associations between vascular risk/disease and geriatric depression might be more prominent in those with APOE4. However further research would be needed to clarify this issue.

• Korean Journal of Biological Psychiatry
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• v.17 no.4
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• pp.218-225
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• 2010

Objectives : The potential association between choline acetyltransferase(CHAT) polymorphism and the risk of mild cognitive impairment(MCI) has not been investigated in Korea. We examined the main effect of CHAT polymorphism and its interaction with apolipoprotein E(APOE) polymorphism in the development of MCI in elderly Korean sample. Methods : We analyzed CHAT 2384G > A polymorphism and APOE polymorphism among 149 MCI subjects with MCI and 298 normal controls. We tested the association between MCI and CHAT A allele status using a logistic regression model. In addition, we employed generalized multifactor dimensionality reduction(GMDR) to investigate the interaction between CHAT and APOE with regard to the risk of MCI. Results : The CHAT A allele was associated with AD risk(OR = 1.59, 95% CI = 1.02-2.48, p = 0.042). No significant gene-gene interaction between CHAT and APOE was found in GMDR method(testing balanced accuracy = 0.540, p = 0.055). Conclusion : The CHAT A allele was associated with MCI risk in the Korean elderly. Its interaction with the APOE ${\varepsilon}4$ allele was not significant with regard to the development of MCI.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.2
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• pp.549-558
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• 2017

The aim of this study was to analyze the effects of aerobic exercise on the blood lipids, leptin, ghrelin, and HOMA-IR factors in obese postmenopausal Korean women. Thirty-six healthy postmenopausal women (mean age, $54.47{\pm}2.50$ years) with >32 % body fat were assigned randomly to an aerobic exercise group (n = 18) or to a "no exercise" control group (n = 18). The subjects' body composition, blood lipid, leptin, ghrelin levels, and HOMA-IR were measured before and after a 16-week line-dancing program. The exercise group showed a significant decrease in body weight, percent body fat, body mass index, visceral fat area, leptin, insulin, glucose, HOMA-IR, total cholesterol, triglycerides, apolipoprotein B, low-density lipoprotein cholesterol, and systolic and diastolic blood pressure. In addition, this group exhibited a significant increase in the apolipoprotein A-I, ghrelin, and high-density lipoprotein cholesterol levels. The energy metabolic factors that influenced the visceral fat included ghrelin, leptin, insulin, glucose, and HOMA-IR. The t-value, which determined the statistical significance of the independent variables, was significant for ghrelin, glucose, insulin, and HOMA-IR (p < 0.05). Regular and continuous aerobic exercise (e.g., line dancing) effectively improved the body composition, visceral fat, serum blood lipids, leptin, ghrelin, and HOMA-IR factors in obese postmenopausal Korean women.