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Han M, Hwang S, Agusbudiman A, Lee JM, Lee KB, Kim BC, Heo DH, Kim TH. Digital coincidence counting with 4πβ(PPC)-γ for the standardization of 60Co. Appl Radiat Isot 2024; 205:111173. [PMID: 38211394 DOI: 10.1016/j.apradiso.2024.111173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
A 4πβ(PPC)-γ coincidence system has been made at KRISS based on a digital DAQ. 60Co sources were measured to verify the system. The maximum detection efficiency for beta particles was estimated to be 96.7 %. Massic activities for sample sources had 0.005 % of the sample variability error, which was well within the expanded standard uncertainty of 0.54 % (k = 2).
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Affiliation(s)
- Minji Han
- Korea Research Institute of Standards and Science (KRISS), Daejeon, 34113, South Korea; University of Science & Technology (UST), Daejeon, 34113, South Korea
| | - Sanghoon Hwang
- Korea Research Institute of Standards and Science (KRISS), Daejeon, 34113, South Korea; University of Science & Technology (UST), Daejeon, 34113, South Korea.
| | - Agung Agusbudiman
- Korea Research Institute of Standards and Science (KRISS), Daejeon, 34113, South Korea; University of Science & Technology (UST), Daejeon, 34113, South Korea
| | - J M Lee
- Korea Research Institute of Standards and Science (KRISS), Daejeon, 34113, South Korea; University of Science & Technology (UST), Daejeon, 34113, South Korea
| | - K B Lee
- Korea Research Institute of Standards and Science (KRISS), Daejeon, 34113, South Korea; University of Science & Technology (UST), Daejeon, 34113, South Korea
| | - B C Kim
- Korea Research Institute of Standards and Science (KRISS), Daejeon, 34113, South Korea
| | - D H Heo
- Korea Research Institute of Standards and Science (KRISS), Daejeon, 34113, South Korea
| | - T H Kim
- Korea Research Institute of Standards and Science (KRISS), Daejeon, 34113, South Korea
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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 DW, Lee SB, Lee JJ, Jhoo JH, Kim KW. Association of Depression With the Progression of Multimorbidity in Older Adults: A Population-Based Cohort Study. Am J Geriatr Psychiatry 2024:S1064-7481(24)00263-X. [PMID: 38443296 DOI: 10.1016/j.jagp.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND The relationship between depression and the risk of multimorbidity progression has rarely been studied in older adults. This study was aimed to determine whether depression is associated with progression in the severity and complexity of multimorbidity, considering the influence of depression's severity and subtype. METHODS As a part of the Korean Longitudinal Study on Cognitive Aging and Dementia, this population-based cohort study followed a random sample of community-dwelling Koreans aged 60 and older for 8 years at 2-year intervals starting in 2010. Participants included those who completed mood and multimorbidity assessments and did not exhibit complex multimorbidity at the study's outset. Depression was assessed using the Geriatric Depression Scale, while multimorbidity was evaluated using the Cumulative Illness Rating Scale. The study quantified multimorbidity complexity by counting affected body systems and measured multimorbidity severity by averaging scores across 14 body systems. FINDINGS The 2,486 participants (age = 69.1 ± 6.5 years, 57.6% women) were followed for 5.9 ± 2.4 years. Linear mixed models revealed that participants with depression had a faster increase in multimorbidity complexity score (β = .065, SE = 0.019, p = 0.001) than those without depression, but a comparable increase in multimorbidity severity score (β = .001, SE = .009, p = 0.870) to those without depression. Cox proportional hazard models revealed that depression was associated with the risk of developing highly complex multimorbidity affecting five or more body systems, particularly in severe or anhedonic depression. INTERPRETATION Depression was associated with the worsening of multimorbidity in Korean older adults, particularly when severe or anhedonic. Early screening and management of depression may help to reduce the burden of multimorbidity in older adults.
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Affiliation(s)
- Dae Jong Oh
- Workplace Mental Health Institute (DJO), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry (JWH, KWK), Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - Tae Hui Kim
- Department of Psychiatry (THK), Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Kyung Phil Kwak
- Department of Psychiatry (KPK), Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Bong Jo Kim
- Department of Psychiatry (BJK), Gyeongsang National University School of Medicine, Jinju, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry (SGK), Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jeong Lan Kim
- Department of Psychiatry (JLK), School of Medicine, Chungnam National University, Daejeon, Korea
| | - Seok Woo Moon
- Department of Psychiatry (SWM), School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry (JHP), Jeju National University Hospital, Jeju, Korea
| | - Seung-Ho Ryu
- Department of Psychiatry (S-HR), School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry (JCY), Kyunggi Provincial Hospital for the Elderly, Yongin, Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry (DWL), Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seok Bum Lee
- Department of Psychiatry (SBL, JJL), Dankook University Hospital, Cheonan, Korea
| | - Jung Jae Lee
- Department of Psychiatry (SBL, JJL), Dankook University Hospital, Cheonan, Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry (JHJ), Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry (JWH, KWK), Seoul National University Bundang Hospital, Gyeonggido, Korea; Department of Brain and Cognitive Science (KWK), Seoul National University College of Natural Sciences, Seoul, Korea.
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Park SA, Byeon G, Jhoo JH, Kim HC, Lim MN, Jang JW, Bae JB, Han JW, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DW, Lee SB, Lee JJ, Lee DY, Kim KW. A Preliminary Study on the Potential Protective Role of the Antioxidative Stress Markers of Cognitive Impairment: Glutathione and Glutathione Reductase. Clin Psychopharmacol Neurosci 2023; 21:758-768. [PMID: 37859449 PMCID: PMC10591176 DOI: 10.9758/cpn.23.1053] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/28/2023] [Accepted: 05/17/2023] [Indexed: 10/21/2023]
Abstract
Objective : To investigate the relationship between reduced glutathione (GSH), a key molecule of the antioxidant defense system in the blood, and glutathione reductase (GR), which reduces oxidized glutathione (glutathione disulfide [GSSG]) to GSH and maintains the redox balance, with the prevalence of Alzheimer's dementia and cognitive decline. Methods : In all, 20 participants with Alzheimer's dementia who completed the third follow-up clinical evaluation over 6 years were selected, and 20 participants with normal cognition were selected after age and sex matching. The GSH and GR concentrations were the independent variables. Clinical diagnosis and neurocognitive test scores were the dependent variables indicating cognitive status. Results : The higher the level of GR, the greater the possibility of having normal cognition than of developing Alzheimer's dementia. Additionally, the higher the level of GR, the higher the neurocognitive test scores. However, this association was not significant for GSH. After 6 years, the conversion rate from normal cognition to cognitive impairment was significantly higher in the lower 50th percentile of the GR group than in the upper 50th percentile. Conclusion : The higher the GR, the lower the prevalence of Alzheimer's dementia and incidence of cognitive impairment and the higher the cognitive test scores. Therefore, GR is a potential protective biomarker against Alzheimer's dementia and cognitive decline.
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Affiliation(s)
- Sang-a Park
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea
| | - Gihwan Byeon
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Hyung-Chun Kim
- College of Pharmacy, Kangwon National University, Chuncheon, Korea
| | - Myoung-Nam Lim
- Biomedical Research Institute, Kangwon National University Hospital, Chuncheon, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Chuncheon, Korea
- Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeonju Hospital, Gyeongju, Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Seok Woo Moon
- Department of Psychiatry, Konkuk University Chungju Hospital, School of Medicine, Konkuk University, Chungju, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
| | - Seung-Ho Ryu
- Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea
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Byun S, Lee HJ, Kim JS, Choi E, Lee S, Kim TH, Kim JH, Han JW, Kim KW. Exploring shared neural substrates underlying cognition and gait variability in adults without dementia. Alzheimers Res Ther 2023; 15:206. [PMID: 38012628 PMCID: PMC10680297 DOI: 10.1186/s13195-023-01354-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND High gait variability is associated with neurodegeneration and cognitive impairments and is predictive of cognitive impairment and dementia. The objective of this study was to identify cortical or subcortical structures of the brain shared by gait variability measured using a body-worn tri-axial accelerometer (TAA) and cognitive function. METHODS This study is a part of a larger population-based cohort study on cognitive aging and dementia. The study included 207 participants without dementia, with a mean age of 72.6, and 45.4% of them are females. We conducted standardized diagnostic interview including a detailed medical history, physical and neurological examinations, and laboratory tests for cognitive impairment. We obtained gait variability during walking using a body-worn TAA along and measured cortical thickness and subcortical volume from brain magnetic resonance (MR) images. We cross-sectionally investigated the cortical and subcortical neural structures associated with gait variability and the shared neural substrates of gait variability and cognitive function. RESULTS Higher gait variability was associated with the lower cognitive function and thinner cortical gray matter but not smaller subcortical structures. Among the clusters exhibiting correlations with gait variability, one that included the inferior temporal, entorhinal, parahippocampal, fusiform, and lingual regions in the left hemisphere was also associated with global cognitive and verbal memory function. Mediation analysis results revealed that the cluster's cortical thickness played a mediating role in the association between gait variability and cognitive function. CONCLUSION Gait variability and cognitive function may share neural substrates, specifically in regions related to memory and visuospatial navigation.
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Affiliation(s)
- Seonjeong Byun
- Department of Neuropsychiatry, College of Medicine, Uijeongbu St Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyang Jun Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea
| | - Jun Sung Kim
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Euna Choi
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
| | - Subin Lee
- Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, 82 Gumiro 173 Beongil, Bundanggu, Seongnamsi, Gyeonggido, 463-707, Republic of Korea.
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea.
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
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An H, Yang HW, Oh DJ, Lim E, Shin J, Moon DG, Suh SW, Byun S, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Lee DW, Lee SB, Lee JJ, Jhoo JH, Bae JB, Han JW, Kim KW. What is the impact of one's chronic illness on his or her spouse's future chronic illness: a community-based prospective cohort study. BMC Med 2023; 21:367. [PMID: 37840129 PMCID: PMC10578032 DOI: 10.1186/s12916-023-03061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 09/04/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Integrating a joint approach to chronic disease management within the context of a couple has immense potential as a valuable strategy for both prevention and treatment. Although spousal concordance has been reported in specific chronic illnesses, the impact they cumulatively exert on a spouse in a longitudinal setting has not been investigated. We aimed to determine whether one's cumulative illness burden has a longitudinal impact on that of their spouse. METHODS Data was acquired from a community-based prospective cohort that included Koreans aged 60 years and over, randomly sampled from 13 districts nationwide. Data from the baseline assessment (conducted from November 2010 to October 2012) up to the 8-year follow-up assessment was analyzed from October 2021 to November 2022. At the last assessment, partners of the index participants were invited, and we included 814 couples in the analysis after excluding 51 with incomplete variables. Chronic illness burden of the participants was measured by the Cumulative Illness Rating Scale (CIRS). Multivariable linear regression and causal mediation analysis were used to examine the longitudinal effects of index chronic illness burden at baseline and its change during follow-up on future index and spouse CIRS scores. RESULTS Index participants were divided based on baseline CIRS scores (CIRS < 6 points, n = 555, mean [SD] age 66.3 [4.79] years, 43% women; CIRS ≥ 6 points, n = 259, mean [SD] age 67.7 [4.76] years, 36% women). The baseline index CIRS scores and change in index CIRS scores during follow-up were associated with the spouse CIRS scores (β = 0.154 [SE: 0.039], p < 0.001 for baseline index CIRS; β = 0.126 [SE: 0.041], p = 0.002 for change in index CIRS) at the 8-year follow-up assessment. Subgroup analysis found similar results only in the high CIRS group. The baseline index CIRS scores and change in index CIRS scores during follow-up had both direct and indirect effects on the spouse CIRS scores at the 8-year follow-up assessment. CONCLUSIONS The severity and course of one's chronic illnesses had a significant effect on their spouse's future chronic illness particularly when it was severe. Management strategies for chronic diseases that are centered on couples may be more effective.
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Affiliation(s)
- Hoyoung An
- Department of Neuropsychiatry, Keyo Hospital, Uiwang-Si, South Korea
| | - Hee Won Yang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eunji Lim
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Jin Shin
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Gyu Moon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | | | - Seonjeong Byun
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea.
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea.
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Park SY, Moon SM, Kim B, Lee MJ, Song KH, Kim ES, Kim TH, Kim HB. Applicability and limitations of quality indicator-based assessment of appropriateness in antimicrobial use: a comparison with expert opinion. J Hosp Infect 2023; 139:93-98. [PMID: 37419187 DOI: 10.1016/j.jhin.2023.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/06/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND The effective implementation of antimicrobial stewardship requires an a-priori assessment of the appropriateness of antimicrobial prescriptions. AIM To evaluate the effectiveness of quality indicators (QIs) in determining the appropriateness of antimicrobial prescriptions compared to that of expert opinions. METHODS The study assessed antimicrobial use in 20 hospitals in Korea, with infectious disease specialists rating the appropriateness based on QIs and expert opinions. The selected QIs were (1) taking two blood cultures, (2) taking cultures from suspected sites of infection, (3) prescribing empirical antimicrobials according to guidelines, and (4) changing from empirical to pathogen-directed therapy for hospitalized patients and (2, 3, and 4) for ambulatory patients. Applicability, compliance with QIs, and agreement between QIs and expert opinions were investigated. FINDINGS Overall, 7999 therapeutic uses of antimicrobials were investigated at the study hospitals. The experts rated 20.5% (1636/7999) as inappropriate use. For hospitalized patients, antimicrobial use was assessed based on all four QIs in 28.8% (1798/6234) of the cases. For ambulatory care patients, only 7.5% (102/1351) of the antimicrobial use cases were assessed using all three QIs. The agreement between expert opinions and all four QIs for hospitalized patients was minimal (κ = 0.332), whereas that between expert opinions and all three QIs for ambulatory patients was weak (κ = 0.598). CONCLUSION QIs have limitations in determining the appropriateness of antimicrobial use, and the degree of agreement with expert opinions was low. Therefore, these QI limitations should be considered when determining the appropriateness of antimicrobial use.
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Affiliation(s)
- S Y Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea; Centres for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - S M Moon
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - B Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - M J Lee
- Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - K-H Song
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - E S Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - T H Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea.
| | - H B Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
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Oh DJ, 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, Skoog I, Najar J, Sterner TR, Guaita A, Vaccaro R, Rolandi E, Scarmeas N, Yannakoulia M, Kosmidis MH, Riedel-Heller SG, Roehr S, Dominguez J, Guzman MFD, Fowler KC, Lobo A, Saz P, Lopez-Anton R, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Trollor J, Kochan N, Kim KW. Parental history of dementia and the risk of dementia: A cross-sectional analysis of a global collaborative study. Psychiatry Clin Neurosci 2023; 77:449-456. [PMID: 37165609 PMCID: PMC10524874 DOI: 10.1111/pcn.13561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/06/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Parental history of dementia appears to increase the risk of dementia, but there have been inconsistent results. We aimed to investigate whether the association between parental history of dementia and the risk of dementia are different by dementia subtypes and sex of parent and offspring. METHODS For this cross-sectional study, we harmonized and pooled data for 17,194 older adults from nine population-based cohorts of eight countries. These studies conducted face-to-face diagnostic interviews, physical and neurological examinations, and neuropsychological assessments to diagnose dementia. We investigated the associations of maternal and paternal history of dementia with the risk of dementia and its subtypes in offspring. RESULTS The mean age of the participants was 72.8 ± 7.9 years and 59.2% were female. Parental history of dementia was associated with higher risk of dementia (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.15-1.86) and Alzheimer's disease (AD) (OR = 1.72, 95% CI = 1.31-2.26), but not with the risk of non-AD. This was largely driven by maternal history of dementia, which was associated with the risk of dementia (OR = 1.51, 95% CI = 1.15-1.97) and AD (OR = 1.80, 95% CI = 1.33-2.43) whereas paternal history of dementia was not. These results remained significant when males and females were analyzed separately (OR = 2.14, 95% CI = 1.28-3.55 in males; OR = 1.68, 95% CI = 1.16-2.44 for females). CONCLUSIONS Maternal history of dementia was associated with the risk of dementia and AD in both males and females. Maternal history of dementia may be a useful marker for identifying individuals at higher risk of AD and stratifying the risk for AD in clinical trials.
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Affiliation(s)
- Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Bin Bae
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Ji Won Han
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Medical Center, Seoul, South Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Therese R Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
| | - Antonio Guaita
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Roberta Vaccaro
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Elena Rolandi
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, NY
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Jacqueline Dominguez
- Institute for Neurosciences, St. Luke’s Medical Center, Quezon City, Philippines
- Institute for Dementia Care Asia, Quezon City, Philippines
| | | | | | - Antonio Lobo
- Department of Medicine and Psychiatry. Zaragoza University. Aragon, Spain
| | - Pedro Saz
- Department of Medicine and Psychiatry. Zaragoza University. Aragon, Spain
| | - Raul Lopez-Anton
- Departamento de Psicología y Sociología. Universidad de Zaragoza, Aragon, Spain
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, Australia
- Centre for Mental Health Research, Australian National University, Canberra, Australia
- Neuroscience Australia, Sydney, Australia
| | - Nicolas Cherbuin
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Moyra E Mortby
- School of Psychology, University of New South Wales, Sydney, Australia
- Neuroscience Australia, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine & Health, University of New South Wales, Sydney, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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8
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Han A, Kim TH. Effects of Self-Compassion Interventions on Reducing Depressive Symptoms, Anxiety, and Stress: A Meta-Analysis. Mindfulness (N Y) 2023; 14:1-29. [PMID: 37362192 PMCID: PMC10239723 DOI: 10.1007/s12671-023-02148-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/28/2023]
Abstract
Objectives A growing body of evidence shows self-compassion can play a key role in alleviating depressive symptoms, anxiety, and stress in various populations. Interventions fostering self-compassion have recently received increased attention. This meta-analysis aimed to identify studies that measured effects of self-compassion focused interventions on reducing depressive symptoms, anxiety, and stress. Methods A comprehensive search was conducted within four databases to identify relevant randomized controlled trials (RCTs). The quality of the included RCTs was assessed using the Cochrane Collaboration risk-of-bias tool. Either a random-effects model or fixed-effects model was used. Subgroup analyses were conducted according to types of control groups, intervention delivery modes, and the involvement of directly targeted populations with psychological distress symptoms. Results Fifty-six RCTs met the eligibility criteria. Meta-analyses showed self-compassion focused interventions had small to medium effects on reducing depressive symptoms, anxiety, and stress at the immediate posttest and small effects on reducing depressive symptoms and stress at follow-up compared to control conditions. The overall risk of bias across included RCTs was high. Conclusions Fewer studies were conducted to compare effects of self-compassion interventions to active control conditions. Also, fewer studies involved online self-compassion interventions than in-person interventions and directly targeted people with distress symptoms. Further high-quality studies are needed to verify effects of self-compassion interventions on depressive symptoms, anxiety, and stress. As more studies are implemented, future meta-analyses of self-compassion interventions may consider conducting subgroup analyses according to intervention doses, specific self-compassion intervention techniques involved, and specific comparison or control groups. Preregistration This study is not preregistered. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-023-02148-x.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, SHPB 339, 1720 2Nd Ave South, Birmingham, AL 35294 USA
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, 20 Ilsan-RoGangwon Province, Wonju, 26426 South Korea
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9
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Oh DJ, Yang HW, Suh SW, Byun S, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Lee DW, Lee SB, Lee JJ, Jhoo JH, Bae JB, Han JW, Kim KW. The impact of the COVID-19 pandemic on depression in community-dwelling older adults: a prospective cohort study. Psychol Med 2023; 53:2992-2999. [PMID: 37449487 PMCID: PMC8692844 DOI: 10.1017/s0033291721005018] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/04/2021] [Accepted: 11/16/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND There are growing concerns about the impact of the COVID-19 pandemic on the mental health of older adults. We examined the effect of the pandemic on the risk of depression in older adults. METHODS We analyzed data from the prospective cohort study of Korean older adults, which has been followed every 2 years. Among the 2308 participants who completed both the third and the fourth follow-up assessments, 58.4% completed their fourth follow-up before the outbreak of COVID-19 and the rest completed it during the pandemic. We conducted face-to-face diagnostic interviews using Mini International Neuropsychiatric Interview and used Geriatric Depression Scale. We performed generalized estimating equations and logistic regression analyses. RESULTS The COVID-19 pandemic was associated with increased depressive symptoms in older adults [b (standard error) = 0.42 (0.20), p = 0.040] and a doubling of the risk for incident depressive disorder even in euthymic older adults without a history of depression (odds ratio = 2.44, 95% confidence interval 1.18-5.02, p = 0.016). Less social activities, which was associated with the risk of depressive disorder before the pandemic, was not associated with the risk of depressive disorder during the pandemic. However, less family gatherings, which was not associated with the risk of depressive disorder before the pandemic, was associated with the doubled risk of depressive disorder during the pandemic. CONCLUSIONS The COVID-19 pandemic significantly influences the risk of late-life depression in the community. Older adults with a lack of family gatherings may be particularly vulnerable.
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Affiliation(s)
- Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Hee Won Yang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Seonjeong Byun
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea
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10
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Oh W, Kim TH, You JSH. Self-perception and anticipated efficacy of the anti-dementia multimodal program in 100 older adults with mild cognitive impairment. NeuroRehabilitation 2023; 52:403-412. [PMID: 36806520 DOI: 10.3233/nre-220253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Effective and sustainable interventions are clearly needed for mild cognitive impairment (MCI) patients. Despite the clinical importance of the multimodal intervention approach, only one study using a multimodal approach demonstrated promising improvements in memory, attention, and executive functions, which also correlated with functional magnetic resonance imaging (MRI) blood oxygenation level dependent (BOLD) changes in cerebral activation in 50 MCI patients. OBJECTIVE To investigate the self-perception and anticipated efficacy of each element of the BRAIN-FIT multimodal intervention program (robotic-assisted gait training (RAGT), computerized cognitive therapy, music, light, transcranial direct current stimulation (tDCS), and diaphragmatic breathing exercises) and the correlation between memory, concentration, depression, and sleep in older adults with MCI. METHODS One hundred participants (mean±standard deviation: 8.63±78.4 years; 47 women) with MCI were recruited from a major university medical center and community dementia relief center. The survey questionnaire comprised four domains with 21 questions, including four pertaining to general demographic characteristics, eight related to exercise and activity, three related to sleep, and nine related to the BRAIN-FIT program. Chi-squared test was used to analyze the Likert scale data. The descriptive frequencies were calculated. Additionally, Spearman's rho statistics measure the rank-order association. The statistical significance was at P < 0.05. RESULTS A strong correlation was observed between memory and concentration (r = 0.850, P = 0.000), memory and depression (r = 0.540, P = 0.000), memory and sleep (r = 0.502, P = 0.000), concentration and depression (r = 0.602, P = 0.000), concentration and sleep (r = 0.529, P = 0.000) and sleep and depression (r = 0.497, P = 0.000). The correlation between medical services and sleep (r = 0.249, P = 0.012) was moderate. The chi-square test revealed a significant difference in memory and low-intensity duration of exercise (χ2[3,N = 100] = 11.69, P = 0.01), concentration and high-intensity exercise duration (χ2[3,N = 100] = 10.08, P = 0.02), concentration with low-intensity exercise duration (χ2[3,N = 100] = 21.11, P = 0.00), depression with high-intensity (χ2[3,N = 100] = 10.36, P = 0.02), high-intensity duration of exercise (χ2[3,N = 100] = 10.48, P = 0.02); low-intensity (χ2[3,N = 100] = 7.90, P = 0.48), and low-intensity duration of exercise (χ2[3,N = 100] = 9.69, P = 0.02). Additionally, significant differences were observed between sleep and high-intensity (χ2[3, N = 100] = 10.36, P = 0.02), low-intensity (χ2[3, N = 100] = 18.14, P = 0.00), and low-intensity duration of exercise (χ2[3, N = 100] = 18.30, P = 0.00). Among the participants 5% answered RAGT, and 20% responded that they had experienced computerized cognitive therapy. Music therapy (20 %), diaphragmatic breathing exercises (45 %), and light therapy (10 %) were used. No patient had experienced tDCS. Conversely, 11% of the participants answered RAGT for programs they wanted to experience and 21% responded to computerized cognitive therapy. 25% of music therapy, 22% of diaphragmatic breathing exercises, 5% of light therapy, and 16% of tDCS participants said they wanted to experience it. Finally, 63% of the participants wanted to participate in the BRAIN-FIT program. CONCLUSION The present study's results provide clinical evidence-based insights into the utilization of BRAIN-FIT in MCI to maximize cognitive score improvement of memory, concentration, depression, and sleep. Therefore, when designing the BRAIN-FIT, six intervention items were set in proportion to the preference based on the survey, to reduce participants' feeling of repulsion. The program was configured according to exercise intensity.
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Affiliation(s)
- Wonjun Oh
- Sports Movement Artificial Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea.,Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Joshua Sung H You
- Sports Movement Artificial Robotics Technology (SMART) Institute, Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea.,Department of Physical Therapy, Yonsei University, Wonju, Republic of Korea
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11
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Kim TH, Jhoo JH, Park JH, Kim JL, Ryu SH, Moon SW, Choo IH, Lee DW, Yoon JC, Do YJ, Lee SB, Kim MD, Kim KW. Retraction to "Korean Version of Mini Mental Status Examination for Dementia Screening and Its Short Form". Psychiatry Investig 2023; 20:182. [PMID: 36891604 PMCID: PMC9996143 DOI: 10.30773/pi.2023.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Affiliation(s)
- Tae Hui Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jin Hyeong Jhoo
- Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea
| | - Jeong Lan Kim
- Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Seung Ho Ryu
- Department of Neuropsychiatry, Konkuk University Hospital, Seoul, Republic of Korea
| | - Seok Woo Moon
- Department of Psychiatry, Konkuk University Chungju Hospital, Chungju, Republic of Korea
| | - Il Han Choo
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Snaggye Paik Hospital, Seoul, Republic of Korea
| | - Jong Chul Yoon
- Departmnet of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea
| | - Yeon Ja Do
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
| | - Moon Doo Kim
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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12
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Byeon G, Kwon SO, Jhoo JH, Jang JW, Bae JB, Han JW, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DW, Lee SB, Lee JJ, Lee DY, Kim KW. Evidence of risky driving in Korean older adults: A longitudinal cohort. Int J Geriatr Psychiatry 2023; 38:e5854. [PMID: 36457243 DOI: 10.1002/gps.5854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/20/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to determine the differences in the risk factors for dangerous driving between older adults with normal cognition and those with cognitive impairment. DESIGN The driving risk questionnaire (DRQ) that was applied to a community-dwelling older adult cohort and 2 years of accident/violation records from the National Police Agency were analyzed. We conducted regression analyses with the presence or absence of risky driving based on records (accidents + violations) 2 years before and after evaluation as a dependent variable and dichotomized scores of each risky driving factor as independent variables. RESULTS According to four identified factors-crash history, safety concern, reduced mileage, and aggressive driving-significant associations were found between risky driving over the past 2 years and crash history and for aggressive driving in the normal cognition group. In the cognitive impairment group, only crash history was significantly associated, although safety concerns showed a trend toward significance. CONCLUSIONS In this study, it was suggested that the factors of DRQ have a significant association with actual risky driving. Our results are expected to contribute to establishing the evidence for evaluating and predicting risky driving and advising whether to continue driving in clinics.
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Affiliation(s)
- Gihwan Byeon
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea
| | - Sung Ok Kwon
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea.,Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeonju Hospital, Gyeongju, Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea
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13
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Han A, Kim TH. Efficacy of Internet-Based Acceptance and Commitment Therapy for Depressive Symptoms, Anxiety, Stress, Psychological Distress, and Quality of Life: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e39727. [PMID: 36485030 PMCID: PMC9789494 DOI: 10.2196/39727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/24/2022] [Accepted: 10/08/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Acceptance and commitment therapy (ACT) is an empirically supported transdiagnostic approach that involves mindfulness processes and behavior change processes for valued living. OBJECTIVE This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to assess the efficacy of internet-based ACT (iACT) for depressive symptoms, anxiety, stress, psychological distress, and quality of life (QoL). METHODS PubMed, CINAHL, PsycINFO, and SCOPUS databases were searched to identify relevant RCTs published up to June 5, 2021. The included RCTs were assessed using the Cochrane Collaboration risk-of-bias tool. The use of either a random effects model or fixed effects model was determined using I2 statistic values for heterogeneity. Subgroup analyses were conducted according to the type of control group, the use of therapist guidance, delivery modes, and the use of targeted participants, when applicable. RESULTS A total of 39 RCTs met the inclusion criteria. Meta-analyses found small effects of iACT on depressive symptoms, anxiety, stress, psychological distress, and QoL at the immediate posttest and follow-up. There was no significant effect of iACT on stress at follow-up. Subgroup analyses showed small to medium effects of iACT on all the outcomes at the immediate posttest and follow-up compared with the passive control groups. In contrast, subgroup analyses that compared iACT with active control groups found no differences between groups on stress, psychological distress, and QoL at the immediate posttest or on depressive symptoms, anxiety, and stress at follow-up. In addition, subgroup analyses conducted according to the use of therapist guidance, delivery modes, and the use of targeted participants found no statistically significant subgroup differences among studies in all the outcomes, except for the subgroup difference among studies according to the use of targeted participants for depressive symptoms at the immediate posttest (ie, a statistically significant, larger effect of iACT when studies targeted people with depressive symptoms). The overall risk of bias across the studies was unclear. CONCLUSIONS The findings of this study contribute to the body of evidence regarding the effects of iACT on depressive symptoms, anxiety, stress, psychological distress, and QoL and may be applicable in any population, as ACT is a transdiagnostic approach. Few studies have compared iACT with active control conditions, especially for stress and psychological distress at the immediate posttest and follow-up. In addition, the active control conditions varied among the included studies. Further high-quality studies are needed to better understand whether iACT is comparable or superior to other evidence-based interventions, such as cognitive behavioral therapy, in decreasing depressive symptoms, anxiety, stress, and psychological distress and improving QoL.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei Wonju Medical College, Wonju, Republic of Korea
- Department of Psychiatry, Wonju Severance Christian Hospital, Wonju, Republic of Korea
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14
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Kim SE, Chun KH, Oh J, Yu HT, Lee CJ, Kim TH, Pak HN, Lee MH, Joung B, Kang SM. Prediction of response to cardiac resynchronization therapy using cardiac magnetic resonance imaging in non-ischemic dilated cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac resynchronization therapy (CRT) is a well-established therapy for symptomatic heart failure with reduced ejection fraction, but the response is different for individuals. Although many modalities have been conducted to predict CRT response, cardiac magnetic resonance (CMR) to predict CRT response has still insufficient usefulness.
Purpose
We determine whether the parameters including late gadolinium enhancement (LGE) identified in CMR could act as predictors of CRT response.
Methods
We retrospectively investigated 124 patients with non-ischemic dilated cardiomyopathy who underwent CMR before CRT implantation between Jan 2010 and July 2021 in a single center. CRT response was defined as a decrease in left ventricular end-systolic volume (LVESV) >15% on echocardiography after at least 3 months after CRT implantation.
Results
Among the study population (mean age 65.7±11.2 years, mean EF 25±6.5%, 50% of female), 85 (69%) patients were defined as CRT responder. The CRT responders had more left bundle branch block (LBBB) compared with non-responders [79 (92.9%) vs. 23 (59.0%), p<0.001], but there was a no difference of QRS duration (158.7 vs 165.0ms, p=0.054) between two groups. CMR analysis showed that there were no significant differences in the left ventricular (LV) chamber volume and LV ejection fraction between CRT-responder and non-responder. However, the right ventricular (RV) chamber volume was smaller (RV end-diastolic volume index, 86.3 vs 103.5 ml/m2, p=0.039; RV end-systolic volume index, 49.3 vs 68.5 ml/m2, p=0.013) and the RV ejection fraction (RVEF) was higher (46.9 vs 37.6%, p=0.002) in CRT-responders compared with non-responders. The LGE on CMR was more shown in non-responders than in CRT-responders [33 (84.6%) vs 45 (52.9%), p<0.001]. In CMR parameters, RV dysfunction (RVEF <45%) [Odds ratio (OR), 0.21 (0.05–0.93), p=0.045] and LGE [OR, 0.21 (0.05–0.58), p=0.01] were significantly associated with poor CRT response.
Conclusions
The presence of LGE and RV dysfunction on CMR were associated with poor CRT response in patients with non-ischemic dilated cardiomyopathy. Further investigation with CMR for pre-CRT patients is needed to support these results.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S E Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - K H Chun
- NHIS Ilsan Hospital, Cardiology , Goyang , Korea (Republic of)
| | - J Oh
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - C J Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H N Pak
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - M H Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - B Joung
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - S M Kang
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
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15
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Kim MH, Hwang I, Park JW, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Blunted atrial reverse remodeling a year after catheter ablation for atrial fibrillation and their long-term rhythm outcome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Although active rhythm control by atrial fibrillation (AF) catheter ablation (AFCA) reduces left atrial (LA) dimension, blunted atrial reverse remodeling can be observed in patients with significant atrial myopathy. We explored the characteristics and long-term outcomes of AF patients who showed blunted atrial reverse remodeling despite no AF recurrence within a year after AFCA.
Methods
Among a total of 2,756 patients with AFCA, we included 1,685 patients (74.8% male, 60.2±10.1 years old, 54.5% paroxysmal AF) who underwent both baseline and 1-year follow-up echocardiogram, baseline LA>40mm, and did not recur within a year. We divided them into tertile groups (T1–T3) based on one-year percent change of LA dimension after propensity matching for age, sex, AF type, and baseline LA dimension. We also investigated the patients' genetic characteristics with blunted LA reverse remodeling (T1) using a genome-wide association study (GWAS).
Results
Patients with blunted LA reverse remodeling (T1, n=424) were independently associated with body mass index (OR 1.082 [1.010–1.160], p=0.025), LA peak pressure (OR 1.010 [1.002–1.019], p=0.019), LA wall thickness (OR 0.448 [0.252–0.789], p=0.006), LA voltage (OR 0.651 [0.463–0.907], p=0.012), and pericardial fat volume (OR 1.004 [1.001–1.008], p=0.014). Throughout 65.9±37.4 months of follow-up, the incidence of AF recurrence a year after the procedure was significantly higher in the T1 group than in T2 or T3 groups (Log-rank p<0.001). Among 894 patients with GWAS, ATXN1, XPO7, KRR1_PHLDA1, ZFHX3, and their polygenic risk score were associated with blunted LA reverse remodeling.
Conclusions
Patients with blunted LA reverse remodeling after AFCA were independently associated with low LA voltage, thin wall thickness, high LA pressure, and fat volume, and have a genetic background. Long-term clinical recurrence a year after AFCA was higher in this patient group with suspicious atrial myopathy.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health and WelfareNational Research Foundation of Korea
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Affiliation(s)
- M H Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - I Hwang
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J W Park
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J S Uhm
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - B Joung
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - M H Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H N Pak
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
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Park H, Yu HT, Kim TH, Park J, Park JK, Kang KW, Shim J, Kim JB, Choi EK, Park HW, Lee YS, Joung B. Oral anticoagulation therapy in atrial fibrillation patients with advanced chronic kidney disease: CODE-AF Registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and objectives
Advanced chronic kidney disease (CKD), including end-stage renal disease (ESRD) on dialysis, increases thromboembolic risk among patients with atrial fibrillation (AF). This study examined the comparative safety and efficacy of direct-acting oral anticoagulant (DOAC) compared to warfarin or no OAC among AF patients with advanced CKD or ESRD on dialysis.
Methods
Using data from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry, 260 non-valvular AF patients with advanced CKD (defined as estimated glomerular filtration rate [eGFR] <3 0ml/min per 1.73 m2) or ESRD on dialysis were enrolled from June 2016 to July 2020. The study population was categorized into DOAC, warfarin, and no OAC group, and differences in major or clinically relevant non-major (CRNM) bleeding, stroke/systemic embolism (SE), myocardial infarction/critical limb ischemia (CLI), and death were assessed.
Results
During a median 24 months of follow-up, major or CRNM bleeding risk was significantly reduced in the DOAC group compared to the warfarin group (hazard ratio [HR] 0.21, 95% confidence interval [CI] 0.05 to 0.95, p=0.042). In addition, the risk of composite adverse clinical outcome (major or CRNM bleeding, stroke/SE, myocardial infarction/CLI, and death) was significantly reduced in the DOAC group compared to the no OAC group (HR 0.32, 95% CI 0.11 to 0.96, p=0.043).
Conclusion
Among AF patients with advanced CKD or ESRD on dialysis, DOAC was associated with a lower risk of major or CRNM bleeding compared to warfarin and a lower risk of composite adverse clinical outcome compared to no OAC.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Korean Healthcare Technology R&D project funded by the Ministry of Health & Welfare (HI15C1200, HC19C0130)
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Affiliation(s)
- H Park
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J Park
- Ewha Womans University School of Medicine , Seoul , Korea (Republic of)
| | - J K Park
- Hanyang university medical center , Seoul , Korea (Republic of)
| | - K W Kang
- Eulji University College of Medicine , Seoul , Korea (Republic of)
| | - J Shim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J B Kim
- Kyunghee University , Seoul , Korea (Republic of)
| | - E K Choi
- Seoul National University Hospital , Seoul , Korea (Republic of)
| | - H W Park
- Chonnam National University School of Medicine , Gwangju , Korea (Republic of)
| | - Y S Lee
- Daegu Catholic University Medical Center , Daegu , Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine , Seoul , Korea (Republic of)
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17
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Park Y, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Effects of early recurrence and extra-PV triggers on long-term recurrence after catheter ablation for atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although early recurrence (ER) within 3 months after atrial fibrillation (AF) catheter ablation (AFCA) was recently reported to be a reliable predictor of late recurrence (LR), the mechanism is not clear.
Purpose
We explored the characteristics of patients with ER and compared the long-term late recurrence (LR) pattern depending on the existence of extra-pulmonary vein trigger (ExPV-trigger).
Methods
Among 3643 patients who underwent de novo AFCA, we included 1249 patients (59.2±11.0 years old, 31.3% persistent AF) who underwent isoproterenol provocation and regular follow-up over three years after AFCA. We evaluated the risk factors for ER and compared the patients with ER alone (10.1%), LR alone (16.6%), and ER+LR (15.9%), and the outcome of repeat procedure.
Results
Overall ER (ER alone and ER+LR) was independently associated with persistent AF (OR 1.58 [1.16–2.14], p=0.003), extra-PV triggers (OR 2.80 [1.90–4.13], p<0.001), and empirical extra-PV ablation (OR 1.54 [1.15–2.07], p=0.004). Overall LR (LR alone and ER+LR) risk was significantly higher in the ER with ExPV-trigger group than in ER without ExPV-trigger or no ER groups (Log-rank p<0.001). The rhythm outcome of the second procedure did not differ between ER+LR and LR alone groups (Log-rank p=0.160), but was worse in the ER+LR ExPV-trigger than in ER+LR without ExPV-trigger or LR alone groups (Log-rank p=0.005).
Conclusion
ER was independently associated with LR after de novo AFCA. ExPV-trigger played crucial roles in ER and LR after de novo AFCA and worse rhythm outcome after redo AFCA.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Park
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - J S Uhm
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - B Joung
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - M H Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
| | - H N Pak
- Severance Cardiovascular Hospital, Yonsei University College of Medicine , Seoul , Korea (Republic of)
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18
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Kim D, Yu HT, Kwon OS, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Effect of the epicardial fat volume on the outcomes after a left atrial posterior wall isolation in addition to pulmonary vein isolation in patients with persistent atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
While the effect of a circumferential pulmonary vein isolation (CPVI) alone is unsatisfactory, that of an additional electrical posterior wall box isolation (POBI) is controversial in persistent atrial fibrillation (PeAF) patients. Increased epicardial adipose tissue (EAT) is associated with higher recurrence rates after AF catheter ablation (AFCA).
Purpose
We investigated the possible effects of a POBI on rhythm outcomes with varying EAT volumes.
Methods
We included 1,187 patients with PeAF undergoing a de novo AFCA (79.6% male, median age 60 years) into two groups including those receiving a CPVI alone (n=687) and those an additional POBI (n=500). The rhythm outcomes at two years post-AFCA were compared in subgroups stratified by the total EAT volume using propensity overlap weighting.
Results
A reduced total EAT volume was linearly associated with more favorable rhythm outcomes for an additional POBI treatment than for a CPVI alone (P for interaction=0.002). Among the patients with smaller EAT volumes (≤116.23 ml, the median value, n=594), an additional POBI was associated with a reduced AF recurrence risk as compared to a CPVI only (weighted hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.56–0.99; weighted log-rank P=0.039). In contrast, among the remaining 593 patients with greater EAT volumes (>116.2 3mL), there was no difference in the AF recurrence risk between an additional POBI and CPVI alone (weighted HR 1.13, 95% CI 0.84–1.52; weighted log-rank P=0.410). Among 185 patients with a repeat ablation, the POBI reconnection rate tended to be higher in the large EAT group (75.0%) than small EAT group (55.4%, P=0.060).
Conclusion
While PeAF patients with a smaller EAT volume averted AF recurrence by an additional POBI after the CPVI, no benefit of the POBI was observed in those with a greater EAT volume. The EAT volume might identify AF patients likely to benefit from linear ablation in addition to the CPVI.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Korean Ministry of Science, ICT & Future Planning (MSIP)Korean Ministry of Health and Welfare
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Affiliation(s)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - H T Yu
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - O S Kwon
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - T H Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - J S Uhm
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - M H Lee
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
| | - H N Pak
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine , Seoul , Korea (Republic of)
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Abstract
Objectives: This quasi-experimental study assessed the effectiveness of two empathy enhancement programs on direct care workers of older adults living alone in South Korea.Methods: A total of 104 direct care workers participated in either a simulation-based program or a lecture-based program. Data were collected prior to and 2 weeks after the program implementation using self-reported questionnaires.Results: The lecture-based group had significantly higher levels of empathy compared to the simulation-based group. Pretest-posttest differences were found in the lecture-based group only, including higher levels of empathy and caring efficacy and lower levels of secondary traumatic stress and burnout.Conclusions: More studies are needed to identify helpful components of empathy enhancement programs to direct care workers working with older adults living alone. Also, a further randomized controlled trial study is needed to assess programs' effectiveness on older adults living alone and direct care workers.Clinical implications: A lecture-based empathy enhancement program can increase levels of empathy and caring efficacy of direct care workers working with older adults and decrease care workers' levels of burnout and stress. Training for direct care workers of older adults is needed to improve the empathy of direct care workers while reducing their stress and burnout.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, South Korea
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20
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Oh DJ, Yang HW, 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, Bae JB, Han JW, Kim KW. Association of Low Emotional and Tangible Support With Risk of Dementia Among Adults 60 Years and Older in South Korea. JAMA Netw Open 2022; 5:e2226260. [PMID: 35951325 PMCID: PMC9372780 DOI: 10.1001/jamanetworkopen.2022.26260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
IMPORTANCE The association between social support and dementia risk has been debated. Most previous prospective studies have not differentiated the subtypes of social support. OBJECTIVE To examine whether the association between social support and risk of dementia differs by subtype of social support and by sex. DESIGN, SETTING, AND PARTICIPANTS This nationwide prospective cohort study included randomly sampled South Korean adults 60 years or older. The study was launched November 1, 2010, with follow-up every 2 years until November 30, 2020. The 5852 participants who completed the assessment for social support and were not diagnosed as having dementia, severe psychiatric disorders including major depressive disorder, or major neurological disorders at the baseline assessment were included in the analysis. EXPOSURES Geriatric psychiatrists administered the structured diagnostic interviews and physical examinations to every participant based on the Korean version of the Consortium to Establish a Registry for Alzheimer Disease (CERAD-K) Assessment Packet Clinical Assessment Battery. MAIN OUTCOMES AND MEASURES Baseline levels of emotional and tangible support using the Medical Outcomes Survey Social Support Survey. RESULTS Among the 5852 participants (mean [SD] age, 69.8 [6.6] years; 3315 women [56.6%]; mean [SD] follow-up duration, 5.9 [2.4] years), 237 (4.0%) had incident all-cause dementia and 160 (2.7%) had incident Alzheimer disease (AD) subtype of dementia. Compared with women who reported having emotional support, those with low emotional support had almost a 2-fold higher incidence of all-cause dementia (18.4 [95% CI, 13.6-23.2] vs 10.7 [95% CI, 9.0-12.5] per 1000 person-years) and AD (14.4 [95% CI, 10.2-18.6] vs 7.8 [95% CI, 6.3-9.3] per 1000 person-years). Adjusted Cox proportional hazard analysis revealed that low emotional support was associated with increased risk of all-cause dementia (hazard ratio, 1.61 [95% CI, 1.10-2.36]; P = .02) and AD (hazard ratio, 1.66 [95% CI, 1.07-2.57]; P = .02) only in women. Low tangible support was not associated with a risk of all-cause dementia or AD regardless of sex. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that older women with low emotional support constitute a population at risk for dementia. The level of emotional support should be included in risk assessments of dementia.
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Affiliation(s)
- Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Psychiatry, SMG-SNU (Seoul National University) Boramae Medical Center, Seoul, South Korea
| | - Hee Won Yang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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21
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An H, Yang HW, Oh DJ, Lim E, Shin J, Moon DG, Suh SW, Byun S, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Lee DW, Lee SB, Lee JJ, Jhoo JH, Bae JB, Han JW, Kim KW. Mood disorders increase mortality mainly through dementia: A community-based prospective cohort study. Aust N Z J Psychiatry 2022; 56:1017-1024. [PMID: 34420415 DOI: 10.1177/00048674211041937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The effects of mood disorders on mortality may be mediated by their effects on the risk of dementia, and interventions to reduce the occurrence of dementia may reduce their overall mortality. This study aimed to investigate the direct effects of depressive and bipolar disorders on the 6-year risk of mortality and also their indirect effects on mortality due to their effect on the risk of dementia. METHODS A total of 5101 Koreans were selected from a community-based prospective cohort study, and 6-year risks of mortality and dementia in participants with depressive and bipolar disorders were estimated by Cox proportional hazard analysis. The direct and indirect effects of depressive and bipolar disorders on the risk of mortality were estimated using structural equation modeling. RESULTS The depressive and bipolar disorder groups showed 51% and 85% higher 6-year mortality, and 82% and 127% higher risk of dementia, respectively, compared to euthymic controls. The effects of depressive and bipolar disorders on mortality were mainly mediated by their effects on the risk of dementia in a structural equation model. The direct effects of each mood disorder on mortality were not significant. CONCLUSION Both depressive and bipolar disorders increased the risks of mortality and dementia, and the effects of mood disorders on mortality were mainly mediated through dementia. As dementia occurs later in life than mood disorders, measures to prevent it may effectively reduce mortality in individuals with a history of mood disorders, as well as being more feasible than attempting to control other causes of death.
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Affiliation(s)
- Hoyoung An
- Seongnam Sarang Hospital, Seongnam, South Korea
| | - Hee Won Yang
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Eunji Lim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jin Shin
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Gyu Moon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Seonjeong Byun
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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22
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Han A, Kim TH. Effects of internet-delivered behavioral activation on individuals with depressive symptoms: A systematic review and meta-analysis. J Psychiatr Res 2022; 152:104-118. [PMID: 35717866 DOI: 10.1016/j.jpsychires.2022.05.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/28/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Behavioral activation is recognized as a stand-alone, evidence-based therapy for depression. Internet-delivered psychological interventions are easy to access and low cost. Therefore, it is important to determine whether internet-delivered behavioral activation (iBA) is an effective option for improving depressive symptoms and other health-related outcomes. This systematic review and meta-analysis aimed to examine the effects of iBA on individuals with depressive symptoms. METHODS A comprehensive search was conducted within four databases to identify randomized controlled trials (RCTs) that involved iBA for people with depressive symptoms. The quality of the included RCTs was assessed using the Cochrane Collaboration risk-of-bias tool. Depending on I2 statistic values for heterogeneity, either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the type of control groups. RESULTS Twenty RCTs met the eligibility criteria. Meta-analyses showed iBA had small to medium effects on depressive symptoms, anxiety, quality of life, functioning, perceived social support, and behavioral activation (BA) in people suffering from depressive symptoms at the immediate posttest and follow-up compared to control conditions. LIMITATIONS Relatively fewer studies were conducted to compare effects of iBA on outcomes other than depressive symptoms and BA process measures compared to comparison or control conditions. The overall risk of bias across the included RCTs was unclear. CONCLUSIONS Further high-quality studies are needed to verify the effects of iBA on varied health outcomes and BA process measures for individuals with depressive symptoms.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, SHPB 340, 1720 2nd Ave South, Birmingham, AL, 35294, USA
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon province, 26426, South Korea.
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23
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Park H, Yu HT, Kim TH, Park J, Park JK, Kang KW, Shim J, Kim JB, Kim J, Choi EK, Park HW, Lee YS, Joung B. Resting heart rate and cardiovascular outcomes in patients with atrial fibrillation: CODE-AF registry. Europace 2022. [DOI: 10.1093/europace/euac053.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
The prognostic significance of resting heart rate and its therapeutic target in atrial fibrillation (AF) is uncertain.
Purpose
The aim of this study was to investigate the relationships between resting heart rate and cardiovascular outcomes in patients with AF.
Methods
A total of 8,886 patients with AF was included from the COmparison study of Drugs for symptom control and complication prEvention of AF (CODE-AF) registry. Patients were categorized according to baseline heart rate, and cardiovascular outcomes were accessed during a median follow-up of 30 months. The primary outcome was a composite of cardiovascular death, hospitalization due to heart failure, and myocardial infarction/critical limb ischemia.
Results
Compared to heart rate ≥100 beats per minute (bpm), heart rate 80-99 bpm was associated with the lowest risk of primary outcome (adjusted hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.40-0.79, p=0.001). In subgroup of patients with heart failure with preserved ejection fraction (HFpEF), heart rate between 80-99 bpm was associated with reduced risk of primary outcome compared to heart rate ≥100 bpm (HR 0.40, 95% CI 0.16-0.98, p=0.045). However, in patients with heart failure with reduced ejection fraction (HFrEF), there was no association between resting heart rate and cardiovascular outcomes (P for interaction 0.001).
Conclusion
Resting heart rate was associated with cardiovascular outcomes in patients with AF, and those with a resting heart rate between 80-99 bpm had the lowest risk of adverse events. The impact of resting heart rate on adverse events persisted in patients with concomitant HFpEF but was not apparent in those with concomitant HFrEF.
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Affiliation(s)
- H Park
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - J Park
- Ewha Womans University School of Medicine, Seoul, Korea (Republic of)
| | - JK Park
- Hanyang University Seoul Hospital, Seoul, Korea (Republic of)
| | - KW Kang
- Eulji University College of Medicine, Seoul, Korea (Republic of)
| | - J Shim
- Korea University Medical Center, Seoul, Korea (Republic of)
| | - JB Kim
- Kyung Hee University Hospital, Seoul, Korea (Republic of)
| | - J Kim
- University of Ulsan College of Medicine, Seoul, Korea (Republic of)
| | - EK Choi
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - HW Park
- Chonnam National University School of Medicine, Gwangju, Korea (Republic of)
| | - YS Lee
- Daegu Catholic University Medical Center, Daegu, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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24
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Yang PS, Kim DH, Jang E, Yu HT, Kim TH, Pak HN, Lee MH, Sung JH, Joung B. Comparative effectiveness of early rhythm control versus rate control for cardiovascular outcomes according to sex in patients with atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health & Welfare, Republic of Korea
Background
Rhythm control is associated with better cardiovascular outcomes than usual care among patients recently diagnosed with atrial fibrillation (AF). However, there are limited data on the outcomes of AF ablation according to sex. The purpose of this study was to evaluate gender differences in the effects of early rhythm control compared to rate control on the primary composite outcome of cardiovascular death, ischaemic stroke, hospitalisation for heart failure (HF), or myocardial infarction.
Methods
We conducted a retrospective population-based cohort study including 22635 patients with AF newly treated with rhythm control (antiarrhythmic drugs or ablation) or rate control in 2011-2015 from the Korean National Health Insurance Service database. Propensity overlap weighting was used.
Results
Among patients with early AF treatment (initiated within 1 year since diagnosis), compared with rate control, rhythm control was associated with a similar lower risk of the primary composite outcome both women (weighted incidence rate per 100 person-years: 8.68 in rhythm control vs. 10.3 in rate control; hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.69 to 0.90; P<0.001) and men (weighted incidence rate per 100 person-years: 6.33 in rhythm control vs. 8.32 in rate control; HR 0.77, 95% CI 0.67 to 0.88; P<0.001). However, the effective initiation time for rhythm control therapy was within 6 and 11 months after AF diagnosis in female and male patients, respectively. Moreover, the effective times for other outcomes were different between genders (hospitalization for HF; female within 2 months, male within 9 months/ ischemic stroke; female within 11 months, male immediately).
Conclusions
Early initiation of rhythm control was associated with a lower risk of primary outcome in both genders. However, the effective rhythm control treatment initiation time for primary outcome, stroke and HF-related admission was different in both genders. For rhythm control treatment to be effective, women should start treatment earlier than men.
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Affiliation(s)
- PS Yang
- CHA University, Seongnam, Korea (Republic of)
| | - DH Kim
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - E Jang
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - HN Pak
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
| | - JH Sung
- CHA University, Seongnam, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Cardiology, Seoul, Korea (Republic of)
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25
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Yu G, Kim TH, Yu HT, Joung BY, Pak HN, Lee MH. Learning curve of left bundle branch area pacing with standard stylet-driven pacing leads: a single center prospective observational study in Korea. Europace 2022. [DOI: 10.1093/europace/euac053.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Although cardiac pacing is an essential therapy for bradycardia, conventional right ventricular pacing (CRVP) can cause electrical-mechanical dyssynchrony. Left Bundle Branch Area Pacing (LBBAP) is a new conduction system pacing strategy that includes a normal conduction system and therefore maintains synchronous ventricular contraction. Most of the experience with LBBAP is done in a lumen-less lead with fixed helix design, and this device is not available in sometimes.
Purpose
This study aimed to evaluate the learning curve of LBBAP using standard stylet-driven lead with extendable helix design.
Methods
This study enrolled patients who underwent permanent cardiac pacemaker implantation at a University Hospital in South Korea from December 2020 to October 2021. LBBAP was performed with a 5.6Fr stylet-driven pacing lead with an extendable helix. The learning curve was assessed by analyzing fluoroscopy time and procedure time.
Results
In 65 patients who underwent LBBAP during the observation period, mean fluoroscopy time and procedural time were 17.1 ± 17.2 minutes and 64.2 ± 33.5 minutes, respectively in this study. The learning curve for achieving LBBAP appears to plateau after around 24th case with a progressive reduction in procedure time. This is a significantly shorter period of time when compared to the previously reported learning curves of his bundle pacing (30-50cases), previously developed conduction system pacing strategy.
Conclusion
During initial experience with LBBAP, fluoroscopy and procedural time continue to improve with operator experience. For physicians who are experienced at cardiac pacemaker implantation, the steepest part of the learning curve of LBBAP appears to be over the first 20-25 cases.
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Affiliation(s)
- G Yu
- Yonsei University, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University, Seoul, Korea (Republic of)
| | - BY Joung
- Yonsei University, Seoul, Korea (Republic of)
| | - HN Pak
- Yonsei University, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University, Seoul, Korea (Republic of)
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26
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Han A, Kim TH. Effects of internet-based acceptance and commitment therapy on process measures: A systematic review and meta-analysis (Preprint). J Med Internet Res 2022; 24:e39182. [PMID: 36040783 PMCID: PMC9472046 DOI: 10.2196/39182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/22/2022] [Accepted: 07/29/2022] [Indexed: 12/03/2022] Open
Abstract
Background Acceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context, being present, values, and committed action. Objective This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to examine the effects of internet-based ACT (iACT) on process measures. Methods A comprehensive search was conducted using 4 databases. The quality of the included RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. A random-effects or fixed-effects model was used. Subgroup analyses for each outcome were conducted according to the type of control group, use of therapist guidance, delivery modes, and use of targeted participants, when applicable. Results A total of 34 RCTs met the inclusion criteria. This meta-analysis found that iACT had a medium effect on psychological flexibility and small effects on mindfulness, valued living, and cognitive defusion at the immediate posttest. In addition, iACT had a small effect on psychological flexibility at follow-up. The overall risk of bias across studies was unclear. Conclusions Relatively few studies have compared the effects of iACT with active control groups and measured the effects on mindfulness, valued living, and cognitive defusion. These findings support the processes of change in iACT, which mental health practitioners can use to support the use of iACT.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Gangwon province, Republic of Korea
- Department of Psychiatry, Yonsei University Wonju Christian Hospital, Wonju, Gangwon province, Republic of Korea
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27
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Lee GY, Shin GW, Park HY, Yoon HK, Kim TH, Lee A, Heo YJ, Lee YJ, Han JY, Park YM. Sonographic Features of Breast Fibroepithelial Masses: Distinguishing Fibroadenoma from Phyllodes Tumour. Hong Kong Journal of Radiology 2022. [DOI: 10.12809/hkjr2217333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- GY Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - GW Shin
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - HY Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - HK Yoon
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - TH Kim
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - A Lee
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - YJ Heo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - YJ Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - JY Han
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
| | - YM Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, South Korea
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28
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Youk S, Le MT, Kang M, Ahn B, Choi M, Kim K, Kim TH, Kim JH, Ho CS, Park C. Development of a high-resolution typing method for SLA-3, swine MHC class I antigen 3. Anim Genet 2021; 53:166-170. [PMID: 34910829 DOI: 10.1111/age.13161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
We developed a high-resolution and comprehensive typing method for swine leukocyte antigen 3 (SLA-3), an MHC class I gene, employing locus-specific genomic PCR followed by subsequent direct sequencing. A total of 292 individuals from nine pure, one cross-breed and six cell lines were successfully typed. A total of 21 SLA-3 alleles were identified, of which four were found to be novel alleles. However, the allelic diversity of SLA-3 was lower than that of previously reported class I genes, SLA-1 and -2. More SLA-3 alleles were observed in the Landrace and Yorkshire breeds than the other breeds. SLA-3*04:01 was identified in seven out of nine breeds and was the most widely distributed allele across all breeds. Therefore, the typing method reported in this study completes our efforts to develop high-resolution typing methods for major SLA molecules, facilitating the combined analysis of major SLA genes from field samples, which is important to understand the relationship between the adaptive immune responses against pathogens and the immunogenetic makeup of an individual.
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Affiliation(s)
- S Youk
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - M T Le
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - M Kang
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - B Ahn
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - M Choi
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - K Kim
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea.,Livestock Support Department, National Agricultural Cooperative Federation Agribusiness Group, Seoul, 04516, Korea
| | - T H Kim
- Animal Genomics and Bioinformatics Division, National Institute of Animal Science, RDA, Wanju, 55365, Korea
| | - J H Kim
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
| | - C S Ho
- Gift of Hope Organ and Tissue Donor Network, 425 Spring Lake Drive, Itasca, IL, 60143, USA
| | - C Park
- Department of Stem Cell and Regenerative Biotechnology, Konkuk University, Gwangjin-gu, Seoul, 05029, Korea
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29
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Han A, Kim TH, Hong H. A factorial randomized controlled trial to examine separate and combined effects of a simulation-based empathy enhancement program and a lecture-based education program on family caregivers of people with dementia. Aging Ment Health 2021; 25:1930-1940. [PMID: 32426989 DOI: 10.1080/13607863.2020.1768214] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The present study was a 2 × 2 factorial randomized controlled trial that examined if a simulation-based empathy enhancement program and a lecture-based education program, together or separately, improved outcomes of family caregivers of people with dementia. METHOD A total of 101 participants were randomly assigned to simulation-based education only, lecture-based education only, simulation-based education plus lecture-based education, or treatment as usual. Data were analyzed using a two-way analysis of covariance while controlling for pretest results, kinship, and gender. RESULTS Statistically significant interaction effects between the simulation program and the lecture program were found in the levels of well-being and helplessness. The lecture program accompanied by the simulation program led to higher level of well-being in terms of happiness and lower level of helplessness than the lecture program alone. Caregivers with the lecture program provided led to less frequent use of dysfunctional coping strategies than those with no lecture program provided. Caregivers with the simulation program provided led to more frequent use of emotion-focused coping strategies than those with no simulation program provided. CONCLUSIONS Findings of the present study support benefits of combined of and separate simulation-based and lecture-based programs on family caregivers of people with dementia in important outcomes affecting quality of care and quality of lives in families of people with dementia. Further studies are needed to identify intervention components that can improve empathy of family caregivers of people with dementia and be embedded into a multicomponent program tailored better to families in different needs.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Hyeon Hong
- Department of Occupational Therapy, Yonsei University, Wonju, South Korea
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30
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Suh SW, Kim YJ, Kwak KP, Kim K, Kim MD, Kim BS, Kim BJ, Kim SG, Kim JL, Kim TH, Moon SW, Park KW, Park JI, Park JH, Bae JN, Seo J, Seong SJ, Son SJ, Shin IS, Ryu SH, Lee KJ, Lee NJ, Lee DY, Lee DW, Lee SB, Lee CU, Chang SM, Jeong HG, Cho MJ, Cho SJ, Jhoo JH, Choe YM, Han JW, Kim KW. A 9-Year Comparison of Dementia Prevalence in Korea: Results of NaSDEK 2008 and 2017. J Alzheimers Dis 2021; 81:821-831. [PMID: 33843678 DOI: 10.3233/jad-201588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In many high-income Western countries, the prevalence of dementia had been reduced over the past decades. OBJECTIVE We investigated whether the prevalence of all-cause dementia, Alzheimer's disease, vascular dementia, and mild cognitive impairment (MCI) had changed in Korea from 2008 to 2017. METHODS Nationwide Survey on Dementia Epidemiology of Korea (NaSDEK) in 2008 and 2017 was conducted on representative elderly populations that were randomly sampled across South Korea. Both surveys employed a two-stage design (screening and diagnostic phases) and diagnosed dementia and MCI according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders and the consensus criteria from the International Working Group, respectively. The numbers of participants aged 65 years or older in the screening and diagnostic phases were 6,141 and 1,673 in the NaSDEK 2008 and 2,972 and 474 in the NaSDEK 2017, respectively. RESULTS The age- and sex-standardized prevalence of all-cause dementia and Alzheimer's disease showed nonsignificant decrease (12.3% to 9.8%, odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.54-1.48 for all-cause dementia; 7.6% to 6.8%, OR [95% CI] = 0.91 [0.58-1.42] for Alzheimer's disease). Vascular dementia decreased in the young-old population aged less than 75 years (2.7% to 0.001%, OR [95% CI] = 0.04 [0.01-0.15]) and in women (1.9% to 0.5%, OR [95% CI] = 0.27 [0.10-0.72]) while MCI remained stable (25.3% to 26.2%, OR [95% CI] = 1.08 [0.67-1.73]). CONCLUSION We found that the prevalence of dementia in Korea showed a nonsignificant decrease between 2008 and 2017.
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Affiliation(s)
- Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | | | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Kiwon Kim
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Korea
| | - Moon-Doo Kim
- Department of Psychiatry, College of Medicine, Jeju National University, Jeju, Korea
| | - Byung-Soo Kim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea
| | - Kyung Won Park
- Department of Neurology, Dong-A University College of Medicine and Department of Translational Biomedical Sciences, Graduate School of Dong-A University, Busan, Korea
| | - Jong-Il Park
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
| | - Jae Nam Bae
- Department of Psychiatry, Inha University Hospital, Incheon, Korea
| | - Jiyeong Seo
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Su Jeong Seong
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.,Department of Psychiatry, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
| | - Kang Joon Lee
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Nam-Jin Lee
- Department of Psychiatry, Jeonju City Welfare Hospital for the Elderly, Jeonju, Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Catholic Agro-Medical Center, The Catholic University of Korea, Seoul, Korea
| | - Sung Man Chang
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.,Korea University Research Institute of Mental Health, Seoul, Korea
| | - Maeng Je Cho
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University, School of Medicine, Incheon, Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon, Korea
| | - Young Min Choe
- Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Brain and Cognitive Sciences, Seoul National University, College of Natural Sciences, Seoul, Korea
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31
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Oh DJ, Han JW, Bae JB, 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. Chronic subsyndromal depression and risk of dementia in older adults. Aust N Z J Psychiatry 2021; 55:809-816. [PMID: 33198490 DOI: 10.1177/0004867420972763] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Subsyndromal depression is prevalent and associated with poor outcomes in late life, but its effect on the risk of dementia has barely been investigated. This study is aimed to investigate the effect of subsyndromal depression on dementia risk in cognitively normal older adults and patients with mild cognitive impairment. METHODS Data were collected from a nationwide, population-based, prospective cohort study on a randomly sampled Korean elderly population aged 60 years or older, which has been followed every 2 years. Using 6-year follow-up data of 4456 non-demented elderly, the authors examined the risk of dementia associated with late-onset subsyndromal depression using multivariate Cox proportional hazard models. After standardized diagnostic interviews, subsyndromal depression and dementia were diagnosed by the operational diagnostic criteria and Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria, respectively. RESULTS Subsyndromal depression tripled the risk of dementia in non-demented elderly individuals (hazard ratio = 3.02, 95% confidence interval = [1.56, 5.85], p < 0.001). In subgroup analyses, subsyndromal depression was associated with the risk of dementia in cognitively normal participants only (hazard ratio = 4.59, 95% confidence interval = [1.20, 17.54], p = 0.026); chronic/recurrent subsyndromal depression with increasing severity during the follow-up period was associated with the risk of dementia (hazard ratio = 15.34, 95% confidence interval = [4.19, 56.18], p < 0.001). CONCLUSION Late-onset subsyndromal depression is a potential predictor of incident dementia when it is chronic or recurrent with increasing severity in cognitively normal older adults.
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Affiliation(s)
- Dae Jong Oh
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea.,Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, School of Medicine, Gyeongsang National University, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, South Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Dong Young Lee
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, School of Medicine, Kangwon National University, Chuncheon, South Korea
| | - Ki Woong Kim
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, South Korea.,Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, South Korea
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Oh DJ, Bae JB, 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, Han JW, Kim KW. Association between plasma monocyte trafficking-related molecules and future risk of depression in older adults. J Gerontol A Biol Sci Med Sci 2021; 77:1803-1809. [PMID: 34228804 DOI: 10.1093/gerona/glab194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The recruitment of monocytes to the brain plays an important role in the development of depression. However, the association between plasma biomarkers of monocyte trafficking and depression is unclear. This study is aimed to examine the effects of plasma monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) on the risk of depression. METHODS Data were acquired from an ongoing prospective cohort study involving randomly sampled, community-dwelling Korean older adults, which has been followed every two years. We included 1,539 euthymic older adults (age = 68.2 [5.6] years; 51.7% were women) without a history of major psychiatric disorders, and dementia and neurological diseases. Geriatric psychiatrists diagnosed incident depression through a structured interview using the Korean version of the Mini International Neuropsychiatric Interview. RESULTS Depression had developed in 134 (8.7 %) participants during the follow-up period of 5.7 (0.8) years. The high plasma MCP-1 tertile group showed two-fold higher risk of depression than the low plasma MCP-1 tertile group (hazards ratio [HR] = 2.00, 95% confidence intervals [CI] = 1.27 - 3.13, p = 0.003). The association between high levels of plasma MCP-1 and future risk of depression was significant in the middle plasma ICAM-1 and VCAM-1 tertile groups; the high plasma MCP-1 tertile group showed about four-fold higher risk of depression than the low plasma MCP-1 tertile group. CONCLUSIONS Molecules involved in monocyte trafficking may be good candidates as diagnostic biomarkers and/or therapeutic targets for late life depression.
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Affiliation(s)
- Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.,Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea
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Moon W, Han JW, Bae JB, Suh SW, 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. Disease Burdens of Alzheimer's Disease, Vascular Dementia, and Mild Cognitive Impairment. J Am Med Dir Assoc 2021; 22:2093-2099.e3. [PMID: 34237255 DOI: 10.1016/j.jamda.2021.05.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/15/2021] [Accepted: 05/29/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Understanding disability-adjusted life-years (DALYs) based on dementia subtypes and mild cognitive impairment (MCI) is essential for optimal resource allocation. This study aimed to investigate disease burdens of various dementias and MCI in a representative South Korean population. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS 6481 Korean older adults. METHODS We estimated the disease-specific DALYs. RESULTS DALYs due to MCI and all-cause dementia are estimated to increase from 1295 per 100,000 in 2016 to 9501 per 100,000 in 2065. In 2016, DALYs attributed to Alzheimer's dementia, vascular dementia, and MCI accounted for 33% (423 per 100,000), 20% (316 per 100,000), and 24% (123 per 100,000), respectively, of the total DALYs due to MCI and all-cause dementia. In 2065, DALYs due to Alzheimer's dementia, vascular dementia, and MCI will account for 38% (3654 per 100,000), 17% (1654 per 100,000), and 27% (2585 per 100,000) of total DALYs due to MCI and all-cause dementia, respectively. The years of life lived with disability (YLDs) due to MCI and all-cause dementia are estimated to rise from 479 per 100,000 in 2016 to 2807 per 100,000 in 2065. In 2016, YLDs due to Alzheimer's dementia, vascular dementia, and MCI composed 37% (177 per 100,000), 18% (85 per 100,000), and 15% (70 per 100,000), respectively, of the total YLDs due to MCI and all-cause dementia. In 2065, YLDs due to Alzheimer's dementia, vascular dementia, and MCI will account for 48% (1358 per 100,000), 15% (410 per 100,000), and 10% (290 per 100,000), respectively, of total YLDs due to MCI and all-cause dementia. CONCLUSIONS AND IMPLICATIONS Considering the rapidly growing disease burden, resources should be allocated to continuously monitor and manage the MCI and dementia burden. Particular attention to Alzheimer's dementia is required considering its significant contribution to current and future disease burden, especially to YLD.
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Affiliation(s)
- Woori Moon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Republic of Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
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Lee GY, Shin GW, Park HY, Yoon HK, Kim TH, Lee A, Heo YJ, Lee YJ, Han JY, Park YM. Predictive sonographic features for differentiation of breast fibroepithelial
tumors: fibroadenoma versus phyllodes tumor. Hong Kong Journal of Radiology 2021. [DOI: 10.12809/hkjr2117333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- GY Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - GW Shin
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - HY Park
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - HK Yoon
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - TH Kim
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - A Lee
- Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - YJ Heo
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - YJ Lee
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - JY Han
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - YM Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
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Bae JB, Han JW, Song J, Lee K, 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. Hypohomocysteinemia may increases the risk of dementia and Alzheimer's disease: A nationwide population-based prospective cohort study. Clin Nutr 2021; 40:4579-4584. [PMID: 34229262 DOI: 10.1016/j.clnu.2021.05.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/18/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hyperhomocysteinemia has been repeatedly found to increase the risk of dementia. However, the effects of hypohomocysteinemia on the risk of dementia have been barely investigated. If hypohomocysteinemia, like hyperhomocysteinemia, increases the risk of dementia, misuse or overuse of homocysteine-lowing agents such as vitamin supplements may increase the risk of dementia. AIMS To investigate whether hypohomocysteinemia, like hyperhomocysteinemia, could increase the risk of dementia and Alzheimer's disease (AD) in a large population-based cohort of older adults. METHODS This prospective cohort study followed 2655 randomly sampled, community-dwelling, non-demented individuals aged 60 years or older from 2010 to 2018. We measured baseline serum total homocysteine (tHcy) levels and examined the effect of serum tHcy on the risks of dementia and AD using Cox proportional hazards models. RESULTS During the follow-up period (mean = 5.4 years, SD = 0.9), dementia and AD developed in 85 and 64 participants, respectively. Not only the participants with high serum tHcy (≥10.6 μmol/L) but also those with low serum tHcy (≤8.9 μmol/L) were 4-5 times more likely to develop dementia and AD compared to those with serum tHcy levels between 9.0 and 10.5 μmol/L. With the increase in serum tHcy concentration, the use of vitamin supplements decreased, and 41.2% of the participants with low serum tHcy (≤8.9 μmol/L) were taking vitamin supplements. CONCLUSIONS Not only hyperhomocysteinemia but also hypohomocysteinemia considerably increased the risk of dementia and AD in older adults. The risk of dementia that results from overuse or misuse of vitamin supplements should be acknowledged and homocysteine-lowering health policies should be tailored to consider dementia risks that are associated with hypohomocysteinemia.
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Affiliation(s)
- Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Junghan Song
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kyunghoon Lee
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Medical Center, Seoul, South Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon, South Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea; Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea.
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Park Y, Yu H, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Antiarrhythmic drug responders among patients with recurrent atrial fibrillation after catheter ablation. Europace 2021. [DOI: 10.1093/europace/euab116.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): The Ministry of Health and Welfare The National Research Foundation of Korea (NRF)
Backgroud
Sinus rhythm (SR) can be maintained with antiarrhythmic drugs (AADs) in a considerable number of patients with recurrent atrial fibrillation (AF) after AF catheter ablation (AFCA).
Purpose
We explored the characteristics and long-term outcomes of patients who maintained clinically acceptable rhythm control with AADs for 2 years.
Methods
Among 2,935 consecutive AAD-resistant patients who underwent a de novo AFCA, we included 512 recurrent patients (73.0% men, 59.2 ± 10.5 years old, 56.4% paroxysmal AF) who were followed up for over 2 years under AAD medications.
Results
In total, 218 patients remained in SR (AAD-responders[2-yrs], 42.6%) and 294 had recurrent AF among whom, 162 underwent repeat procedures (redo-AFCA[AAD failure-2-yrs]). We also compared the AAD-responders[2-yrs] with 40 patients who underwent AFCA before AADs (redo-AFCA[Before AAD]). AAD-responders[2-yrs] were independently associated with an old age (odds ratio [OR] 1.02 [1.00-1.04] p = 0.037), paroxysmal AF (OR 1.51 [1.04-2.19] p = 0.003), and a delayed recurrence timing of > 18 months (OR 1.52 [1.04-2.22] p = 0.032). When comparing the AAD-responder[2-yrs] and redo-AFCA[AAD failure-2-yrs] groups, the recurrence pattern showed a convergence after 7 years. The overall rhythm outcome was better in the redo-AFCA[Before AAD] group than AAD group (log rank p = 0.013).
Conclusion
Among the patients with recurrent AF after AFCA, over 40% remained in SR with AADs for 2 years, especially those who were old, those with a paroxysmal type, and those who had a delayed recurrence timing of >18 months after the de novo procedure. UnivariateMultivariateOdds Ratio(95% CI)p valueOdds Ratio(95% CI)p valueAge1.02 (1.00-1.04)0.0231.02 (1.00-1.04)0.037Female1.64 (1.11-2.42)0.0141.29 (0.85-1.95)0.236PAF1.58 (1.11-2.26)0.0121.51 (1.04-2.19)0.030Time to recurrence after the initial AFCA >18mo*1.59 (1.11-2.30)0.0131.52 (1.04-2.22)0.032LA dimension, mm0.99 (0.96-1.02)0.360LV ejection fraction, %1.03 (1.01-1.06)0.0111.02 (0.997-1.046)0.081Heart failure0.65 (0.34-1.24)0.192Hypertension1.18 (0.83-1.67)0.358Diabetes1.01 (0.65-1.71)0.844Stroke or TIA0.96 (0.56-1.66)0.879Vascular disease1.43 (0.88-2.31)0.151Logistic regression analysis for AAD responders Abstract Figure. K-M analysis of AF-free survival rate
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Affiliation(s)
- Y Park
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - H Yu
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - TH Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - JS Uhm
- Yonsei University, Seoul, Korea (Republic of)
| | - B Joung
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - MH Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - HN Pak
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
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Kim D, Yu HT, Kim TH, Uhm JS, Joung B, Lee MH, Pak HN. Malnutrition and risk of procedural complication in patients with atrial fibrillation undergoing catheter ablation. Europace 2021. [DOI: 10.1093/europace/euab116.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health and Welfare of Korea Ministry of Science, ICT & Future Planning of Korea
Background
Malnutrition is common in the elderly, even in developed countries, and increases mortality.
Purpose
To investigate the prevalence and prognostic value of malnutrition among patients with atrial fibrillation (AF) which is a type of metabolic disease.
Methods
We included 3,239 patients (age 58.5 ± 10.8 years, 73.2% male, 67.7% paroxysmal type) undergoing de novo AF catheter ablation (AFCA) between 2009 and 2020. Nutritional status was assessed using controlling nutritional status (CONUT) score. The associations between malnutrition and the risk of AFCA complications or long-term rhythm outcome were evaluated by multivariable logistic regression.
Results
Among 3,239 patients, 1,005 (31.0%) patients had malnutrition; 991 (30.6%) with mild (CONUT scores 2-4) and 14 (0.4%) with moderate-to-severe (CONUT scores ≥5) malnutrition. Overall complication rates after AFCA were 3.3% in normal nutrition, 4.2% in mild malnutrition, and 21.4% in moderate to severe malnutrition, respectively (P for trend = 0.031). Major complication rates were 1.9%, 2.6%, and 14.3% in normal nutrition, mild malnutrition, and moderate to severe malnutrition (P for trend = 0.042). After multivariable adjustment, moderate-to-severe malnutrition status was associated with increased risks of overall (OR 8.215 [2.199-30.691], P = 0.002) and major (OR 7.392 [1.568-34.837], P = 0.011) complications compared with normal nutrition. However, CONUT score did not affect the long-term rhythm outcome during the mean follow-up of 40 (interquartile range 18-74) months (log-rank P = 0.760).
Conclusion
Malnutrition is common in patients undergoing AFCA. Those with moderate-to-severe malnutrition status were at substantially higher risk of complications after AFCA. Abstract Figure. Overall and major complication rates
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Affiliation(s)
- D Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - JS Uhm
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - B Joung
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
| | - HN Pak
- Yonsei University College of Medicine, Division of Cardiology, Department of Internal Medicine, Seoul, Korea (Republic of)
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Pak HN, Park JW, Yang SY, Kim M, Yu HT, Kim TH, Uhm JS, Joung BY, Lee MH. Sex differences in mapping and rhythm outcomes of a repeat atrial fibrillation ablation. Europace 2021. [DOI: 10.1093/europace/euab116.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
The risk of procedure-related complications and rhythm outcomes differ between men and women after atrial fibrillation catheter ablation (AFCA). We evaluated whether consistent sex differences existed in mapping and rhythm outcomes in repeat ablation procedures.
Methods
Among 3,282 patients in the registry, we analysed 443 consecutive patients (24.6% female, 58.5 ± 10.3 years old, 61.5% paroxysmal AF) who underwent a second AFCA. We compared the clinical factors, mapping, left atrial (LA) pressure, complications, and long-term clinical recurrences after propensity score matching.
Results
The LA volume index (43.1 ± 18.6 vs. 35.8 ± 11.6 ml/m2, p < 0.001) was higher, but LA dimension (40.0 ± 6.8 vs. 41.6 ± 6.3mm, p = 0.018), LA voltage (0.94 ± 0.55 vs. 1.20 ± 0.68 mV, p = 0.002), and pericardial fat volume (89.5 ± 43.1 vs. 122.1 ± 53.9 cm3, p < 0.001) lower in women with a repeat ablation than in their male counterparts. The pulmonary vein (PV) reconnections were lower (58.7% vs. 74.9%, p = 0.001), but the proportion of extra-PV triggers (27.5% vs. 17.0%, p = 0.026) and elevated LA pulse pressures (79.7% vs. 63.7%, p = 0.019) was significantly higher in women than men. There was no significant sex difference in the procedure-related complication rate (4.6% vs. 4.2%, p = 0.791). During a 31(8∼60) month median follow-up, clinical recurrences were significantly higher in women after both the de novo procedure (log rank p = 0.039, antiarrhythmic drug [AAD]-free log rank p < 0.001) and second procedure (log rank p = 0.006, AAD-free log rank p = 0.093). A female sex (HR 1.51 [1.06-2.15], p = 0.023), non-paroxysmal AF (HR 1.78 [1.30-2.34], p < 0.010), and extra-PV triggers (HR 1.88 [1.28-2.75], p = 0.001) were independently associated with clinical recurrences after repeat procedures.
Conclusions
During the repeat AFCA procedures, PV reconnections were lower in women than men, and the existence of extra-PV triggers and an LA pressure elevation was more significant, which resulted in poor rhythm outcomes.
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Affiliation(s)
- HN Pak
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JW Park
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - SY Yang
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - M Kim
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JS Uhm
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - BY Joung
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University Health system, Seoul, Korea (Republic of)
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Park JW, Kwon OS, Shim JM, Yu HT, Kim TH, Uhm JS, Kim JY, Choi JI, Joung BY, Lee MH, Kim YH, Pak HN. Artificial intelligence-predicted poor responders to catheter ablation for atrial fibrillation. Europace 2021. [DOI: 10.1093/europace/euab116.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Although atrial fibrillation (AF) catheter ablation is effective for rhythm control, in some patients it is hard to maintain sinus rhythm in spite of repeated AF catheter ablation (AFCA) procedures and anti-arrhythmic drugs (AADs). We explored the pre-procedural predictors for poor responders to AFCA and tested whether artificial intelligence (AI) assists the prediction of poor responders in the independent cohort by determining the invasive parameters.
Methods
Among 1,214 patients who underwent AFCA and regular rhythm follow-up for 56.2 ± 33.8 months (59 ± 11 years, 73.5% male, 68.6% paroxysmal AF), we differentiated 92 poor responders defined as those with sustained AF despite repeat AFCAs, AADs, or electrical cardioversion. Using the Youden index, we identified advanced LA remodeling with lower LA voltage under 1.109mV. AI model, which was derived from development cohort using medical record, was applied to predict LA voltage <1.109mV in the independent cohort (n = 634, poor responders = 24) using a grad-cam score.
Results
The patients with lower LA voltage under 1.109mV showed significantly poorer rhythm outcomes (Log-rank p < 0.001). We determined invasive parameter LA voltage by using the multiple variables (age, female sex, AF type, CHA2DS2VASc score, LA dimension, E/em, hemoglobin, PR interval) and achieved relatively good prediction power of AI for LA voltage <1.109mV (AUC = 0.734, sensitivity 0.729, specificity 0.643) in the test cohort. In the independent cohort, the AI model showed good discrimination power for poor responders (AUC 0.751, p < 0.001) by estimating LA voltage, which is an invasive variable. The patients with predicted lower LA voltage (grad-cam score <0) showed poorer rhythm outcome after active rhythm control (Log-rank p < 0.001)
Conclusions
The patients with advanced atrial remodeling with low LA voltage, which can be predicted by an AI, showed significantly higher recurrence of AF after AFCA with AADs or cardioversion. AI may assist to select these poor responder patients before the AFCA procedure. Abstract Figure.
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Affiliation(s)
- JW Park
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - OS Kwon
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JM Shim
- Korea University, Cardiovascular Center, Seoul, Korea (Republic of)
| | - HT Yu
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JS Uhm
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JY Kim
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - JI Choi
- Korea University, Cardiovascular Center, Seoul, Korea (Republic of)
| | - BY Joung
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University Health system, Seoul, Korea (Republic of)
| | - YH Kim
- Korea University, Cardiovascular Center, Seoul, Korea (Republic of)
| | - HN Pak
- Yonsei University Health system, Seoul, Korea (Republic of)
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Lee J, Kwon OS, Lee JS, Yu HT, Kim TH, Uhm JS, Joung BY, Lee MH, Pak HN. Left atrial wall stress and the outcome of catheter ablation for atrial fibrillation: artificial intelligence-based prediction of clinical outcome. Europace 2021. [DOI: 10.1093/europace/euab116.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction: Left atrial (LA) wall stress (LAW-str) may contribute to the mechanism of atrial fibrillation (AF).
Purpose
We explored the clinical characteristics and the rhythm outcome of AF depending on LAW-str among the patients who underwent AF catheter ablation (AFCA). We also tested whether artificial intelligence (AI) properly estimate LAW-str without invasive parameters.
Methods
We included 2223 patients (72.8% male, 59.0 [52.0–67.0] years old, 28.7% with persistent AF [PeAF]) who underwent radiofrequency catheter ablation (RFCA). LAW-str was calculated by the Law of Laplace using LA diameter (echocardiogram), peak LA pressure, and mean LA wall thickness (computed tomography) measured by customized software. Based on the quartile (Q1–4) or AI-estimated values of LAW-str, we compared clinical characteristics and rhythm outcome.
Results
LAW-str was independently associated with PeAF (p < 0.001), diabetes (p = 0.012) and vascular disease (p = 0.002), body mass index (p < 0.001), E/Em (p < 0.001), and mean LA voltage (p < 0.001). During 26.0 (12.0–52.0) months follow-up, clinical recurrence of AF was significantly higher in the Q4 of LAW-str group (log rank p = 0.001). LAW-str was independently associated with clinical recurrence after AFCA (HR 1.001 [1.000–1.002], p = 0.013). AI-based model using non-invasive parameters predicted Q4 of LAW-str with area under the curve (AUC) 0.734, which was similar to logistic regression based predictive model using all data including invasive parameters (AUC 0.726). Patients in Q4 of LAW-str showed consistently worse rhythm outcome regardless of the type of AF, sex, or AI-based prediction (p = 0.039).
Conclusions
The LAW-str seems to be associated with rhythm outcome of AFCA and AI can predict this complex parameter with moderate accuracy. TableMultivariateβ (95% CI)PPersistent AF31.08 (21.77-40.39)<0.001Diabetes mellitus15.36 (3.35-27.38)0.012Vascular disease22.27 (8.4-36.14)0.002Body mass index2.91 (1.53-4.29)<0.001E/Em4.95 (3.87-6.02)<0.001Mean LA voltage-22.24 (-27.96–16.52)<0.001Linear regression analysis for clinical variables predictive of LA wall stress (10^3 dyn/cm2).Abstract Figure. AF recurrence by LAW-str, AI-prediction
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Affiliation(s)
- J Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - OS Kwon
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - JS Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - HT Yu
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - TH Kim
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - JS Uhm
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - BY Joung
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - MH Lee
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - HN Pak
- Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea (Republic of)
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Park JW, Yang PS, Yu HT, Kim TH, Jang ES, Pak HN, Lee MH, Joung BY. The reduction of body mass index and risk of incidence of cardiovascular events in the elderly population. Europace 2021. [DOI: 10.1093/europace/euab116.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Obesity is known to be risk factor for incidence of cardiovascular (CV) events. However, the association between the reduction of body mass index (BMI) and incidence of cardiovascular event is not well established in elderly Asian population.
Methods
From the National Health Insurance Service-Senior (≥60 years) cohort from 2002 to 2013, 13,038 participants over 75 years old without baseline comorbidities (mean age: 78.4 ± 3.2 years 5243 (40.2%) male) were included in this study. We measured the change of BMI from first to second visit for health check-up within mean 23.6 ± 5.8months of follow-up. We categorized the reduction of BMI as five group according to the amount of change in BMI in overall patients (group 1: BMI change <-10%, group 2: -10%≤BMI change<-3%, group 3: -3% ≤ BMI change < 3%, group 4: 3% ≤BMI change < 10%, group 5: 10% ≤BMI change). We investigated the influence of change in BMI on the incidence of new-onset AF, stroke, acute myocardial infarction (MI), and CV mortality
Results
In the overall patients, new-onset AF, stroke, acute MI, and CV death was occurred in the 494 patients (3.5%), 775 patients (5.9%), 16 patients (0.1%), and 458 patients (3.5%) respectively. The Kaplan-Meier curve showed significant cumulative incidence rate of CV death in group 1 (Log rank p < 0.001). The multivariate cox regression after adjusting for compound clinical covariates showed the risk of stroke (HR 1.43, 95% CI [1.09-1.89], p = 0.01) and CV death (HR 2.06, 95% CI [1.49-2.84] were significant higher in the group 1 as compared with group 3. In the high BMI (≥25) group, the risk of AF was significant higher in the group 5 as compared with group 3 (HR 2.38, 95% CI [1.02-5.54], p = 0.04). In contrast, the risk of stroke (HR 1.70, 95% CI [1.07-2.71], p = 0.02) and CV death (HR 3.27, 95% CI [1.66-6.41], p < 0.001) was significant higher in the group 1 than in group 3.
Conclusions
In the elderly Asian population over 75 years old, the reduction of body weight affected worse effect on the incidence of stroke and CV death in overall patient and high BMI (≥25) group. It needs careful consideration to reduce BMI in the elderly Asian population even with high BMI (≥25) for purpose of CV events.
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Affiliation(s)
- JW Park
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - PS Yang
- Bundang CHA General Hospital, Seongnam, Korea (Republic of)
| | - HT Yu
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - TH Kim
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - ES Jang
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - HN Pak
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - MH Lee
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
| | - BY Joung
- Yonsei University College of Medicine, Seoul, Korea (Republic of)
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Oh DJ, Han JW, Bae JB, 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. Executive dysfunction and risk of suicide in older adults: a population-based prospective cohort study. J Neurol Neurosurg Psychiatry 2021; 92:528-533. [PMID: 33563806 DOI: 10.1136/jnnp-2020-324390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/27/2020] [Accepted: 12/22/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE It is uncertain what factors increases the risk of suicide in older adults without depression, and it is unknown whether executive dysfunction (ED) is one of those factors. We aimed to examine the effect of ED on the risk of suicide in non-demented older adults without depression. METHODS In an ongoing population-based prospective cohort of Korean older adults, we identified suicide using the National Mortality Database and suicidal ideation or attempt (SIA) based on the Korean version of the Mini International Neuropsychiatric Interview. We defined ED as performing below -1.5 SD of age-adjusted, gender-adjusted and education-adjusted norms in any of following tests: Frontal Assessment Battery, Trail Making Test A, Digit Span Test or Verbal Fluency Test. RESULTS The mean age of the 4791 participants at baseline was 69.7 (SD 6.4) years, and 57.1% of them were women (mean follow-up duration=4.9 years). ED at baseline increased the risk of suicide by about seven times (HR 7.20, 95% CI 1.84 to 28.12, p=0.005) but did not change the risk of SIA. However, cognitive impairment without ED did not change the risks of suicide and SIA. In participants with ED, being aged 75 years or above, living alone, and having a low socioeconomic status were associated with the risk of suicide. CONCLUSION ED is a strong risk factor of late life suicide independent from depression, particularly in very old adults living in disadvantaged environments.
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Affiliation(s)
- Dae Jong Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea (the Republic of)
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea (the Republic of)
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea (the Republic of)
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea (the Republic of)
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea (the Republic of)
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea (the Republic of)
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea (the Republic of)
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea (the Republic of)
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea (the Republic of)
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea (the Republic of)
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea (the Republic of)
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea (the Republic of)
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea (the Republic of)
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon, Korea (the Republic of)
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea (the Republic of) .,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of).,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Korea (the Republic of)
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Byeon G, Oh GH, Jhoo JH, Jang JW, Bae JB, Han JW, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DW, Lee SB, Lee JJ, Lee DY, Kim KW. Dual Sensory Impairment and Cognitive Impairment in the Korean Longitudinal Elderly Cohort. Neurology 2021; 96:e2284-e2295. [PMID: 33827964 DOI: 10.1212/wnl.0000000000011845] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 02/05/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the effects of single sensory impairment (SSI; visual or auditory) or dual sensory impairment (DSI; visual and auditory) on dementia and longitudinal changes of neuropsychological test scores. METHODS In this nationwide, prospective, community-based elderly cohort study, KLOSCAD (the Korean Longitudinal Study on Cognitive Aging and Dementia), 6,520 elderly individuals (58-101 years) representing the general population were included. We defined visual and auditory sensory impairment via self-report questionnaire: 932 had normal sensory function, 2,957 had an SSI, and 2,631 had a DSI. Demographic and clinical variables including cognitive outcomes were evaluated every 2 years over 6 years. Through logistic regression, Cox regression, and linear mixed model analysis, the relationship between SSI or DSI and dementia prevalence, dementia incidence, and change in neuropsychological scores were evaluated. RESULTS At baseline, DSI was significantly associated with increased dementia prevalence compared to normal sensory function (odds ratio [OR] 2.17, 95% confidence interval [CI] 1.17-4.02), but SSI was not (OR 1.27, 95% CI 0.66-2.41). During the 6-year follow-up, the incidence of dementia was significantly higher in the DSI group than in the normal sensory function group (hazard ratio 1.9, 95% CI 1.04-3.46) and neuropsychological scores significantly decreased (β -0.87, 95% CI [-1.17 to -0.58]). CONCLUSIONS Our results suggest that coexisting visual and hearing impairments facilitate dementia prevalence, dementia incidence, and cognitive decline, but visual or hearing impairment alone do not. Visual and hearing impairment may lead to dementia or cognitive decline independent of Alzheimer pathology.
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Affiliation(s)
- Gihwan Byeon
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Gyu Han Oh
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Jin Hyeong Jhoo
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea.
| | - Jae-Won Jang
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Jong Bin Bae
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Ji Won Han
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Tae Hui Kim
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Kyung Phil Kwak
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Bong Jo Kim
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Shin Gyeom Kim
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Jeong Lan Kim
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Seok Woo Moon
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Joon Hyuk Park
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Seung-Ho Ryu
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Jong Chul Youn
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Dong Woo Lee
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Seok Bum Lee
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Jung Jae Lee
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Dong Young Lee
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
| | - Ki Woong Kim
- From the Departments of Psychiatry (G.B., J.H.J.) and Neurology (J.-W.J.), Kangwon National University Hospital, Chuncheon; Public Health Medical Service (G.H.O.) and Department of Neuropsychiatry (D.Y.L.), Seoul National University Hospital; Department of Neuropsychiatry (J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Psychiatry (T.H.K.), Yonsei University Wonju Severance Christian Hospital; Department of Psychiatry (K.P.K.), Dongguk University Gyeonju Hospital; Department of Psychiatry (B.J.K.), Gyeongsang National University School of Medicine, Jinju; Department of Neuropsychiatry (S.G.K.), Soonchunhyang University Bucheon Hospital; Department of Psychiatry, School of Medicine (J.L.K.), Chungnam National University, Daejeon; Department of Psychiatry, School of Medicine (S.W.M., S.-H.R.), Konkuk University, Konkuk University Chungju Hospital; Department of Neuropsychiatry (J.H.P.), Jeju National University Hospital; Department of Neuropsychiatry (J.C.Y.), Kyunggi Provincial Hospital for the Elderly, Yongin; Department of Neuropsychiatry (D.W.L.), Inje University Sanggye Paik Hospital, Seoul; Department of Psychiatry (S.B.L., J.J.L.), Dankook University Hospital, Cheonan; and Department of Psychiatry, College of Medicine (D.Y.L., K.W.K.), and Department of Brain and Cognitive Science, College of Natural Sciences (K.W.K.), Seoul, Korea
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Kwan Y, Choi S, Eom TR, Kim TH. Development of a Structured Interview to Explore Interpersonal Schema of Older Adults Living Alone Based on Autobiographical Memory. Int J Environ Res Public Health 2021; 18:ijerph18052316. [PMID: 33652880 PMCID: PMC7956442 DOI: 10.3390/ijerph18052316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 11/21/2022]
Abstract
With a growing public interest in the social health of older adults, studies focusing on social networks and interpersonal relationships of older adults are needed. The present study was conducted to develop a structured interview to evaluate the interpersonal schema based on Self-Defining Memory of older adults. First, the word cues that the older adults often report on interpersonal events were confirmed. Next, the indices and scoring rules were prepared, including Relationship frequency (RF), Conflict frequency (CF), Dominance mean (Dm), and Warmth mean (Wm). Healthy older adults living alone (mean age = 71.81, SD = 3.95) were interviewed. Finally, the correlation between each index and Short form of Korean Inventory of Interpersonal Problems Circumplex Scales (KIIP-SC) was analyzed for criterion validity. The inter-rater reliability was substantial (Kappa = 0.61~0.66). Based on the analysis of criterion validity, the indices of CF, Dm, and Wm indices showed an appropriate level of criterion validity. This study developed a structural interview based on a novel system of reporting autobiographical memory and established indices with appropriate validity to evaluate interpersonal relationships. The interview is expected to identify the characteristics of interpersonal relationships of the older adults and contribute to the establishment of the older adults’ community accordingly.
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Affiliation(s)
- Yunna Kwan
- Department of Psychiatry, Wonju Severance Christian Hospital, Wonju 26426, Korea;
- Department of Psychology, Duksung Women’s University, Seoul 01369, Korea;
| | - Sungwon Choi
- Department of Psychology, Duksung Women’s University, Seoul 01369, Korea;
| | - Tae Rim Eom
- Health Insurance Research Institute, National Health Insurance Service, Wonju 26464, Korea;
| | - Tae Hui Kim
- Department of Psychiatry, Wonju Severance Christian Hospital, Wonju 26426, Korea;
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
- Correspondence: ; Tel.: +82-33-741-0534
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Kim GE, Han JW, Kim TH, Suh SW, Bae JB, Kim JH, Kim KW. Hippocampus Mediates the Effect of Emotional Support on Cognitive Function in Older Adults. J Gerontol A Biol Sci Med Sci 2021; 75:1502-1507. [PMID: 31403162 DOI: 10.1093/gerona/glz183] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Despite strong evidence that emotional support has a protective effect on cognitive decline, the neural basis for how an individual's emotional support is associated with cognition is unknown. We investigated if the hippocampus mediates the relationship between emotional support and cognition in older adults. METHOD Four hundred and ten nondemented Korean older adults were classified into two groups according to their Medical Outcomes Study-Social Support Survey emotional support scores: the poor emotional support (score ≤ 25th percentile of entire sample) and normal emotional support (score > 25th percentile of entire sample) groups. Cognitive function was assessed using the Verbal Memory Score and Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet Neuropsychological Assessment Battery total score (CERAD-TS). Left and right hippocampal volume were obtained using 3T T1-weighted magnetic resonance images. Mediation analyses were conducted. RESULTS In the association of emotional support with Verbal Memory Score, left hippocampal volume played a mediating role (indirect effect = 0.40, SE = 0.21, bias-corrected 95% confidence interval = 0.04, 0.86). In the association of emotional support with CERAD-TS, both left (indirect effect = 0.82, SE = 0.45, bias-corrected 95% confidence interval = 0.09, 1.83) and right (indirect effect = 0.51, SE = 0.32, bias-corrected 95% confidence interval = 0.02, 1.24) HPVs played mediating roles. CONCLUSIONS The hippocampus may mediate the association between emotional support and cognition. Higher levels of emotional support may be associated with better verbal memory and global cognition via larger HPV.
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Affiliation(s)
- Grace Eun Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Republic of Korea
| | - Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ki Woong Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Republic of Korea
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Chung H, Park CH, Kim YJ, Kim JY, Min PK, Yoon YW, Lee KA, Lee BK, Hong BK, Kim TH, Rim SJ, Kwon HM, Choi EY. Myocardial extracellular space expansion is related to burden of premature ventricular contractions in patients with hypertrophic cardiomyopathy without non-sustained ventricular tachycardia. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Current guidelines suggest the presence of non-sustained ventricular tachycardia (NSVT) as a risk factor of sudden cardiac death in patients with hypertrophic cardiomyopathy (HCM). However, high burden of premature ventricular contraction (PVC) may reflect myocardial fibrosis although the absence of NSVT.
Purpose
We investigated the association between PVC burden and myocardial extracellular space expansion in HCM patients without NSVT.
Methods
Of the 212 patients prospectively enrolled to the HCM registry of genetics, 84 patients were evaluated with both cardiac magnetic resonance and 24hr holter. Among them, 71 patients (58 males, mean age: 71 ± 13 years) have not been diagnosed with NSVT.
Results
Patients with NSVT (n = 13) showed more impaired LA functional indices and higher myocardial fibrosis burden compared with patients without NSVT (n = 71). Among patients who have not been diagnosed with NSVT, patients with late gadolinium enhancement (LGE, n = 46) had a higher total beats (109 ± 332 vs. 7 ± 13 beats per a day, p = 0.003) and burden (0.114 ± 0.225 vs. 0.008 ± 0.014 %, p = 0.003) of PVC during 24-hour compared with patients without LGE (n = 25). %LGE was correlated with total beats of PVC (r = 0.358, p = 0.002) and PVC burden (r = 0.377, p = 0.001). ECV also correlated with total beats of PVC (r = 0.387, p = 0.001) and PVC burden (r = 0.401, p = 0.001). The optimal cutoff value for PVC number was 45 (37.0% of sensitivity and 100% of specificity) with 0.733 of the area under the ROC curve (p < 0.001). Pathogenic or likely pathogenic sarcomere mutation was higher in NSVT group than no NSVT group (p < 0.05), and had a higher tendency in higher PVC burden group (0.05 < p < 0.1) than lower PVC burden group.
Conclusions
Total beats and burden of PVC are significantly related to increase in myocardial fibrosis in HCM patients without NSVT.
Abstract Figure. Mechanism of ventricular arrhythmia
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Affiliation(s)
- H Chung
- Kyung Hee Medical Center, Seoul, Korea (Republic of)
| | - CH Park
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - YJ Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - JY Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - PK Min
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - YW Yoon
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - KA Lee
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - BK Lee
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - BK Hong
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - TH Kim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - SJ Rim
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - HM Kwon
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
| | - EY Choi
- Gangnam Severance Hospital, Seoul, Korea (Republic of)
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Han A, Kim TH. A Simulation-Based Empathy Enhancement Program for Non-Medical Care Providers of Older Adults: A Mixed-Methods Study. Psychiatry Investig 2021; 18:132-139. [PMID: 33517619 PMCID: PMC7960746 DOI: 10.30773/pi.2020.0290] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/14/2020] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Studies using simulation-based programs for empathy enhancement have been conducted mostly for health profession students and medical care providers in Western countries. No empirical research has been conducted for non-medical care providers of older adults in community settings in Asian countries. The purposes of this mixed-methods study were: to explore experiences and perceived usability of non-medical care providers of older adults in a simulation-based empathy enhancement program; and to examine if the program is effective in improving empathy and relevant outcomes. METHODS 104 non-medical care providers of older adults in South Korea participated in a simulation-based empathy enhancement program in 2018. Data were collected using self-reported questionnaires for effectiveness testing, a program evaluation questionnaire, and individual interviews and analyzed using statistical tests and thematic analysis. RESULTS Care providers showed higher levels of empathy and lower levels of stress and burnout after the program participation (p<0.05). Qualitative findings supported the improved attitude and care strategies, increased empathy towards older adults, preparing for their own aging, and restoration of emotional stability through the participation in the program. CONCLUSION This study suggests that the simulation-based program is useful in promoting empathic responses of non-medical care providers working with older adults.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Hyun Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woori Moon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hye Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dae Jong Oh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
| | - Seonjeong Byun
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jiyeong Seo
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University, School of Medicine, Chuncheon, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea.,Department of Brain and Cognitive Sciences, Seoul National University, College of Natural Sciences, Seoul, Korea
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Park JS, Kim TH, Oh YJ, Park EJ, Kim JW, Jeong H. Investigation of photodarkening in tandem-pumped Yb-doped fibers. Opt Express 2020; 28:27316-27323. [PMID: 32988028 DOI: 10.1364/oe.400094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/25/2020] [Indexed: 06/11/2023]
Abstract
Investigation of photodarkening (PD) in Yb-doped fibers tandem-pumped at 1018 nm is reported. For a homemade Yb-doped aluminosilicate double-clad fiber (YADF), the transmitted power of a 633 nm probe beam is reduced by 2.4% over 2 hours for the tandem pumping configuration at 1018 nm, which is significantly smaller than 33.3% for a laser diode (LD) pumping at 976 nm. A tandem-pumped Yb fiber amplifier also shows a much smaller decrease in the amplified output power over time than a LD-pumped Yb fiber amplifier. Based on fluorescence spectra of the YADF, we can not only associate PD of the YADF to intrinsic oxygen deficiency centers or Tm3+ impurities but also confirm the impact of the excited Yb3+ ion density on PD. The benefits of the tandem pumping in a high-power Yb fiber laser system will be discussed.
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50
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Ha T, Kang DK, Kim TH. Percentage volume of delayed kinetics in computer-aided diagnosis of MRI of the breast to reduce false-positive results and unnecessary biopsies. Clin Radiol 2020; 75:962.e1-962.e8. [PMID: 32888654 DOI: 10.1016/j.crad.2020.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 08/03/2020] [Indexed: 11/30/2022]
Abstract
AIM To investigate the best cut-off percentage volume of delayed kinetics using magnetic resonance imaging (MRI) with computer-aided diagnosis (CAD) to reduce unnecessary biopsies in patients with newly diagnosed breast cancer. MATERIALS AND METHODS Between January 2017 and December 2018, 94 malignant and 56 benign masses were analysed using MRI CAD. All malignant and benign masses measured <2 cm and were confirmed histopathologically. The optimal cut-off values for washout, plateau, and persistent components were determined using the maximum Youden Index. The positive predictive value (PPV) was analysed using morphological descriptors and combining the percentage volume of delayed kinetics. RESULTS The area under the curve (AUC) was highest at ≤73% persistent component (AUC=0.759). In the subgroup analyses of masses <1 cm, the AUC was highest a plateau of >26% (AUC=0.697). When the persistent ≤73% criterion was applied to the lesions of C4a, the positive predictive value (PPV) increased from 61.9% to 72.44% with reduced false-negative cases and when applied to the lesions of C4a and C4b, the PPV increased from 61.9% to 78.1% with slightly increased false-negative cases. For subcentimetre lesions, the PPV increased from 46.77% to 54.72% with the same number of false-negative cases, when a plateau of >26% was applied to C4a, and the PPV increased from 46.77% to 61.36% with five false-negative cases when applied to C4a and C4b. CONCLUSION The percentage volume of delayed kinetics has the potential to improve the PPV of breast MRI. When suspicious masses <2 cm do not show ≤73% persistence, follow-up rather than biopsy could be considered; however, to avoid increasing false-negative cases, delayed kinetic information should be used with caution and accurate margin assessment is essential.
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Affiliation(s)
- T Ha
- Department of Radiology, Ajou University School of Medicine, Worldcup-ro 164, Youngtong-gu, Suwon, Gyeonggi-do, 16499, South Korea
| | - D K Kang
- Department of Radiology, Ajou University School of Medicine, Worldcup-ro 164, Youngtong-gu, Suwon, Gyeonggi-do, 16499, South Korea
| | - T H Kim
- Department of Radiology, Ajou University School of Medicine, Worldcup-ro 164, Youngtong-gu, Suwon, Gyeonggi-do, 16499, South Korea.
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