Korean J Psychosom Med.  2021 Jun;29(1):67-76. 10.22722/KJPM.2021.29.1.67.

Association between Medial Temporal Atrophy, White Matter Hyperintensities, Neurocognitive Functions and Activities of Daily Living in Patients with Alzheimer’s Disease and Mild Cognitive Impairment

• An Mh
• Kim H
• Lee KJ

• KMID: 2524484
• DOI: http://doi.org/10.22722/KJPM.2021.29.1.67

Abstract

Objectives
：The aim of this study was to compare activities of daily living (ADLs) according to degenerative changes in brain [i.e., medial temporal lobe atrophy (MTA), white matter hyperintensities] and to examine the association between neurocognitive functions and ADLs in Korean patients with dementia due to Alzheimer's disease (AD) and mild cognitive impairment (MCI).
Methods
：Participants were 111 elderly subjects diagnosed with AD or MCI in this cross-sectional study. MTA in brain MRI was rated with standardized visual rating scales (Scheltens scale) and the subjects were divided into two groups according to Scheltens scale. ADLs was evaluated with the Korean version of Blessed Dementia Scale-Activity of daily living (BDS-ADL). Neurocognitive function was evaluated with the Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease assessment packet (CERAD-K). Independent ttest was performed to compare ADLs with the degree of MTA. Pearson correlation and hierarchical multiple regression analyses were performed to analyze the relationship between ADLs and neurocognitive functions.
Results
：The group with high severity of the MTA showed significantly higher BDS-ADL scores (p<0.05). The BDS-ADL score showed the strongest correlation with the word list recognition test among sub-items of the CERAD-K test (r=-0.568). Findings from the hierarchical multiple regression analysis revealed that the scores of MMSE-K and word list recognition test were factors that predict ADLs (F=44.611, p<0.001).
Conclusions
：ADLs of AD and MCI patients had significant association with MTA. Our study, which identi-fies factors correlated with ADLs can provide useful information in clinical settings. Further evaluation is need-ed to confirm the association between certain brain structures and ADLs.

Keyword

Alzheimer’s disease; Mild cognitive impairment; Medial temporal lobe atrophy; Activities of daily living; Neurocognitive function.