Cho JS, et al. J Clin Neurol. 2007 Mar;3(1):53-56. http://dx.doi.org/10.3988/jcn.2007.3.1.53

Previous studies have found an association between serum albumin levels and cognitive function. However, the results of this association are inconsistent, and the effect of Apolipoprotein E (APOE) on the association is less clear. Using retrospective cohort data (2008–2020), we investigated whether chronic serum albumin was associated with cognitive performance in older adults. We further assessed how the APOE genotype modifies its relevance. A total of 2396 Korean veterans and their families who were aged 65 years or older in 2008 and who had both data of serum albumin and cognitive performance (assessed by the Mini-Mental State Examination, MMSE) were included for the current study. The serum albumin levels were divided into four groups by quartiles: Group 1 (<4.0 g/dL), Group 2 (4.0–4.19 g/dL), Group 3 (4.2–4.49 g/dL), and Group 4 (≥4.5 g/dL). APOE ε4 carriers were defined as the presence of at least one ε4 allele (ε2/4, ε3/4, ε4/4). After adjusting for age, sex, and medical conditions, serum albumin levels (assessed by the median serum albumin levels during the study period) were significantly associated with increases in the median MMSE scores (beta = 3.30, p < 0.0001). Compared with the lowest median albumin category (Group 1), the beta coefficients for the median MMSE score were significantly and gradually increased in Group 2 (beta = 2.80, p < 0.0001), Group 3 (beta = 3.71, p < 0.0001), and Group 4 (beta = 4.01, p < 0.0001), respectively. In the analysis of repeated albumin measures, similar patterns were observed in cognitive function. All regression coefficients were greater in ε4 carriers than in non-carriers. Our findings suggested that sustained lower serum albumin levels were associated with lower MMSE scores. This observation may be modified by APOE polymorphisms.

Hwang JY, et al. J Clin Neurol. 2012 Dec;8(4):311-313. http://dx.doi.org/10.3988/jcn.2012.8.4.311

Han YS, et al. J Clin Neurol. 2006 Jun;2(2):146-148. http://dx.doi.org/10.3988/jcn.2006.2.2.146

Background: Functional limitations and disabilities have been associated with a decrease in cognitive function due to increasing age. Gait performance and cognitive function have been associated with gait variability in executive function, the phase domain in memory, and gait abnormalities in cognitive decline. Objective: Our study aimed to investigate whether gait harmony was associated with cognitive function in the older adult population. Moreover, we aimed to investigate whether gait harmony was associated with cognitive function and explore each cognitive function in a specific harmonic state. Methods: The study population included 510 adults aged ≥60 years who visited the Department of Neurology at the Veterans Health Service Medical Center, Seoul, South Korea. Gait data were collected using a 3D motion capture device with a wireless inertial measurement unit system. For cognitive function assessments, we used the Seoul Neuropsychological Screening Battery-Core test, which evaluates the level of cognitive function or impairment in 5 cognitive domains. Results: In general, the association between the Seoul Neuropsychological Screening Battery-Core tests and the stance-to-swing ratio in the >1.63 ratio group yielded lower β coefficients than those in the 1.50-1.63 ratio group. After adjustment for confounders, the odds ratio (OR) for the Digit Symbol Coding test (adjusted OR 0.42, 95% CI 0.20-0.88) and the Korean version of the Color Word Stroop Test: 60 seconds (adjusted OR 0.51, 95% CI 0.29-0.89) for frontal and executive function were significantly lower for the >1.63 ratio group than the reference group. Conclusions: Our findings suggest that the gait phase ratio is a valuable indicator of walking deficits and may also be associated with cognitive impairment in older adults.

Background: Parkinson disease (PD) is a prevalent neurodegenerative disorder characterized by both movement and non-motor symptoms, potentially contributing to malnutrition. This study aims to investigate the association between malnutrition, assessed through the mini nutritional assessment-short form (MNA-SF), and motor/non-motor symptoms in elderly PD patients.Methods: A total of 48 PD patients were recruited, and their nutritional status was evaluated using MNA-SF. Motor/non-motor symptoms were assessed using the unified Parkinson’s disease rating scale (UPDRS). Statistical analysis was performed using linear regression, considering various covariates such as disease severity, cognitive function, and disease duration.Results: The mean age of the study group was 76.8 years, with 75% displaying abnormal nutritional status. An inverse correlation was evident between MNA-SF and UPDRS I, II, III, and overall scores. Patients with abnormal nutritional status developed severe limitations in daily activities and motor dysfunction. Both motor and non-motor symptoms were associated with malnutrition.Conclusions: This study suggests the significant relationship between nutritional status and motor/non-motor symptoms in elderly PD patients. The prevalence of malnutrition was particularly notable among older PD patients, highlighting the importance of consistent nutritional assessment due to its impact on PD severity. These findings suggest a complex interplay between PD symptoms and malnutrition, warranting further investigation with larger participant cohorts.