An in-person survey of the influence of the COVID-19 pandemic on physical function, functional capacity, cognitive function, and mental health among community-dwelling older adults in Japan from 2016 to 2022.

BACKGROUND: The COVID-19 outbreak might have had several effects on older adults; however, much of the previous research only included self-report, cross-sectional, and online-survey data in the early stage of the pandemic. We conducted a face-to-face survey before and after the COVID-19 pandemic and investigated the influence of the pandemic on several functions to distinguish between changes due to aging and changes due to the pandemic using a linear mixed model. METHODS: A total of 8 longitudinal surveys were conducted from 2016 to 2022. Physical function was assessed by weight, body mass index, body fat percentage, skeletal muscle mass index, calf circumference, grip strength, knee extension strength, the 5-times chair stand test, the timed up & go test and 5-m walking test. Functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology index of competence, cognitive function was measured using the Trail Making Test - A, and mental health was measured using the Geriatric Depression Scale. RESULTS: Of a total of 73 participants, 51 (69.9%) were female. The mean age at first participation was 71.82 years (SD = 4.64). The results of the linear mixed model showed that lower-limb muscle strength and body fat percentage and cognitive function changed significantly before and after the pandemic, while grip strength, functional capacity, and mental health did not. CONCLUSIONS: The changes in these functions between before and after the pandemic might be attributed to the diminished opportunities for the independent older individuals to go out and engage in activities. Although functional capacity did not change, lower-limb muscle strength is important for functional independence. This decline might influence the functional capacity of these individuals in the future.

Symptoms and risk factors of depression and PTSD in the prolonged COVID-19 pandemic: a longitudinal survey conducted from 2020 to 2022 in Japan.

BACKGROUND: The present study aimed to explore changes in depression and posttraumatic stress disorder (PTSD) among the general population during the prolonged COVID-19 pandemic and to investigate risk factors and adaptive/nonadaptive strategies. METHODS: A web-based longitudinal survey was conducted across five timepoints from 2020 to 2022 in Japan. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), PTSD was measured using Impact of Event Scale-Revised (IESR), and coping strategies were measured using Brief Coping Orientation to Problems Experienced (Brief COPE). Higher scores of PHQ-9 and IESR indicate more symptoms and Higher score of Brief COPE indicate that these means of coping are used very frequently. RESULTS: A total of 1,366 participants (mean age = 52.76, SD = 15.57) were analyzed. Regarding levels of depression, PHQ-9 scores in 2022 were lower than in 2020 and 2021 (all p < 0.01). Regarding levels of PTSD, IESR scores in 2022 were lower than in 2021 among females (p < 0.001). Being younger (ß = -0.08 and - 0.13, both p < 0.01) and engaging in self-blame (ß = 0.12 and 0.18, both p < 0.01) increased PHQ-9 scores regardless of sex. For males, not working (ß = 0.09, p = 0.004) and having suffered an economic impact (ß = 0.07, p = 0.003) were risk factors for depressive symptoms, and active coping (ß = -0.10, p = 0.005) was associated with decreased depressive symptoms. For females, substance use (ß = 0.07, p = 0.032) and behavioral disengagement (ß = 0.10, p = 0.006) increased depressive symptoms, and females did not show strategies that decreased the symptoms. CONCLUSIONS: Levels of depression might have increased in the early stages of the pandemic and decreased in January 2022. Although males need to improve their economic situation to decrease depressive symptoms, adaptive strategies might be difficult to identify due to the prolonged pandemic among both sexes. In addition, the pandemic might be a depressive event but not a traumatic event among the general population, at least in Japan.

Development of the Parenting Behavior Checklist to Promote Preschoolers' Sleep (PCPP).

OBJECTIVES: To develop the Parenting Behavior Checklist to Promote Preschoolers' sleep (PCPP), quantify sleep-promoting parenting behaviors for children, and examine the scale's reliability and validity. METHODS: The PCPP was developed based on the recommendations of the ABCs of SLEEPING for children's sleep, which is strongly supported by research evidence. Its validity and reliability were evaluated using data from 140 participants. Structural validity was estimated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency was evaluated by Cronbach's α. Hypothesis testing was evaluated by analyzing the correlations between each factor of the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) and the PCPP. RESULTS: Regarding structural validity, EFA was conducted because CFA showed a poor model fit. The PCPP comprised one factor and six items. The JSQ-P subfactors of insomnia or circadian rhythm sleep-wake disorders, undesirable morning symptoms and behaviors, and insufficient sleep were moderately negatively correlated with the PCPP; the subfactor of undesirable daytime behaviors related to sleep problems was weakly negatively correlated with the PCPP. Thus, the sleep-promoting parenting behaviors listed in the PCPP were associated with better sleep in children. CONCLUSIONS: The PCPP showed sufficient reliability and validity. Future studies should use the scale to examine more effective interventions regarding sleep-promoting parental behaviors for children.

Health care providers' perspectives on providing end-of-life psychiatric care in cardiology and oncology hospitals: a cross-sectional questionnaire survey.

BACKGROUND: Psychological distress is a major concern for patients with end-stage heart failure (HF). However, psychiatric care for patients with HF is not as organized as that for patients with cancer. Therefore, the aim of this study was to elucidate and compare the barriers faced by health care providers of cardiology and oncology hospitals in providing end-of-life psychiatric care to patients with HF and cancer, respectively. METHODS: We conducted a cross-sectional questionnaire survey among the health care providers of Japan. Questionnaires were mailed to physicians and nurses of 427 cardiology and 347 oncology hospitals in March 2018 to assess health care providers' perspectives. First, we compared the scores of the Palliative Care Difficulties Scale and the original scale of end-of-life psychiatric care difficulties between health care providers of cardiology and oncology hospitals. Second, we asked the health care providers to describe the barriers to providing end-of-life psychiatric care with an open-ended question and then compared the freely-provided descriptions using content analysis. RESULTS: A total of 213 cardiology and 224 oncology health care providers responded to the questionnaire. No significant differences were found between health care providers of cardiology and oncology hospitals in the frequency of experiencing barriers to providing end-of-life psychiatric care (59.8% and 62.2%, respectively). A content analysis identified the following eight barriers: "patients' personal problems," "family members' problems," "professionals' personal problems," "communication problems between professionals and patients," "problems specific to end-of-life care," "problems specific to psychiatric care," "problems of institution or system," and "problems specific to non-cancer patients." The "problems specific to noncancer patients" was described more frequently by health care providers in cardiology hospitals than that in oncology hospitals. However, there were no significant differences in other items between the two. CONCLUSION: Although health care providers of both cardiology and oncology hospitals faced barriers to providing end-of-life psychiatric care, those of cardiology hospitals particularly faced challenges pertaining to non-cancer patients, such as unpredictability of prognosis or insufficiency of guideline development. A system of psychiatric care, specifically for patients with HF, should be established.

Association of childhood maltreatment history with salivary interleukin-6 diurnal patterns and C-reactive protein in healthy adults.

Childhood maltreatment has been associated with increased inflammation, as indicated by elevated levels of proinflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP). Studies in humans show that secretion of IL-6 follows a clear circadian rhythm, implying that its disturbed rhythm represents an important aspect of dysregulated inflammatory system. However, possible alterations in diurnal secretion patterns of IL-6 associated with childhood maltreatment have not been studied. Here we investigated this association in 116 healthy adults. Diurnal levels of IL-6 were examined using saliva samples collected at 5 times a day across 2 consecutive days. Salivary CRP levels were also determined by averaging measurements at 2 times a day for 2 days. Different types of childhood maltreatment were assessed with the Childhood Trauma Questionnaire (CTQ). CTQ total and emotional abuse scores were significantly correlated with smaller IL-6 diurnal variation as indexed by lower standard deviation across the measurement times (p = 0.024 and p = 0.008, respectively). Individuals with emotional abuse, as defined by a cut-off score of CTQ, showed flatter IL-6 rhythm than those without (p = 0.031). These results, both correlation and group comparison, remained significant after controlling for age, sex, and body mass index. Childhood maltreatment was not associated with total output of IL-6 or CRP. Our findings indicate that childhood trauma can have a long-term negative effect on the circadian rhythm of inflammatory system. The findings are consistent with those of previous studies on adulthood trauma, suggesting that the disrupted IL-6 rhythmicity may be associated with a broad range of trauma-related conditions.

Depression, risk factors, and coping strategies in the context of social dislocations resulting from the second wave of COVID-19 in Japan.

BACKGROUND: Social dislocations resulting from coronavirus disease 2019 (COVID-19) pandemic have been prolonged, which has led to general population social suppression. The present study aimed to reveal risk factors associated with mental health problems and suggest concrete coping strategies in the context of COVID-19. METHODS: A web-based survey was conducted in July when Japan was experiencing a second wave of COVID-19. Demographics, Patient Health Questionnaire-9 (PHQ-9), state anger, anger control, and the Brief Coping Orientation to Problems Experienced were measured. Multivariate logistic regression analysis on PHQ-9 scores by set variables was conducted. RESULTS: The participants were 2708 individuals, and 18.35% of them were depressed. Logistic regression analysis showed that in the order of odds ratios (ORs), underlying disease (OR = 1.96, 95% confidence interval (CI) = 1.32-2.92), not working (OR = 1.85, CI = 1.22-2.80), negative economic impact (OR = 1.33, CI = 1.01-1.77), state anger (OR = 1.17, CI = 1.14-1.21), anger control (OR = 1.08, CI = 1.04-1.13), age (OR = 0.97, CI = 0.96-0.98), high income (OR = 0.45, CI = 0.25-0.80), and being married (OR = 0.53, CI = 0.38-0.74) were predictors of depressive symptoms. Regarding coping strategies, planning (OR = 0.84, CI = 0.74-0.94), use of instrumental support (OR = 0.85, CI = 0.76-0.95), denial (OR = 0.88, CI = 0.77-0.99), behavioural disengagement (OR = 1.28, CI = 1.13-1.44), and self-blame (OR = 1.47, CI = 1.31-1.65) were associated with probable depression. CONCLUSIONS: During prolonged psychological distress caused by COVID-19 pandemic, the prevalence of depressive symptoms in Japan was two to nine times as high as before the COVID-19 pandemic, even though Japan was not a lockdown country. Although some coping strategies were useful for maintaining mental health, such as developing ways, alone or with others, to address or avoid social dislocations, the influence of demographics was more powerful than these coping strategies, and medical treatments are needed for high-risk individuals.

The influence of ageism on stereotypical attitudes among allied health students in Japan: a group comparison design.

BACKGROUND: Ageism is a serious problem in medical care. The importance of ageism-related education for students has been emphasized. To determine the most effective approach to ageism-related education for allied health students, this study examined ageism among this group of students, with the hypothesis that ageism was expressed not only toward elderly adults but also toward individuals other than elderly adults. METHODS: A questionnaire survey was conducted among 154 allied health students in Japan. The questionnaire involved tree drawings to evaluate the drawer's personality and a measurement of the participants' ageism. There were two display conditions for tree drawing. In the elderly display condition, participants were informed that the drawer was an elderly person, and in a control condition, participants were not informed of the drawer's age. Participants were randomly assigned to each condition and were required to evaluate the drawer's personality based on 5 personality traits. After the evaluation, all participants were required to complete the Japanese short version of the Fraboni Scale of Ageism (FSA-J). RESULTS: The participants were 123 allied health students, 61 of whom were in the elderly display condition and 62 of whom were in the control condition. Based on the mean score on the FSA-J (M = 29.80), we divided the participants into a low-FSA-J group (N = 64) and a high-FSA-J group (N = 59). There was no significant difference between the display conditions on the FSA-J score. In the high-FSA-J groups, the control condition evaluated the drawer's personality as more timid than did the elderly display condition (F = 4.26, df = 1, 119). For negligence, the high-FSA-J group evaluated the drawer's personality as more negligent than did the low-FSA-J group (F = 4.08). For broad interests, the main effects of condition and groups were significant (F = 4.23). CONCLUSIONS: The results suggested that ageism indicated a negative evaluation not only of elderly adults but also of individuals other than elderly adults, and students with negative ageism might evaluate the elderly drawer more positively. We have discussed the possibility that negative ageism among allied health students in Japan might underlie these positive stereotypes.

Evaluating depression in cognitively healthy elderly people by using Mini-Mental State Examination.

AIM: We examined a method for evaluating depression with the Mini-Mental State Examination in cognitively healthy elderly people and employed the projective perspective. METHODS: In MMSE three groups-normal, depressed tendency, and depressed-completed the Mini-Mental State Examination (MMSE) and a Japanese version of the 15-item Geriatric Depression Scale. The Mini-Mental State Examination evaluated individuals' writing based on a sentence, the number of written words, and sentence content; it also assessed their copying of drawn figures. RESULTS: In the depressed group, the proportion corresponding to the characteristics of (i) to (iii) was higher than in the other two groups: (i) the calculation score was 0 or 1; (ii) subjects scored above the median in sentence writing relative to similar subjects with the same language and clinical setting; and (iii) subjects expressed feelings in their writing. One point was given for each characteristic, and we calculated the sum. Depressed subjects had a score ≥2. CONCLUSIONS: This evaluation method can differentiate depressed subjects with high accuracy (sensitivity: 77.8%, specificity: 76.4%) without placing an extra burden on the subjects.

The role of psychological autonomy in the acceptance of ageing among community-dwelling elderly.

AIM: Previous research on psychological autonomy has focused on self-reliance. However, given that ageing is inevitable, acceptance of ageing might be a more stable factor that reflects quality of life (QOL) status. This study examined factors that affect the acceptance of ageing as a part of psychological autonomy. METHODS: We conducted questionnaire surveys among community-dwelling elderly people. The questionnaires consisted of the psychological autonomy scale, the Instrumental Activities of Daily Living Scale, and the QOL scale. RESULTS: In total, 572 elderly people completed the questionnaire, including 293 younger elderly and 279 older elderly. In both age groups, a ceiling effect was observed for the Instrumental Activities of Daily Living Scale. There was no positive relation between acceptance of ageing and QOL, and particularly in younger elderly people, acceptance of ageing was negatively related to QOL. However, the correlation between acceptance of ageing and self-reliance was positive, and self-reliance was positively related to QOL in younger elderly people. CONCLUSIONS: The acceptance of ageing did not show a positive relation in our participants who had high activities of daily living. Acceptance of ageing might be important for elderly people who have a physical disability and several restrictions in their daily life. For younger elderly people, acceptance of ageing was correlated with getting depression, in which case it is useful to reject self-ageing for QOL, and it was related to QOL through self-reliance.

Cognitive dysfunction in patients with very mild Alzheimer's disease and amnestic mild cognitive impairment showing hemispheric asymmetries of hypometabolism on ¹8F-FDG PET.

OBJECTIVE: We investigated cognitive dysfunction in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) who present hemispheric asymmetries of cerebral metabolic rate of glucose (CMRglc) decrease on (18) F-fluorodeoxyglucose positron emission tomography. METHODS: Based on the hemispheric asymmetries of CMRglc decrease in the posterior cingulate cortex, precuneus, and parietotemporal cortex, the patients were divided into three groups (a left-dominant hypometabolism group, a right-dominant hypometabolism group, and a non-dominant hypometabolism group). CMRglc decrease in the whole brain was controlled among the three groups. All the patients underwent mini-mental state examination (MMSE), Wechsler Memory Scale-Revised (WMS-R), and Wechsler Adult Intelligent Scale-Third (WAIS-III). RESULTS: There were no significant differences in MMSE and WAIS-III scores among the three groups. In WMS-R, the results indicated that the left-dominant group demonstrated significantly lower scores in verbal memory than the other two groups. Furthermore, the left-dominant group had a greater tendency to be diagnosed with AD rather than aMCI. CONCLUSIONS: Patients with AD and aMCI showing left-dominant hypometabolism tend to show severer impairment in verbal memory function and to be diagnosed with AD dementia.

Characteristics of depression in community-dwelling elderly people as indicated by the tree-drawing test.

BACKGROUND: The tree-drawing test (TDT) is a typical projective method, but previous studies have paid little attention to it for elderly people. We investigated the characteristics of depression in community-dwelling elderly people as indicated by the TDT. METHODS: This study was a complete enumeration survey of elderly people conducted through home visits. The contents of the survey included gender, age, presence or absence of housemates, frequency of going out, the 15-item Geriatric Depression Scale, and TDT. The subjects were divided into three groups (normal, depressed tendency, and depressed) according to the total 15-item Geriatric Depression Scale score. RESULTS: In TDT, no significant difference was observed in drooping crown, shadow of the whole tree, or shadow near the base, which have been regarded as indices of depression in younger people. However, the values concerning the size of the tree, such as the height and width of the whole tree, height and width of the crown, and number of occupied areas (of the paper), were significantly lower in the depressed group than in the other groups. In addition, the width of the trunk was significantly smaller in the depressed group than in the normal group. Subjects were classified as being in a 'depressed state' if they used 40 or fewer areas for drawing (i.e. occupied areas) and a 'non-depressed state' if they used 41 or more areas. This enabled depression to be detected (sensitivity: 71.4%; specificity: 79.9%). CONCLUSIONS: The size of the tree in TDT is suggested to reflect characteristics of depression in elderly people, such as introversion, reserve, antisocial attitude, a feeling of inferiority, weakness of ego, and lack of vigour. Furthermore, the numbers of occupied areas were found to be relatively useful in detecting depression in elderly people.

[Methylphenidate].

Methylphenidate enhances dopaminergic neurotransmission in the central nervous system. Methylphenidate improves social functions as well as clinical symptoms of patients suffered of narcolepsy and attention deficit hyperactivity disorder (ADHD), though it has the potential of abuse. It is reported that approximately 4% of older teens and emerging adults in the US annually misusing methylphenidate. Non-medical/illegal use of methylphenidate causes many consequences including addiction, negative reactions and medical complications. Growing number of illegal trades of methylphenidate and medical complications caused by misuse of methylphenidate urged Japanese government to introduce regulations limiting access to prescribed methylphenidate in 2008. Clinicians should be cautious about prescribing methylphenidate, especially patients with complaint of excessive daytime sleepiness.

[Circadian rhythm sleep-wake disorder (circadian rhythm sleep disorder)].

The role of the circadian system is forecasting the daily and yearly change of environment. Circadian rhythm sleep-wake disorder (CRSWD) is defined as physical and social impairment caused by misalignment between circadian rhythm and desirable social schedule. CRSWDs are induced by medical or environmental factors as well as dysfunctions of circadian system. Clinicians should be aware that sleep-inducing medications, restless legs syndrome, delirium and less obedience to social schedule are frequent cause of CRSWD among elderly. Bright light therapy and orally administered small dose of melatonin or melatonin agonist at proper circadian phase are recommended treatments. Sleep-inducing medications should not be considered as CRSWD treatments, especially to elderly.

[Sleep disorders].

Some sleep disorders and sleep problems are reported as risk of dementia. It is reported that 50-80% of idiopathic REM sleep behavior had a later conversion to a synucleinopathy, thus this parasomnia is regarded as early marker of Parkinson disease, dementia with Lewy bodies and multiple system atrophy. Obstructive sleep apnea syndrome causes reversible decline of cognitive functions in children and adults, and it increases the risk of dementia and mild cognitive impairment in elderly women. A decrease of amplitude of circadian activity rhythm and habitual long sleep duration (> or = 9 hours) are reported to increase the risk of dementia in elderly people. Some reports indicate that hypnotic use may be a risk factor of dementia. However, it is not cleared whether insomnia itself related with dementia or not, since no study evaluated the risk of insomnia without hypnotic treatment.

Work productivity loss and work-related factors during the first wave of the COVID-19 pandemic: A cross-sectional web-based survey.

BACKGROUND: The COVID-19 pandemic could have led to a technological revolution however it has caused work productivity loss, especially among people working from home. OBJECTIVE: This study examined the frequency and related factors of work productivity loss, focusing on work-related factors, during the first wave of the COVID-19 pandemic in Japan. METHODS: We conducted a cross-sectional, web-based survey of Japanese workers. Questionnaires were distributed using snowball sampling through e-mail and social networking sites. RESULTS: Of the respondents, 708 non-medical workers reported subjective work productivity loss during the first wave of the pandemic, compared with before. A multiple regression analysis showed that living with preschool-age children, having poor mental health, not using video conferencing solutions, and increased e-mail communication were related to work productivity loss. A subgroup analysis of those working from home showed similar variables associated with work productivity loss. CONCLUSIONS: More than 70% of workers in Japan experienced work productivity loss during the first wave of the pandemic. Moreover, factors such as time-consuming tasks or background distractions might lead to operational inefficacy.

The relationship among sleep, resilience, and stress response in Japanese female university students during the COVID-19 pandemic.

We examined the effect of sleep and resilience on stress responses in female Japanese university students during the COVID-19 pandemic. Sleep was measured using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J), stress response was evaluated using the Stress Response Scale-18 (SRS-18), and resilience using the Resilience Scale for Students (RS-S). Multiple regression analysis showed that approximately 40% of the SRS-18 score could be explained by PSQI-J score and RS-S score. Subjective sleep quality, daytime dysfunction, and global score of PSQI-J had direct influences on SRS-18.

Association between Physical Frailty and Sleep Disturbances among Patients on Hemodialysis: A Cross-Sectional Study.

INTRODUCTION: Among patients on hemodialysis (HD), physical frailty and sleep disturbances are not only common but also associated with adverse outcomes. The aim of this study was to evaluate the association between physical frailty and sleep disturbances in patients on HD. METHODS: This cross-sectional study was conducted from June 2017 to March 2021, with outpatients receiving HD 3 times a week at two dialysis facilities in Japan. Sleep disturbances were identified with the Athens Insomnia Scale (AIS). Physical frailty was defined using the Fried Frailty Phenotype. Patients were classified as "non-frailty (number of frailty components: 0-2)" or "frailty (3-5)." We examined the association of sleep disturbances with physical frailty and its components by performing a logistic regression analysis. RESULTS: We analyzed 360 patients (mean age 65.6 years; 62% men). Eighty-one patients (23%) were classified into the group with frailty, and the mean AIS score was 5.2 ± 4.2 points. After adjusting for clinical characteristics, increasing the AIS score per 1 point was associated with higher odds of physical frailty (odds ratio, 1.12; 95% confidence interval, 1.05-1.20; p < 0.01). As for the frailty components, exhaustion, low physical activity, and weak grip strength showed an association with sleep disturbances (all p < 0.05). CONCLUSIONS: Sleep disturbances were independently associated with physical frailty in patients on HD. Future studies are warranted to investigate the causality between physical frailty and sleep disturbances in this population.

Neuropsychological detection of the early stage of amnestic mild cognitive impairment without objective memory impairment.

AIM: We investigate the assessment method to detect the early stage of amnestic mild cognitive impairment (aMCI) using Wechsler Memory Scale - Revised (WMS-R) and Wechsler Adult Intelligence Scale - Third Edition (WAIS-III). METHODS: Three groups (normal group, aMCI group, and early aMCI group), controlled for age and years of education, underwent brain (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET), WAIS-III, WMS-R, and other tests. The early aMCI group does not fulfill the clinical diagnostic criteria of aMCI because patients do not have objective memory impairment, but their clinical symptoms and results of (18)F-FDG PET indicate that they should be included in the category of aMCI. RESULTS: The discrepancy of scores between Verbal IQ and General Memory had the highest accuracy in discriminating between normal and early aMCI groups. CONCLUSION: The cutoff point determined in this study is useful to detect an early stage of aMCI, which may be distinguished from aMCI using the current criteria.

Intelligence or years of education: which is better correlated with memory function in normal elderly Japanese subjects?

BACKGROUND: We compared differences in intelligence and memory function between normal elderly Japanese subjects with more years of education and those with fewer years of education. We also investigated clinical and neuropsychological factors that are strongly correlated with memory function. METHODS: There were 118 normal elderly subjects who underwent the Mini-Mental State Examination, Wechsler Adult Intelligence Scale, 3rd edition (WAIS-III), and Wechsler Memory Scale Revised. Subjects with at least 13 years of education were categorized as the H group, and those with 12 years of education or less were categorized as the L group. RESULTS: Age and Mini-Mental State Examination scores were not significantly different between the two groups. On the WAIS-III, there were significant differences between the two groups in Verbal IQ and Full Scale IQ. On the Wechsler Memory Scale Revised, there were significant differences between the two groups in Visual Memory, General Memory, and Delayed Recall. Correlation coefficients between memory function and the other factors demonstrated significant but weak correlations between years of education and General Memory (R = 0.22) and between years of education and Delayed Recall (R = 0.20). Strong correlations were found between Verbal IQ and Verbal Memory (R = 0.45), between Verbal IQ and General Memory (R = 0.49), between Full Scale IQ and General Memory (R = 0.50) and between Full Scale IQ and Delayed Recall (R = 0.48). CONCLUSIONS: In normal elderly Japanese subjects, years of education weakly correlated with memory function while Verbal IQ, Full Scale IQ and Verbal Comprehension on WAIS-III had stronger correlations with memory function. Verbal IQ and Verbal Comprehension on WAIS-III were found to be insusceptible to the cognitive decline characteristic of Alzheimer's disease or amnestic mild cognitive impairment. Therefore, verbal intelligence, as measured by Verbal IQ and Verbal Comprehension, may be the most useful factor for inferring premorbid memory function in Alzheimer's disease or amnestic mild cognitive impairment patients.

Blunted diurnal interleukin-6 rhythm is associated with amygdala emotional hyporeactivity and depression: a modulating role of gene-stressor interactions.

Background: The immune system has major roles in the brain and related psychopathology. Disrupted interleukin-6 secretion and aberrant amygdala emotional reactivity are well-documented in stress-related mental disorders. The amygdala regulates psychosocial stress-related interleukin-6 affected by related genes. These led us to comprehensively examine the relationship between interleukin-6, amygdala activity, and stress-related mental symptoms under gene-stressor interactions. Methods: One hundred eight nonclinical participants with various levels of anxiety/depression underwent magnetic resonance imaging scans during an emotional face task for amygdala activity and saliva collection (at 10-time points across 2 days) for the total output and diurnal patterns of interleukin-6. Gene-stressor interactions between rs1800796 (C/G) and rs2228145 (C/A) and stressful life events for the biobehavioral measures were explored. Results: The blunting of interleukin-6 diurnal pattern was associated with hypoactivation of the basolateral amygdala in response to fearful (vs. neutral) faces (t = 3.67, FWE-corrected p = 0.003), and was predominantly observed in individuals with rs1800796 C-allele homozygotes and negative life changes in the past year (F = 19.71, p < 0.001). When considered in a comprehensive model, the diminished diurnal pattern predicted greater depressive symptoms (ß = -0.40), modulated by the amygdala hypoactivity (ß = 0.36) and rs1800796-stressor interactions (ß = -0.41; all p < 0.001). Conclusion: Here we show that the blunted interleukin-6 diurnal rhythm predicts depressive symptoms, modulated by amygdala emotional hyporeactivity and gene-stressor interactions. These findings indicate a potential mechanism underlying vulnerability to depressive disorders, suggesting their early detection, prevention, and treatment through the understanding of immune system dysregulation.