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Background@#and Purpose: The Montreal Cognitive Assessment (MoCA) has been known as a screening test for detecting mild cognitive impairment (MCI) better than Mini-Mental State Examination (MMSE). However, in previous domestic studies, no significant difference was found in the discriminability between MoCA and MMSE. Researchers have suggested that this might be because older Koreans are less educated than older Westerners. This study was conducted to examine the effect of education on the discriminability of MoCA compared to the MMSE. @*Methods@#Participants were 123 cognitively normal elderly, 118 with vascular MCI, 108 with amnestic MCI, 121 with vascular dementia, and 113 with dementia of the Alzheimer’s type.The Korean-MoCA (K-MoCA) and Korean-MMSE (K-MMSE) were administered. Multiple regression analyses and receiver operating characteristic (ROC) curve analyses were performed. @*Results@#In all participants, education significantly affected both K-MoCA and K-MMSE scores along with age. The effect of education was re-examined by subgroup analysis after dividing subjects according to the level of education. Effect of education on K-MoCA and K-MMSE was only shown in the group with <9 years of education. ROC curve analyses revealed that the discriminability of K-MoCA to differentiate between vascular MCI and normal elderly was significantly higher than that of K-MMSE. When re-examining subgroups divided by education level, however, this higher discriminability of K-MoCA disappeared in the group with <9 years of education. @*Conclusions@#These results indicate no difference in discriminating cognitive deficits between K-MoCA and K-MMSE in Korean elderly with <9 years of education.
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Background@#Evaluating the activities of daily living (ADL) is an important factor for diagnosing dementia. The Everyday Cognition (ECog) scale was developed to measure ADL changes that were correlated with specific neuropsychological impairments. A short form of the ECog (ECog-12) was also developed, consisting of 12 items, two from each of the six cognitive domains of the ECog. The Korean full version of ECog (K-ECog) has recently been standardized, but the need for a shortened version has been raised in clinical practice. The purpose of this study was to develop a Korean version of ECog-12 (K-ECog-12) and to verify its reliability and validity by comparing those to the full version of K-ECog. @*Methods@#The participants were 267 cognitively normal older adults (CN), 183 patients with mild cognitive impairment (MCI), and 89 patients with dementia. The Korean-Mini Mental State Examination (K-MMSE), Korean-Montreal Cognitive Assessment (K-MoCA), and Short form of Geriatric Depression Scale (SGDS) were administered to all participants. The K-ECog and Korean-Instrumental Activities of Daily Living (K-IADL) were rated by the informants of patients. @*Results@#K-ECog-12 was newly constructed by replacing one item for the visuospatial function in the original ECog-12 with another one through an item response theory analysis on Korean data. The internal consistencies (Cronbach’s α) of K-ECog-12 and K-ECog were 0.95 and 0.99, respectively. The test–retest reliabilities (Pearson’s r) were 0.67 for K-ECog-12 and 0.73 for K-ECog. The K-ECog-12 was significantly correlated with K-ECog as well as K-IADL, K-MMSE, and K-MoCA. The K-ECog-12 scores differed significantly between the CN, MCI, and dementia groups, as did the K-ECog scores. Receiver operating characteristic curve analyses showed that K-ECog-12, like K-ECog, could differentiate MCI and dementia patients from CN as well. @*Conclusion@#The K-ECog-12 is as reliable and valid as the K-ECog in assessing ADL.Therefore, K-ECog-12 can be used as an alternative to the K-ECog in clinical and community settings in Korea.
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Background@#and Purpose: A new approach was proposed to score the Montreal Cognitive Assessment (MoCA) index scores for 6 cognitive domains: orientation (OIS), attention (AIS), language (LIS), visuospatial function (VIS), memory (MIS), and executive function (EIS). This study investigated whether the MoCA index scores represent the functions of each cognitive domain by examining the correlations with the corresponding cognitive domain scores derived from conventional neuropsychological tests included in the Seoul Neuropsychological Screening Battery, 2nd Edition (SNSB-II). @*Methods@#The participants were 104 amnestic mild cognitive impairment (aMCI), 74 vascular mild cognitive impairment (VaMCI), 73 dementia of the Alzheimer's type (DAT), and 41 vascular dementia (VaD) patients. All participants were administered the Korean-MoCA and SNSB-II. @*Results@#Like the MoCA total score, the MoCA-OIS, MoCA-VIS, and MoCA-MIS showed differences between aMCI and AD groups and between VaMCI and VaD groups. The MoCAAIS, MoCA-LIS, and MoCA-EIS showed significant differences between VaMCI and VaD groups, but no difference between aMCI and DAT groups. In the aMCI and VaMCI groups, all index scores of the MoCA showed significant correlations with the corresponding cognitive domain scores of the SNSB-II. Except for MoCA-MIS, the MoCA-AIS, MoCA-LIS, MoCA-VIS, and MoCA-EIS also showed significant correlations with the corresponding domain scores of the SNSB-II in the DAT and VaD groups. @*Conclusions@#These results indicate that all MoCA index scores, except for MoCA-MIS, which does not reflect the severity of memory impairment in dementia patients, provide highly valid information on the function of each cognitive domain in patients with mild cognitive impairment and dementia.
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Background@#and Purpose: A new approach was proposed to score the Montreal Cognitive Assessment (MoCA) index scores for 6 cognitive domains: orientation (OIS), attention (AIS), language (LIS), visuospatial function (VIS), memory (MIS), and executive function (EIS). This study investigated whether the MoCA index scores represent the functions of each cognitive domain by examining the correlations with the corresponding cognitive domain scores derived from conventional neuropsychological tests included in the Seoul Neuropsychological Screening Battery, 2nd Edition (SNSB-II). @*Methods@#The participants were 104 amnestic mild cognitive impairment (aMCI), 74 vascular mild cognitive impairment (VaMCI), 73 dementia of the Alzheimer's type (DAT), and 41 vascular dementia (VaD) patients. All participants were administered the Korean-MoCA and SNSB-II. @*Results@#Like the MoCA total score, the MoCA-OIS, MoCA-VIS, and MoCA-MIS showed differences between aMCI and AD groups and between VaMCI and VaD groups. The MoCAAIS, MoCA-LIS, and MoCA-EIS showed significant differences between VaMCI and VaD groups, but no difference between aMCI and DAT groups. In the aMCI and VaMCI groups, all index scores of the MoCA showed significant correlations with the corresponding cognitive domain scores of the SNSB-II. Except for MoCA-MIS, the MoCA-AIS, MoCA-LIS, MoCA-VIS, and MoCA-EIS also showed significant correlations with the corresponding domain scores of the SNSB-II in the DAT and VaD groups. @*Conclusions@#These results indicate that all MoCA index scores, except for MoCA-MIS, which does not reflect the severity of memory impairment in dementia patients, provide highly valid information on the function of each cognitive domain in patients with mild cognitive impairment and dementia.
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Background@#and Purpose: Everyday Cognition (ECog) has been widely used to differentiate individuals with mild cognitive impairment (MCI) and dementia from normal elderly individuals. It has also been used to assess subjective cognitive decline (SCD). This study investigated the feasibility of using ECog as a screening measure for SCD in communitydwelling elderly individuals. @*Methods@#The participants included 84 older adults with and 93 without SCD living in the community. These 2 groups were classified based on their response (“yes” or “no”) to the question “Do you perceive memory or cognitive difficulties?” All participants were evaluated using the Korean-Mini Mental State Examination (K-MMSE), Short form of the Geriatric Depression Scale (SGDS), and the Korean version of Everyday Cognition (K-ECog). @*Results@#The scores of all participants were within the normal range on the K-MMSE and SGDS. The total K-MMSE score did not differ significantly between the 2 groups after controlling for age, education, and depression. The scores of SCD group were significantly higher than those of the non-SCD group for memory, language, and executive function:planning domains, as well as K-ECog total score. Receiver operating characteristic curve analysis revealed that the K-ECog total score was effective in moderately differentiating between subjects with and without SCD (area under the curve: 0.73). @*Conclusions@#ECog is a feasible and useful screening measure for SCD in older adults living in the community, and can be used to assess the full spectrum of cognitive and functional deficits, ranging from SCD to MCI and dementia.
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Background@#and Purpose: The Korean-Color Word Stroop Test: Color Reading (K-CWST:CR) included in the Seoul Neuropsychological Screening Battery, 2nd Edition (SNSB-II) examines inhibitory control deficit. It provides normative data for both 60- and 120-second conditions, but the validity of the 60-second condition has not yet been proven. This study examined the validity of the 60-second condition by observing concordance between the performances in cognitively normal, MCI, and mild dementia groups. @*Methods@#There were 1,336 patients performed the SNSB-II, including the K-CWST: CR.Based on the cognitive test results, activities of daily living, and clinical interview, the patients were assigned to normal cognition (n=104), MCI (n=884), or mild dementia (n=348) groups. Abnormal performance on the K-CWST: CR was operationally defined as 1SD below the normative mean. The receiver operating characteristic curve analyses were conducted to compare the discriminability between the 60- and 120-second conditions. @*Results@#The percentages of abnormal performance in the MCI group were 41.5% and 42.3%, and those in the mild dementia group were 82.7% and 82.4% for the 60- and 120-second conditions, respectively. The areas under the curve for the 60- and 120-seconds were as follows; 0.80 and 0.81 in differentiating normal from MCI; 0.95 and 0.96 in normal from mild dementia; and 0.77 and 0.77 in MCI from mild dementia. @*Conclusions@#The 60-second condition of the K-CWST showed very similar results, not statistically different from the 120-second condition. Therefore, the 60-second condition could be used interchangeably with the 120-second condition in a clinical setting.
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At the request of the authors, the NRF-support number in ‘Acknowledgements’ is modified.
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Background@#and Purpose: The Mini Mental State Examination, 2nd edition: Expanded version (MMSE-2: EV) involves an immediate recall (IR) of story memory (SM). A full version of SM has been developed and standardized; it includes delayed recall (DR) and recognition tests in addition to IR to increase its clinical utility as an independent story recall test. This study was conducted to provide norms for the full version of SM in the Korean version of MMSE-2: EV for clinical use. @*Methods@#A total of 1,168 participants (496 males and 672 females) were included in the study. The ages ranged from 19 to 90 years, and the education level ranged from illiterate to post-graduate. Regression analysis was used to evaluate the relative contributions of demographic variables (age, education, and sex) on the SM measures. @*Results@#We stratified age into 11 groups, and categorized the education level into 6 groups.It was found that the IR, DR, and recognition scores of SM were affected by age, education level, and sex. We provided corrected means and standard deviations of the IR, DR, and recognition scores of the SM for the demographic variables. @*Conclusions@#The results indicate the importance of considering demographic variables in interpreting the full version of SM measures. The normative data we have provided in this study should be useful in clinical and research settings for detecting the impairment in verbal memory.
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Background@#and Purpose: The Mini Mental State Examination, 2nd edition: Expanded version (MMSE-2: EV) involves an immediate recall (IR) of story memory (SM). A full version of SM has been developed and standardized; it includes delayed recall (DR) and recognition tests in addition to IR to increase its clinical utility as an independent story recall test. This study was conducted to provide norms for the full version of SM in the Korean version of MMSE-2: EV for clinical use. @*Methods@#A total of 1,168 participants (496 males and 672 females) were included in the study. The ages ranged from 19 to 90 years, and the education level ranged from illiterate to post-graduate. Regression analysis was used to evaluate the relative contributions of demographic variables (age, education, and sex) on the SM measures. @*Results@#We stratified age into 11 groups, and categorized the education level into 6 groups.It was found that the IR, DR, and recognition scores of SM were affected by age, education level, and sex. We provided corrected means and standard deviations of the IR, DR, and recognition scores of the SM for the demographic variables. @*Conclusions@#The results indicate the importance of considering demographic variables in interpreting the full version of SM measures. The normative data we have provided in this study should be useful in clinical and research settings for detecting the impairment in verbal memory.
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BACKGROUND: In the early diagnosis of dementia, an important factor is the evaluation of activities of daily living. The Everyday Cognition (ECog) scale was developed to measure functional changes that are the everyday correlates of specific neuropsychological impairments. This study aimed to examine the validity of the Korean version of Everyday Cognition (K-ECog). METHODS: The participants were 268 cognitively normal older adults (NA), 151 amnestic mild cognitive impairment (aMCI), and 77 dementia of the Alzheimer's type (DAT). The Korean-Mini Mental State Examination (K-MMSE), Korean-Montreal Cognitive Assessment (K-MoCA), and Short form of the Geriatric Depression Scale (SGDS) were administered to all the participants. The K-ECog and Korean-Instrumental Activities of Daily Living (K-IADL) were rated by their informants. RESULTS: Internal consistency (Cronbach's α) of K-ECog global function was 0.93, and its test-retest reliability (Pearson's r) was 0.73. K-ECog was significantly correlated with K-IADL (0.66), K-MMSE (−0.38), and K-MoCA (−0.26). Confirmatory factor analysis of K-ECog yielded seven factor model that the original ECog proposed. K-ECog global score and six domain scores were significantly different across the NA, aMCI, and DAT groups. Receiver operating characteristic curve analyses showed that K-ECog effectively differentiated aMCI and DAT patients from NA, suggesting that K-ECog is as sensitive for detecting functional impairments as K-IADL. The proposed optimal cut-off score to differentiate aMCI from NA was 1.41. CONCLUSION: K-ECog is proven reliable and valid for clinical use. K-ECog can be used to distinguish very early stages of impaired ADL and cognitive impairment in the community.
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Adulto , Humanos , Atividades Cotidianas , Transtornos Cognitivos , Cognição , Demência , Depressão , Diagnóstico Precoce , Fibrinogênio , Disfunção Cognitiva , Reprodutibilidade dos Testes , Curva ROCRESUMO
BACKGROUND AND PURPOSE: The Korean version of Story Memory (SM) in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV) was developed. Based on the SM, we additionally developed a full version of SM including delayed recall (DR) and recognition adding to immediate recall (IR). This study aimed to examine the reliabilities and validities of the newly developed SM in the K-MMSE-2: EV and its full version. METHODS: Ninety-five healthy elderly individuals (HE), 90 patients with amnestic mild cognitive impairment (aMCI), and 53 patients with dementia of the Alzheimer's type (DAT) participated in the study. They were administered the full version of SM with the Seoul Verbal Learning Test-Elderly's version (SVLT-E) and Rey Complex Figure Test (RCFT). In addition, the SM was re-administered to 51 participants after a 5-week interval. Two clinical neuropsychologists independently rated the performance of 50 participants. RESULTS: The test-retest reliabilities of the IR, DR, and recognition of the SM were statistically significant. The inter-rater reliabilities (Cohen's kappa) were high (0.87–1.00) for all the measures. The IR, DR, and recognition of SM had significant positive correlations with those of the SVLT-E and RCFT. Significant group differences in IR and DR of SM were found among the HE, aMCI, and DAT groups. The recognition scores were significantly different between the aMCI and DAT groups, but not between the HE and aMCI groups. CONCLUSIONS: The newly developed full version of SM in the K-MMSE-2: EV was proven to be a reliable and valid memory measure for clinical use.
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Idoso , Humanos , Demência , Memória , Memória de Curto Prazo , Disfunção Cognitiva , Seul , Aprendizagem VerbalRESUMO
BACKGROUND AND PURPOSE: Although the clock drawing test (CDT) is a widely used cognitive screening instrument, there have been inconsistent findings regarding its utility with various scoring systems in patients with mild cognitive impairment (MCI) or dementia. The present study aimed to identify whether patients with MCI or dementia exhibited impairment on the CDT using three different scoring systems, and to determine which scoring system is more useful for detecting MCI and mild dementia. METHODS: Patients with amnestic mild cognitive impairment (aMCI), vascular mild cognitive impairment (VaMCI), mild Alzheimer's disease (AD), mild vascular dementia (VaD), and cognitively normal older adults (CN) were included. All participants were administered the CDT, the Korean-Mini Mental State Examination (K-MMSE), and the Clinical Dementia Rating scale. The CDT was scored using the 3-, 5-, and 15-point scoring systems. RESULTS: On all three scoring systems, all patient groups demonstrated significantly lower scores than the CN. However, while there were no significant differences among patients with aMCI, VaMCI, and AD, those with VaD exhibited the lowest scores. Area under the Receiver Operating Characteristic curves revealed that the three CDT scoring systems were comparable with the K-MMSE in differentiating aMCI, VaMCI, and VaD from CN. In differentiating AD from CN, however, the CDT using the 15-point scoring system demonstrated the most comparable discriminability with K-MMSE. CONCLUSIONS: The results demonstrated that the CDT is a useful cognitive screening tool that is comparable with the Mini-Mental State Examination, and that simple CDT scoring systems are sufficient for differentiating patients with MCI and mild dementia from CN.
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Adulto , Humanos , Doença de Alzheimer , Demência , Demência Vascular , Programas de Rastreamento , Disfunção Cognitiva , Curva ROCRESUMO
BACKGROUND AND PURPOSE: Evaluating instrumental activities of daily living (IADL) is an important part of procedure to diagnose dementia. The Korean-Instrumental Activities of Daily Living (K-IADL) has been used extensively in Korea. However, its cut-off score has not been reformulated since 2002. The purpose of this study was to yield a new optimal cut-off score for the K-IADL and confirm the validity of this new cut-off score with various dementia groups. METHODS: We retrospectively collected a total of 2,347 patients' K-IADL data from 6 general hospitals in Korea. These patients had mild cognitive impairment (MCI) or dementia with various etiologies for cognitive impairment. We also recruited a normal control group (n=254) from the community. Korean-Mini Mental State Examination, Short version of the Geriatric Depression Scale, Clinical Dementia Rating, and Global Deterioration Scale were administered to all participants. Caregivers completed K-IADL and Barthel Index. RESULTS: K-IADL scores were significantly different among dementia subgroups, but not significantly different among MCI subgroups. Based on internal consistency, correlations with other scales, and factor analysis, K-IADL showed excellent reliability and validity. The new optimal cut-off score to diagnose dementia was 0.40, which gave a sensitivity of 0.901 and a specificity of 0.916. Positive predictive value for dementia using the new cut-off score was 94.2% for Alzheimer's disease, 100% for vascular dementia, and 84% for Parkinson's disease. CONCLUSIONS: Our results illustrate that the new K-IADL cut-off score of 0.40 is reliable and valid for screening impairments of daily functioning resulting from various etiologies.
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Humanos , Atividades Cotidianas , Doença de Alzheimer , Cuidadores , Transtornos Cognitivos , Demência , Demência Vascular , Depressão , Hospitais Gerais , Coreia (Geográfico) , Programas de Rastreamento , Disfunção Cognitiva , Doença de Parkinson , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Pesos e MedidasRESUMO
BACKGROUND AND PURPOSE: This study was performed to newly develop the Way-Finding Ability Scale (WFAS) for middle-aged and older adults and validate its clinical utility. METHODS: The participants for verifying construct validity included 324 adults aged from 45 to 79 years, and 22 normal old adults without way-finding deficit (WFD), 41 amnestic mild cognitive impairment (aMCI), and 35 patients with Parkinson's disease (PD-MCI) for verifying discriminant validity. All participants were administered the newly constructed 28-item WFAS. RESULTS: Exploratory factor analysis of the WFAS revealed a four-factor solution (sense of direction and inattention, spatial learning and memory, strategic ability, and cardinal direction). This four-factor structure was confirmed by confirmatory factor analysis. The discriminant validity was examined by administering the WFAS to normal older adults and two patient groups (aMCI & PD-MCI). The results showed that the total scores of two patient groups were lower than that of normal older adults. The patients with WFD had significantly lower total scores than those without WFD. Interestingly, the total scores of patients without WFD were significantly lower than those of normal older adults suggesting that the cognitive functions associated with way-finding ability (WFA) were partially impaired in aMCI and PD-MCI patients without apparent WFD. The patients with WFD had consistently lower scores in every four-factor than those without WFD. CONCLUSIONS: These results indicated that the WFAS assesses the WFD reliably as well as estimates the degree of decline in WFA.
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Adulto , Humanos , Cognição , Memória , Disfunção Cognitiva , Doença de Parkinson , Aprendizagem EspacialRESUMO
We would like to correct the grant information.
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BACKGROUND AND PURPOSE: Many literatures indicate that executive dysfunction exists in mild cognitive impairment (MCI) as well as Alzheimer’s disease (AD). However, there are few studies that found how early the deficits of the executive function (EF) exist in MCI. The present study investigated the presence of executive dysfunctions in the earliest stage of MCI, and the sub-domains of EF which are disproportionately impaired earlier than others. METHODS: The participants were 41 normal elderly (NE), 86 with amnestic multi-domain MCI, and 41 with mild AD. The MCI group was further sub-divided into two groups: Early MCI (EMCI, n=45) and late MCI (n=41), based on the Clinical Dementia Rating-Sum of Boxes. All participants were given neuropsychological tests to assess the sub-domains of EF, such as verbal fluency, psychomotor speed, inhibitory control, and mental set-shifting. RESULTS: Impairment of semantic fluency was observed in EMCI, with gradual worsening as cases approached mild AD. Phonemic fluency and psychomotor speed were also impaired at the early stage of MCI relative to the NE, but maintained at the same level up to mild AD. EMCI exhibited the same degree of performance with NE for inhibitory control and mental set-shifting; however, they progressively worsened from EMCI to mild AD. CONCLUSIONS: These results suggest that impairments of EF exist even in the earliest stage of the MCI, with a disproportionate decline in the sub-domains of EF.
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Idoso , Humanos , Doença de Alzheimer , Demência , Função Executiva , Disfunção Cognitiva , Testes Neuropsicológicos , SemânticaRESUMO
Caring for people with dementia is associated with multiple devastating social, financial, physical, and psychological challenges. There is strong evidence that multicomponent tailored caregiver intervention is effective in improving caregiver well-being and delaying institutionalization. In US, the government is actively funding for developing caregiver program and to prove its efficacy through randomized controlled trials (RCTs) to translate into practice. Even with the introduction of Korean Long-term Care Plan, still, the most of the patients with dementia are being cared by the family members. The distress of caregiving is enormous, but structured therapeutic intervention program which efficacy is proven through RCT is very insufficient in Korea. The purpose of this article is to review the caregiver intervention programs of ongoing clinical trials comparing US and Korea, and to propose a tailored, therapeutic intervention program (I-CARE; A multicenter, randomized trial to assess efficacy of therapeutic intervention programs for decreasing caregiver burden in dementia caregiver) for hospital-care in Korea.
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Humanos , Cuidadores , Demência , Administração Financeira , Institucionalização , Coreia (Geográfico) , Assistência de Longa DuraçãoRESUMO
BACKGROUND AND PURPOSE: The brief version of the Seoul Neuropsychological Screening Battery (SNSB), the SNSB-Core (SNSB-C), has been developed. Although each subtest score of the SNSB-C provides information on different features of broad cognitive functioning or impairment, a composite score is needed to identify the severity of global cognitive impairment. We aimed to develop and validate a composite score of the SNSB-C that would provide a normative-based summary score of global cognitive functioning, especially for differentiating patients with cognitive impairment from normal elderly. METHODS: A normative sample of 1067 elderly was used to develop a composite score of SNSB-C. The composite score was corrected for the effects of age, years of education, and sex by the regression method. Patients with Alzheimer's disease (n=41), vascular dementia (n=40), amnestic mild cognitive impairment (MCI) (n=73), vascular MCI (n=41), and Parkinson's disease with MCI (n=41) were differentiated from a normal sample (n=70) by the uncorrected and corrected composite scores using receiver operating characteristic (ROC) curve analysis. RESULTS: Confirmatory factor analysis showed that the composite score equal weight to each standardized cognitive domain of SNSB-C is appropriate for indexing overall cognitive functioning. The corrected and uncorrected composite scores yielded a satisfactory size of the area under the ROC curve comparable to the Mini Mental State Examination (MMSE). CONCLUSIONS: The composite scores of SNSB-C, especially the corrected score, provide an index of overall cognitive functioning, and they can be used as an alternative to MMSE for screening patients with cognitive impairment.
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Idoso , Humanos , Indexação e Redação de Resumos , Doença de Alzheimer , Demência Vascular , Educação , Programas de Rastreamento , Disfunção Cognitiva , Doença de Parkinson , Curva ROC , SeulRESUMO
BACKGROUND: Alzheimer's disease (AD) is a representative neurodegenerative disorder associated with memory disturbance. Recent research has shown that risk factors for cerebrovascular disorders are also causes of dementia. Of these risk factors, hyperhomocysteinemia is well known to be positively correlated with all types of dementias including AD. But it is not clear if there is a difference in the concentration of homocysteine according to subtypes of memory impairment of AD. We performed this study to explore the relationship between homocysteine and memory. METHODS: A total of 54 patients (male: 15 patients) to the dementia clinic at our hospital were recruited for this study. All subjects underwent neuropsychological tests including detailed memory function tests and brain magnetic resonance images. The plasma homocysteine level was measured routinely in all patients. RESULTS: Verbal and visual memories in AD were significantly associated with the concentration of plasma homocysteine. The plasma homocysteine level was significantly correlated with delayed recalls of verbal and visual memories and recognition of visual memory. However, there was no relationship between plasma homocysteine and working memory. CONCLUSIONS: This study showed that plasma homocysteine level was related to the consolidation and retrieval stage of memory in AD. Therefore, we cautiously assumed that control of plasma homocysteine level could contribute to management for the prevention of cognitive impairment.