Facial Expressions Track Depressive Symptoms in Old Age.

Facial expressions play a crucial role in the diagnosis of mental illnesses characterized by mood changes. The Facial Action Coding System (FACS) is a comprehensive framework that systematically categorizes and captures even subtle changes in facial appearance, enabling the examination of emotional expressions. In this study, we investigated the association between facial expressions and depressive symptoms in a sample of 59 older adults without cognitive impairment. Utilizing the FACS and the Korean version of the Beck Depression Inventory-II, we analyzed both "posed" and "spontaneous" facial expressions across six basic emotions: happiness, sadness, fear, anger, surprise, and disgust. Through principal component analysis, we summarized 17 action units across these emotion conditions. Subsequently, multiple regression analyses were performed to identify specific facial expression features that explain depressive symptoms. Our findings revealed several distinct features of posed and spontaneous facial expressions. Specifically, among older adults with higher depressive symptoms, a posed face exhibited a downward and inward pull at the corner of the mouth, indicative of sadness. In contrast, a spontaneous face displayed raised and narrowed inner brows, which was associated with more severe depressive symptoms in older adults. These findings suggest that facial expressions can provide valuable insights into assessing depressive symptoms in older adults.

Efficacy of Smart Speaker-Based Metamemory Training in Older Adults: Case-Control Cohort Study.

BACKGROUND: Metamemory training (MMT) is a useful training strategy for improving cognitive functioning in the older adult population. Despite the advantages, there are limitations imposed by location and time constraints. OBJECTIVE: This study aimed to develop a smart speaker-based MMT program and evaluate the efficacy of the program in older adults without cognitive impairment. METHODS: This study used a case-control cohort design. The smart speaker-based MMT program comprised 3 training sessions per day, 5 days a week, for 8 weeks. Each training session took approximately 15 minutes. This program was implemented using smart speakers, not human trainers. All participants completed the Mini-Mental State Examination, Subjective Memory Complaints Questionnaire, Verbal Learning Test, Digit Span Test, fluency tests, and a short-form version of the Geriatric Depression Scale before and after training. RESULTS: A total of 60 subjects (29 in the MMT group and 31 in the control group) participated in the study. The training group showed significant increases in the delayed free recall, digit span forward, digit span backward, and fluency test scores compared with the control group. CONCLUSIONS: This study confirmed the efficacy of smart speaker-based MMT in older adults. Home-based smart speaker-based MMT is not limited with respect to location or constrained by space and may help older adults with subjective cognitive decline without requiring intervention by human professionals.

Changes in Computer-Analyzed Facial Expressions with Age.

Facial expressions are well known to change with age, but the quantitative properties of facial aging remain unclear. In the present study, we investigated the differences in the intensity of facial expressions between older (n = 56) and younger adults (n = 113). In laboratory experiments, the posed facial expressions of the participants were obtained based on six basic emotions and neutral facial expression stimuli, and the intensities of their faces were analyzed using a computer vision tool, OpenFace software. Our results showed that the older adults expressed strong expressions for some negative emotions and neutral faces. Furthermore, when making facial expressions, older adults used more face muscles than younger adults across the emotions. These results may help to understand the characteristics of facial expressions in aging and can provide empirical evidence for other fields regarding facial recognition.

Bullying Perpetration, Victimization, and Low Self-esteem: Examining Their Relationship Over Time.

Bullying experiences in adolescents could cause maladjusted developments like low self-esteem, which in turn could increase the likelihood of having bullying experiences. Examining these longitudinal reciprocal relationships by considering the co-occurrence of bullying experience is critical, but under-examined. The current study clarifies the longitudinal reciprocal relationship between adolescents' bullying perpetration, victimization, and low self-esteem. An autoregressive cross-lagged model was analyzed with data collected from 3658 Korean secondary students (47.2% were females, Mean age = 12.07, standard deviation = 0.27, range = 11-14) from the Seoul Education Longitudinal study in three waves (seventh to ninth grades). After controlling prior bullying perpetration, victimization, and low self-esteem, low self-esteem positively predicted subsequent victimization, and victimization also positively predicted subsequent low self-esteem longitudinally. However, low self-esteem failed to predict subsequent bullying perpetration, which in turn, failed to predict subsequent low self-esteem. After the prior bullying experiences and low self-esteem are controlled, their longitudinal association becomes clearly distinct. Victims of bullying may fall into a vicious circle, where after being victimized, they themselves feel unlovable or incompetent, and their increased low self-esteem is linked to subsequent victimization. To break out of this vicious circle and temporal stability of victimization, interventions focusing on victims' self-esteem would be effective.

Development and Validation of a Short-Form Internet Overuse Screening Questionnaire for Adults.

AIMS: The aim of the current study was to develop and validate a short-form of the internet overuse screening questionnaire (IOS-Qs). METHODS: A total of 571 adults were recruited from a representative, stratified, and multistage cluster sample. Among participants, 188 and 383 were used in the development and validation of the IOS-Qs, respectively. RESULTS: Experts' ratings and Rasch model analyses led to the selection of 8 items from the IOS-Qs; latent-class analysis using these 8 items revealed an estimated prevalence of 8.6% (33 out of 383) of problematic internet over-users. Problematic internet over-users were positively associated with a 1-year prevalence rate of any mental disorder (OR 3.08, p = 0.008), mood disorder (OR 7.11, p = 0.003), and depressive disorder (OR 5.22, p = 0.016). The receiver operating characteristic curves identified an optimal cutoff score of 9.5 for differentiating problematic internet over-users from unproblematic internet users with 94% sensitivity and 94% specificity. CONCLUSION: The results suggest that the IOS-Qs was valid, and items including social isolation were crucial to the brief distinction of at-risk internet users. Because of its brevity, the questionnaire can be effectively administered as a large-scale survey.

Differences in Facial Expressions between Spontaneous and Posed Smiles: Automated Method by Action Units and Three-Dimensional Facial Landmarks.

Research on emotion recognition from facial expressions has found evidence of different muscle movements between genuine and posed smiles. To further confirm discrete movement intensities of each facial segment, we explored differences in facial expressions between spontaneous and posed smiles with three-dimensional facial landmarks. Advanced machine analysis was adopted to measure changes in the dynamics of 68 segmented facial regions. A total of 57 normal adults (19 men, 38 women) who displayed adequate posed and spontaneous facial expressions for happiness were included in the analyses. The results indicate that spontaneous smiles have higher intensities for upper face than lower face. On the other hand, posed smiles showed higher intensities in the lower part of the face. Furthermore, the 3D facial landmark technique revealed that the left eyebrow displayed stronger intensity during spontaneous smiles than the right eyebrow. These findings suggest a potential application of landmark based emotion recognition that spontaneous smiles can be distinguished from posed smiles via measuring relative intensities between the upper and lower face with a focus on left-sided asymmetry in the upper region.

Interactions between subjective memory complaint and objective cognitive deficit on memory performances.

BACKGROUND: Subjective memory complaint (SMCs) is a common trait amongst older population. The subjective cognition about their memory could depend on objective cognition. The aim of the current study was to examine the interaction between subjective memory cognition (i.e., SMC) and objective cognition on cognitive functions in participants from older generation. METHODS: A total of 219 patients, 181 normal control (NC) patients and 38 patients with mild cognitive impairment (MCI), were examined through standardized and comprehensive clinical evaluation and neuropsychological assessment. The Subjective Memory Complaints Questionnaire was used to assess SMCs along with five cognitive tasks were used to evaluate cognitive decline over following areas: verbal memory, visuospatial memory, attention, fluency, and language. RESULTS: The results of 2 × 2 two-way analysis of variance (ANOVA) showed that there were significant interactions between SMCs and cognitive status (NC, MCI) on memory performances. NC with SMCs showed significantly lower performance in verbal memory and visuospatial memory compared to NCs without SMCs. Conversely, no effect was observed in the MCI group. CONCLUSION: There are interactions between subjective cognition (i.e., SMC) and objective cognition (i.e., cognitive status) on memory performances in older adults. The roles of SMCs on memory performances should be interpreted with older adults' objective cognitive status.

Relationship between education, leisure activities, and cognitive functions in older adults.

This study aimed to reveal the relationship between life activities and cognitive function and to evaluate the interaction between education and various leisure activities in predicting cognitive function. Using a cross-sectional research design with retrospective data, a total of 210 healthy Korean older adults participated and reported their years of education, working, and lifelong leisure activities. Cognitive function was measured using the Mini Mental State Examination. A hierarchical multiple regression analysis showed that education was positively associated with cognitive function, whereas working activity was not. Craft activities positively predicted cognitive function. Furthermore, education moderated the relationship between leisure activities and cognitive function. Only low-educated participants showed a decrease in cognitive function as they performed domestic chores and an increase in cognitive function as they participated in social activities and volunteering. High-educated participants showed no relation between leisure activities and cognitive function. The results of the current study suggest that the relationship between various leisure activities and cognitive function can vary based on the nature of the leisure activity and educational level. Professionals examining older adults' cognitive function should pay closer attention to educational level, as well as life styles (i.e. leisure activities), to provide appropriate interventions.

Montreal cognitive assessment reflects cognitive reserve.

BACKGROUND: The Montreal Cognitive Assessment (MoCA) is known to have discriminative power for patients with Mild Cognitive Impairment (MCI). Recently Cognitive Reserve (CR) has been introduced as a factor that compensates cognitive decline. We aimed to assess whether the MoCA reflects CR. Furthermore, we assessed whether there were any differences in the efficacy between the MoCA and the Mini-Mental State Examination (MMSE) in reflecting CR. METHODS: MoCA, MMSE, and the Cognitive Reserve Index questionnaire (CRIq) were administered to 221 healthy participants. Normative data and associated factors of the MoCA were identified. Correlation and regression analyses of the MoCA, MMSE and CRIq scores were performed, and the MoCA score was compared with the MMSE score to evaluate the degree to which the MoCA reflected CR. RESULTS: The MoCA reflected total CRIq score (CRI; B = 0.076, P < 0.001), CRI-Education (B = 0.066, P <  0.001), and CRI-Working activity (B = 0.025, P = 0.042), while MMSE reflected total CRI (B = 0.044, P <  0.001) and CRI-Education (B = 0.049, P <  0.001) only. The MoCA differed from the MMSE in the reflection of total CRI (Z = 2.30). CONCLUSION: In this study, we show that the MoCA score reflects CR more sensitively than the MMSE score. Therefore, we suggest that MoCA can be used to assess CR and early cognitive decline.

Who Becomes a Bullying Perpetrator After the Experience of Bullying Victimization? The Moderating Role of Self-esteem.

It is well known that victims of bullying could become a bullying perpetrator later on. However, there are some cases where victims do not become bullies after being bullied. What constitutes the differences between the two groups, who show different response strategies despite the similar experiences of victimization, is the main question that the current study poses. Based on the threatened egotism theory, the current longitudinal study postulates that there could be possible moderating effects of self-esteem in the relationship between prior bullying victimization and subsequent bullying perpetration. The data was drawn from 3,660 Korean secondary students (51.5% male) in the Seoul Education Longitudinal Study for 2 waves (7th to 8th grades). The results from structural equation modeling indicated that there is a significant interaction effect between bullying victimization and self-esteem in the 7th grade, in prediction to bullying perpetration in the 8th grade, after controlling for the prior level of bullying victimization and perpetration experiences, demographic and background characteristics (i.e., gender and family income), students' school-environmental factor (i.e., perceived seriousness of school bullying), individual factor (i.e., self-control) and family-environmental factor (i.e., parent-child relationship). Students with higher self-esteem were the most likely to engage in future bullying perpetration in response to bullying victimization, while the students with lower self-esteem were the least likely to engage in future bullying perpetration. Educators who examine adolescents' social problems should pay closer attention to self-esteem, as well as their bullying and victimization experiences, in order to provide appropriate interventions.

Development and Validation of the Rappel Indicé-24: Behavioral and Brain Morphological Evidence.

The primary goals of the present study were to develop and validate the Rappel Indicé 24 (RI-24), a shorter version of the original Rappel Indicé, which includes 48 items (RI-48), and to identify the specific brain regions that were correlated with scores on the RI-24. Using these clinical scales, the present study evaluated 91 elderly Korean participants who were classified into 3 groups: normal control (NC; n = 34), patients with mild cognitive impairment (MCI; n = 29), and patients with Alzheimer disease (AD; n = 28). Of the 91 participants, 77 also underwent magnetic resonance imaging scans. The RI-24 delayed cued recall (DCR) scores significantly differed among the NC, MCI, and AD groups. A receiver-operating characteristic curve analysis revealed that the RI-24 was very sensitive (89%) and specific (91%) for the detection of AD. Furthermore, although the time needed to administer the RI-24 was half that needed for the RI-48, the 24-item version showed a high correlation (r= .85 for the DCR score) with the 48-item version. In terms of brain morphological characteristics, voxel-based morphometry analyses revealed a significant positive correlation between DCR score and gray matter volume in the parahippocampal gyrus (r= .468), which plays a role in cued recall. Taken together, the present findings indicate that the RI-24 is a sensitive and reliable test for the detection of memory impairments in patients with MCI and AD despite its brief administration time.

Exploring the mechanisms between socio-economic status and health: Mediating roles of health-related behaviors before and during COVID-19.

The relationship between individuals' socioeconomic characteristics and their health outcomes is widely acknowledged. However, the specific mechanisms through which these factors are interconnected have not been studied sufficiently. The current study investigated the association among socio-economic status (education of parents, economic status of family) and perceived health mediated by physical activity and sedentary time (purpose for study or not), before and during Covid-19. Three cross-sectional and population-based representative surveys from 2019, 2020, and 2021 were utilized. Overall, 167,099 Korean adolescents (57,303 in 2019, 54,948 in 2020, 54,848 in 2021) participated. A multi-group structural equation model showed that socio-economic status was associated with perceived health through physical activity and sedentary behaviors. Both measures of socio-economic status were positively associated with sedentary time for study purposes, but negatively associated with purposes other than study. Higher education of parents negatively predicted physical activity, whereas higher economic status of family positively predicted physical activity. The impact of socio-economic status on sedentary time tended to increase after the pandemic. Covid-19 significantly affected adolescents' health and health-related behaviors. Comprehensive policies considering adolescents' socio-economic status and their physical activity and sedentary time would mitigate the health effects of the pandemic.

Incidence and Cognitive Decline of Alzheimer's Disease and Other Dementia by Apolipoprotein ε4 Allele Presence: A Community-Based Cohort Study in Korean Elderly.

OBJECTIVE: This study aimed to investigate the role of apolipoprotein E (APOE) ε4 allele to the incidence of dementia and cognitive decline in a cohort of a Korean community. METHODS: From a community-based dementia-free cohort, 357 participants were genotyped. Participants underwent 2 cognitive assessments separated by a hiatus between 6 to 7 years and were diagnosed as healthy control (n=297), Alzheimer's disease (AD) (n=44), and other dementia (n=16) at the second assessment. Incidence risk and onset age of disease according to APOE ε4 presence were analyzed in AD and other dementia. Differences in cognitive decline rate depending on APOE ε4 were also examined across all groups. RESULTS: The relative risks and onset age of dementia were not different by the presence of the APOE ε4 allele. Cognitive decline was more prominent in the presence of APOE ε4 allele (score change=7.4) than non-presence (score change=3.1), and this interaction was significant only in the AD group (F=10.51, p=0.003). CONCLUSION: The APOE ε4 alleles can be a critical factor in predicting cognitive change for AD in the Korean community population but not in predicting AD incidence. This finding suggest that clinicians consider the presence of APOE ε4 allele examining patients with rapid declining dementia.

Opto-vTrap, an optogenetic trap for reversible inhibition of vesicular release, synaptic transmission, and behavior.

Spatiotemporal control of brain activity by optogenetics has emerged as an essential tool to study brain function. For silencing brain activity, optogenetic probes, such as halorhodopsin and archaerhodopsin, inhibit transmitter release indirectly by hyperpolarizing membrane potentials. However, these probes cause an undesirable ionic imbalance and rebound spikes. Moreover, they are not applicable to use in non-excitable glial cells. Here we engineered Opto-vTrap, a light-inducible and reversible inhibition system to temporarily trap the transmitter-containing vesicles from exocytotic release. Light activation of Opto-vTrap caused full vesicle clusterization and complete inhibition of exocytosis within 1 min, which recovered within 30 min after light off. We found a significant reduction in synaptic and gliotransmission upon activation of Opto-vTrap in acute brain slices. Opto-vTrap significantly inhibited hippocampus-dependent memory retrieval with full recovery within an hour. We propose Opto-vTrap as a next-generation optogenetic silencer to control brain activity and behavior with minimal confounding effects.

N termini of apPDE4 isoforms are responsible for targeting the isoforms to different cellular membranes.

Phosphodiesterases (PDEs) are known to play a key role in the compartmentalization of cAMP signaling; however, the molecular mechanisms underlying intracellular localization of different PDE isoforms are not understood. In this study, we have found that each of the supershort, short, and long forms of apPDE4 showed distinct localization in the cytoplasm, plasma membrane, and both plasma membrane and presynaptic terminals, respectively. The N-terminal 20 amino acids of the long form of apPDE4 were involved in presynaptic terminal targeting by binding to several lipids. In addition, the N terminus of the short form of apPDE4 bound to several lipids including phosphoinositols, thereby targeting the plasma membrane. Overexpression of the long and the short forms, but not the supershort form attenuated 5-HT-induced membrane hyperexcitability. Finally, the knockdown of apPDE4s in sensory neurons impaired both short-term and long-term facilitation. Thus, these results suggest that apPDE4s can participate in the regulation of cAMP signaling through specific subcellular localization by means of lipid binding activities.

Leveraging Text Mining Approach to Identify What People Want to Know About Mental Disorders From Online Inquiry Platforms.

Online inquiry platforms, which is where a person can anonymously ask questions, have become an important information source for those who are concerned about social stigma and discrimination that follow mental disorders. Therefore, examining what people inquire about regarding mental disorders would be useful when designing educational programs for communities. The present study aimed to examine the contents of the queries regarding mental disorders that were posted on online inquiry platforms. A total of 4,714 relevant queries from the two major online inquiry platforms were collected. We computed word frequencies, centralities, and latent Dirichlet allocation (LDA) topic modeling. The words like symptom, hospital and treatment ranked as the most frequently used words, and the word my appeared to have the highest centrality. LDA identified four latent topics: (1) the understanding of general symptoms, (2) a disability grading system and welfare entitlement, (3) stressful life events, and (4) social adaptation with mental disorders. People are interested in practical information concerning mental disorders, such as social benefits, social adaptation, more general information about the symptoms and the treatments. Our findings suggest that instructions encompassing different scopes of information are needed when developing educational programs.

Brain Structural Alterations, Diabetes Biomarkers, and Cognitive Performance in Older Adults With Dysglycemia.

Despite the high risk of dementia in older adults with type 2 diabetes, the neuroanatomical correlates of cognitive dysfunction that are particularly affected by diabetes are not well characterized. This study is aimed to examine the structural brain alterations in dysglycemic older adults. Using voxel-based morphometric and tract-based spatial statistics, we examined changes in gray matter volume, white matter volume, and microstructural integrity in older adults with prediabetes and diabetes. We also assessed the correlation of these structural changes with diabetes biomarkers and cognitive performance. A total of 74 non-demented older adults (normal, n = 14; prediabetes, n = 37; and diabetes, n = 23) participated in this study and underwent structural and diffusion magnetic resonance imaging (MRI) scans and neuropsychological tests. Subjects with diabetes showed reduced volume of cerebellar gray matter and frontal white matter and diffuse white matter dysintegrity, while those with prediabetes only showed reduced volume of insular gray matter. Atrophic changes in the cerebellum and frontal lobe and frontal white matter dysintegrity were correlated with chronic hyperglycemia and insulin resistance and worse performance in verbal memory recognition and executive function tests. Our findings suggest that chronic hyperglycemia and insulin resistance may alter brain structures forming the fronto-cerebellar network, which may cause cognitive dysfunction in older adults.

Differences in Brain Morphology between Hydrocephalus Ex Vacuo and Idiopathic Normal Pressure Hydrocephalus.

OBJECTIVE: The distinction between idiopathic normal pressure hydrocephalus (iNPH) and hydrocephalus ex vacuo caused by encephalic volume loss remains to be established. This study aims to investigate radiological parameters as clinically useful tools to discriminate iNPH from hydrocephalus ex vacuo caused by Alzheimer's disease (AD). METHODS: A total of 54 patients with ventriculomegaly (iNPH, 25; hydrocephalus ex vacuo, 29) were recruited in this study. Consequently, nine radiological parameters were compared between iNPH and hydrocephalus ex vacuo using magnetic resonance imaging (MRI). RESULTS: A small callosal angle (CA), the Sylvian fissure dilatation, and absence of narrowing of superior parietal sulci discriminated the iNPH group from the hydrocephalus ex vacuo group (p<0.05). The final binary logistic regression model included narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure after controlling for age and global Clinical Dementia Rating (CDR). The composite score made from these three indicators (narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure) was statistically different between iNPH and hydrocephalus ex vacuo. CONCLUSION: The narrowing of the CA, dilatation of the Sylvain fissure, and narrowing of superior parietal sulci may be used as radiological key indices and noninvasive tools for the differential diagnosis of iNPH from hydrocephalus ex vacuo.

Multivariate neuroanatomical correlates of behavioral and psychological symptoms in dementia and the moderating role of education.

Neuropsychiatric symptoms are commonly observed as brain pathology progresses with dementia. Behavioral and affective disturbances underly the distinct neuroanatomical basis of typical symptoms of cognitive impairment; however it remains unclear whether enriched intellectual experience, such as educational attainment, can mitigate the effect of brain structural patterns on neuropsychiatric symptom severity. We utilized the Open Access Series of Imaging Studies (OASIS-3) dataset, which includes brain structural MRI and behavioral symptom evaluation. We included 904 older adults who were mostly cognitively normal, clinically diagnosed with very mild to moderate Alzheimer's disease, or other types of dementia. Canonical correlation analysis was used to identify the patterns of multivariate association between the gray matter structure and neuropsychiatric symptom severity. First, we identified two canonical modes capturing the distinct neuroanatomical basis of common and mood-specific factors of neuropsychiatric symptoms. The first common pattern reflected a smaller volume in the amygdala and adjacent temporal regional thickness. The second mood-specific pattern reflected patterns in lateral and orbital prefrontal regional thickness. In the external correlational analysis, the two canonical correlations reflected global brain volume and white matter lesions; however, the second pattern was not associated with functional impairments or cognitive function. Moreover, older adults with higher education showed an attenuated severity of behavioral symptoms, even with the presence of a brain structural pattern. Our findings suggest that educational attainment, as a proxy of cognitive reserve, can mitigate the severity of behavioral and affective symptoms of dementia.

Cognitive Improvement in Older Adults with Mild Cognitive Impairment: Evidence from a Multi-Strategic Metamemory Training.

Intervention programs to relieve memory impairment and memory-related complaints in older adults with mild cognitive impairment are needed. Objective: The purpose of the current study was to assess the efficacy of a novel cognitive training approach-named multi-strategic metamemory training-in older adults with amnestic mild cognitive impairment. Among a total of 113 older adults with mild cognitive impairment, 66 participated in the memory training program (training group) and 47 did not (control group). Repeated measures of analysis of variance revealed that compared with the control group, the training group experienced: i) a significantly greater increase in cognitive test scores of long-term delayed free recall (Finteraction = 6.04, p = .016) and fluency (Finteraction = 4.11, p = .045) and ii) significantly greater decrease in their subjective memory complaints for everyday memory (Finteraction = 7.35, p = .009). These results suggest that the training program can improve verbal memory (i.e., delayed free recall), language processing (i.e., categorical fluency) and limit complaints in everyday instrumental memory activities of mildly impaired older adults.