To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Background: Low education and illiteracy are associated with an increased risk of dementia. This study aimed to develop a neuropsychological test battery applicable to both illiterate and literate elderly and to assess its reliability and validity for a diagnosis of dementia.
Methods: We developed the Literacy Independent Cognitive Assessment (LICA), which consists of 13 subtests assessing memory, language, visuoconstruction, executive function, attention and calculation. We investigated its reliability and validity on 152 patients with dementia, 66 with mild cognitive impairment and 639 normal controls.
Results: The subtests were found to be applicable to most of the illiterate normal controls (97.3%) and were found to have high inter-rater reliabilities (r = 0.85–1.00, p < 0.001) and moderate to high test-retest reliabilities (r = 0.50–0.86, p < 0.001). The LICA performed well in discriminating participants across Clinical Dementia Rating stages and showed excellent internal consistency and good concurrent validity with the Korean Mini-mental State Examination in both literate and illiterate participants. The area under the curve of the receiver operating characteristic was 0.985 in each of the two literacy groups. Sensitivity and specificity of the LICA to make a diagnosis of dementia was 91.9% and 91.8% at the cutoff point of 186.0 in the literate subjects and 96.2% and 91.1% at the cutoff point of 154.5 in the illiterate subjects. The battery was factored into two separate factors consisting of verbal memory tests and tests for other cognitive domains.
Conclusion: The LICA is a valid and reliable instrument for a diagnosis of dementia in both illiterate and literate elderly.
Hepatitis B virus (HBV) infections are endemic in Korea. The aims of this study were to determine the prevalence of HBsAg positivity in Korea and to evaluate the changes in intrafamilial transmission after introduction of HBV vaccination in 1983. This study was based on the 2001 Korea National Health and Nutrition Examination Survey. A total of 2512 study subjects, aged 10–29 years, were selected from across Korea using a stratified multi-stage probability sampling design. To identify the changes in intrafamilial transmission after the introduction of the HBV vaccination programme, 1850 subjects with parental serological markers were selected. These subjects were then grouped into two birth cohorts (cohort 1: born before 1983; cohort 2: born after 1983). Appropriate sampling weights were used for all analyses. The weighted age-specific prevalence of HBsAg was 4·9% in participants in their 20s and 1·9% in adolescents; the combined weighted prevalence was 3·2%. Of subjects with HBsAg positivity in either parent, 17·5% were HBsAg-seropositive. Of subjects with two HBsAg-negative parents, 1·5% were HBsAg-seropositive. The HBsAg positivity rate of offspring with HBsAg-positive mothers was higher than those with HBsAg-positive fathers (27·3% vs. 4·8%, P<0·001). The weighted HBsAg positivity rate of offspring with HBsAg-negative mothers was 2·3% for cohort 1 and 0·4% for cohort 2 (P<0·01), and for those offspring with HBsAg-positive mothers it was also significantly decreased compared to cohorts 1 and 2 (40·2% vs. 16·4%, P<0·01). However, the weighted HBsAg positivity rate of offspring with HBsAg-positive mothers was still high. Our results showed that introduction of HBV vaccination has resulted in a decline in the overall HBsAg positivity rate and a reduction in intrafamilial transmission in Korea, but further preventive measures for maternal intrafamilial transmission are needed.
Vascular dementia (VaD) is a cognitive syndrome caused by cerebrovascular disease with clinically apparent ischemic or hemorrhagic lesions. It is not synonymous with post-stroke dementia, which refers to any type of dementia developed after a clinical stroke, irrespective of the presumed cause for the dementia (Pasquier et al.,1997). Unlike Alzheimer's disease (AD), which is accepted as the most common cause of dementia, reports on VaD show remarkably variable prevalence. Compared with western countries, the prevalence of VaD seems somewhat higher in eastern Asian countries such as China, South Korea and Japan, ranking second (Lee et al., 2002; Zhang et al., 2005; Dong et al., 2007) or even approaching the prevalence of AD (Yanagihara 2002). As the occurrence of stroke rises exponentially with age, the contribution of vascular disease to the incidence, pathogenesis and clinical course of dementia is becoming more important in the elderly. Also, the incidence of AD doubles in stroke patients, confounding understanding of the relative contribution of the two conditions to clinical status and treatment (Kokmen et al., 1996). Importantly, cognitive decline after stroke is common. In patients with a first stroke, fully one-fourth develop a newly diagnosed dementia within 1 year after the event (Andersen et al., 1996). Similarly, the relative risk of new onset of dementia is 5.5 within 4 years after first ever stroke (Tatemichi et al., 1994).
The clinical patterns of VaD differ, depending on the vessels involved (large versus small vessel), location of vascular lesions and the stages of disease.
To investigate the causal relationship of blood clotting factors and hepatitis A virus (HAV) infection in haemophilia patients during 1998–1999 in Korea, we performed a 1:3 matched case-control study and molecular detection of HAV from clotting factors and patients. The epidemiological investigation showed that one lot of clotting factor VIII was related epidemiologically to patients with hepatitis A with an odds ratio of 35·0, or 38·4 when adjusted for the interval between injections. We examined 17 sera collected from seven patients and 124 lots of blood clotting factors (factor VIII and factor IV) by HAV reverse transcriptase–polymerase chain reaction (RT–PCR). HAV RNA was detected in five clotting factors and six sera. The HAV sequence of one of the factor VIII samples was identical to the sequences found in three patients' sera. Findings from the laboratory and epidemiological studies suggested that the clotting factor was causally related to HAV infection in three haemophilia patients.
Email your librarian or administrator to recommend adding this to your organisation's collection.