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Stagge F, Lanzi AM, Saylor AK, Cohen ML. Montreal Cognitive Assessment Scores Do Not Associate With Communication Challenges Reported by Adults With Alzheimer's Disease or Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1902-1910. [PMID: 38713811 DOI: 10.1044/2024_ajslp-23-00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
PURPOSES Screening for cognitive-communication challenges in people with Alzheimer's disease (AD) or Parkinson's disease (PD) may benefit from multiple kinds of information about the client (e.g., patient-reported, performance-based). The purposes of this report are (a) to describe, using recently published score range descriptors (e.g., "mild," "moderate"), the patient-reported communication challenges of people with AD or PD using the Communicative Participation Item Bank (CPIB) and the Aphasia Communication Outcome Measure (ACOM); and (b) to examine the relationships between the performance-based Montreal Cognitive Assessment (MoCA), a cognitive screener, and patient-reported CPIB and ACOM scores. METHOD Participants were a convenience sample of 49 community-dwelling adults with AD or PD. Participants completed the measures in person as part of a larger assessment battery. RESULTS MoCA total scores ranged from 7 to 28. CPIB T-scores fell in the following ranges: 31% were "within normal limits," 57% reflected "mildly" restricted participation, and 12% reflected "moderately" restricted participation. ACOM T-scores fell in the following ranges: 50% were either "within normal limits" or reflected "mild" impairment, 29% reflected "mild-moderately" impaired functional communication, and 21% reflected "moderately" impaired functional communication. There were only weak and nonsignificant correlations between T-scores on the ACOM or CPIB and scores on the MoCA, and there were no group differences on the ACOM or CPIB between individuals who screened positive versus negative on the MoCA. CONCLUSION When screening individuals with AD or PD, patient-reported communication challenges seem to be complementary to information provided by the MoCA and perhaps most useful in screening for mild communication challenges.
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Affiliation(s)
- Faith Stagge
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Alyssa M Lanzi
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Anna K Saylor
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Matthew L Cohen
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
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Cohen ML, Harnish SM, Lanzi AM, Brello J, Hula WD, Victorson D, Nandakumar R, Kisala PA, Tulsky DS. Establishing severity levels for patient-reported measures of functional communication, participation, and perceived cognitive function for adults with acquired cognitive and language disorders. Qual Life Res 2022; 32:1659-1670. [PMID: 36572789 PMCID: PMC10172211 DOI: 10.1007/s11136-022-03337-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To empirically assign severity levels (e.g., mild, moderate) to four relatively new patient-reported outcome measures (PROMs) for adults with acquired cognitive/language disorders. They include the Communicative Participation Item Bank, the Aphasia Communication Outcome Measure, and Neuro-QoL's item banks of Cognitive Function (v2.0) and Ability to Participate in Social Roles and Activities (v1.0). METHOD We conducted 17 focus groups that comprised 22 adults with an acquired cognitive/language disorder from stroke, Parkinson's disease, or traumatic brain injury; 30 care partners of an adult with an acquired cognitive/language disorder; and 42 speech-language pathologists who had experience assessing/treating individuals with those and other cognitive/language disorders. In a small, moderated focus-group format, participants completed "PROM-bookmarking" procedures: They discussed hypothetical vignettes based on PROM item responses about people with cognitive/language disorders and had to reach consensus regarding whether their symptoms/function should be categorized as within normal limits or mild, moderate, or severe challenges. RESULTS There was generally good agreement among the stakeholder groups about how to classify vignettes, particularly when they reflected very high or low functioning. People with aphasia described a larger range of functional communication challenges as "mild" compared to other stakeholder types. Based on a consensus across groups, we present severity levels for specific score ranges for each PROM. CONCLUSION Standardized, stakeholder-informed severity levels that aid interpretation of PROM scores can help clinicians and researchers derive better clinical meaning from those scores, for example, by identifying important clinical windows of opportunity and assessing when symptoms have returned to a "normal" range.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA. .,Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, 43210, USA
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, 43210, USA
| | - William D Hula
- Geriatric Research, Education, and Clinical Center, VA Health Care System, and Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Victorson
- School of Medicine Department of Medical Social Science, Northwestern University, Chicago, IL, 60611, USA
| | - Ratna Nandakumar
- University of Delaware School of Education, Newark, DE, 19713, USA
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, 19713, USA
| | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, 19713, USA
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