1
|
Kaltsa M, Tsolaki A, Lazarou I, Mittas I, Papageorgiou M, Papadopoulou D, Tsimpli IM, Tsolaki M. Language Markers of Dementia and Their Role in Early Diagnosis of Alzheimer's Disease: Exploring Grammatical and Syntactic Competence via Sentence Repetition. J Alzheimers Dis Rep 2024; 8:1115-1132. [PMID: 39114543 PMCID: PMC11305841 DOI: 10.3233/adr-230204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 06/21/2024] [Indexed: 08/10/2024] Open
Abstract
Background Earlier research focuses primarily on the cognitive changes due to Alzheimer's disease (AD); however, little is known with regard to changes in language competence across the lifespan. Objective The present study aims to investigate the decline of language skills at the grammatical and syntactic levels due to changes in cognitive function. Methods We administered the Litmus Sentence Repetition Task (SRT) to 150 native speakers of Greek who fall into five groups: 1) young healthy speakers, 2) cognitively intact elder healthy speakers, 3) speakers with subjective cognitive impairment (SCI), 4) speakers with mild cognitive impairment (MCI); and 5) speakers with AD dementia at the mild/moderate stages. All participants underwent a physical and neurological examination and cognitive screening with a standardized neuropsychological battery to assess cognitive status comprehensively and evaluate aspects like working memory, executive function, attention and memory to appropriately classify them. Results The data analysis revealed that the SRT had high discriminatory value in the development of AD; specifically, both accuracy and grammaticality indices were related to cognitive decline. Additionally, syntax significantly affected the performance of speakers with structures such as clitics being particularly challenging and in most structures the performance of speakers with MCI drops significantly compared to speakers with SCI. Conclusions Linguistic indices revealed subtle early signs of cognitive decline that can be helpful in the early detection of AD, thus facilitating the clinical process offering support to language-based assessment tools such as sentence repetition, a non-invasive type of assessment to evaluate symptoms of AD.
Collapse
Affiliation(s)
- Maria Kaltsa
- Department of Theoretical & Applied Linguistics, School of English, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anthoula Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Alzheimer’s Association and Related Disorders (GAARD), Thessaloniki, Greece
| | - Ioulietta Lazarou
- Greek Alzheimer’s Association and Related Disorders (GAARD), Thessaloniki, Greece
- Centre for Research and Technology-Hellas, Thessaloniki, Greece
| | - Ilias Mittas
- Department of Linguistics, School of Philology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mairi Papageorgiou
- Department of Linguistics, School of Philology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despina Papadopoulou
- Department of Linguistics, School of Philology, Faculty of Philosophy, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ianthi Maria Tsimpli
- Faculty of Modern and Medieval Languages and Linguistics, University of Cambridge, Cambridge, UK
| | - Magda Tsolaki
- Greek Alzheimer’s Association and Related Disorders (GAARD), Thessaloniki, Greece
- First Department of Neurology, AHEPA University Hospital, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI – AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
2
|
Ameen A, Williams N, Guthrie DM. Language and pain predict persistent depression among seriously ill home care clients. Palliat Support Care 2024; 22:137-145. [PMID: 36727276 DOI: 10.1017/s1478951522001821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study examined potential predictors of persistent depressive symptoms in a cohort of seriously ill older adults (aged 65+ years) receiving home care services. METHODS This was a retrospective cohort study using secondary data collected from the Resident Assessment Instrument for Home Care for all assessments completed between 2001 and 2020. The cohort included seriously ill individuals with depressive symptoms at baseline and who continued to have depressive symptoms on reassessment within 12 months (n = 8,304). Serious illness was defined as having severe health instability, a prognosis of less than 6 months, or a goal of care related to palliative care (PC) on admission to the home care program. RESULTS The mean age of the sample was 80.8 years (standard deviation [SD] = 7.7), 61.1% were female, and 82.1% spoke English as their primary language. The average length of time between assessments was 4.9 months (SD = 3.3). During that time, 64% of clients had persistent symptoms of depression. A multivariate logistic regression model found that language, pain, caregiver burden, and cognitive impairment were the most significant predictors of experiencing persistent depressive symptoms. SIGNIFICANCE OF RESULTS Persistent depressive symptoms are highly prevalent in this population and, left untreated, could contribute to the person experiencing a "bad death." Some of the risk factors for this outcome are amenable to change, making it important to continually assess and flag these factors so interventions can be implemented to optimize the person's quality of life for as long as possible.
Collapse
Affiliation(s)
- Aaisha Ameen
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Nicole Williams
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Dawn M Guthrie
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| |
Collapse
|
3
|
Zolnoori M, Zolnour A, Topaz M. ADscreen: A speech processing-based screening system for automatic identification of patients with Alzheimer's disease and related dementia. Artif Intell Med 2023; 143:102624. [PMID: 37673583 PMCID: PMC10483114 DOI: 10.1016/j.artmed.2023.102624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 06/22/2023] [Accepted: 07/08/2023] [Indexed: 09/08/2023]
Abstract
Alzheimer's disease and related dementias (ADRD) present a looming public health crisis, affecting roughly 5 million people and 11 % of older adults in the United States. Despite nationwide efforts for timely diagnosis of patients with ADRD, >50 % of them are not diagnosed and unaware of their disease. To address this challenge, we developed ADscreen, an innovative speech-processing based ADRD screening algorithm for the protective identification of patients with ADRD. ADscreen consists of five major components: (i) noise reduction for reducing background noises from the audio-recorded patient speech, (ii) modeling the patient's ability in phonetic motor planning using acoustic parameters of the patient's voice, (iii) modeling the patient's ability in semantic and syntactic levels of language organization using linguistic parameters of the patient speech, (iv) extracting vocal and semantic psycholinguistic cues from the patient speech, and (v) building and evaluating the screening algorithm. To identify important speech parameters (features) associated with ADRD, we used the Joint Mutual Information Maximization (JMIM), an effective feature selection method for high dimensional, small sample size datasets. Modeling the relationship between speech parameters and the outcome variable (presence/absence of ADRD) was conducted using three different machine learning (ML) architectures with the capability of joining informative acoustic and linguistic with contextual word embedding vectors obtained from the DistilBERT (Bidirectional Encoder Representations from Transformers). We evaluated the performance of the ADscreen on an audio-recorded patients' speech (verbal description) for the Cookie-Theft picture description task, which is publicly available in the dementia databank. The joint fusion of acoustic and linguistic parameters with contextual word embedding vectors of DistilBERT achieved F1-score = 84.64 (standard deviation [std] = ±3.58) and AUC-ROC = 92.53 (std = ±3.34) for training dataset, and F1-score = 89.55 and AUC-ROC = 93.89 for the test dataset. In summary, ADscreen has a strong potential to be integrated with clinical workflow to address the need for an ADRD screening tool so that patients with cognitive impairment can receive appropriate and timely care.
Collapse
Affiliation(s)
- Maryam Zolnoori
- Columbia University Medical Center, New York, NY, United States of America; School of Nursing, Columbia University, New York, NY, United States of America.
| | - Ali Zolnour
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Maxim Topaz
- Columbia University Medical Center, New York, NY, United States of America; School of Nursing, Columbia University, New York, NY, United States of America
| |
Collapse
|
4
|
Pigliautile M, Colombo M, Pizzuti T, Procopio N, Stillo M, Curia R, Mecocci P. DMapp: a developing promising approach to monitor symptoms progression and stimulate memory in Italian people with cognitive impairments. Aging Clin Exp Res 2022; 34:2721-2731. [PMID: 36036304 DOI: 10.1007/s40520-022-02219-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/31/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Based on recent researches on the use of natural language processing techniques for very early detection of cognitive decline and the benefits of cognitive stimulation for people with cognitive impairments, the Dementia Monitoring application (DMapp) is developed inside the Memento project. AIMS The aims of this work are: (1) to present DMapp; (2) to report the results of two preliminary studies on DMapp; (3) to describe the clinical and experimental potentiality of DMapp. METHODS Italian people with the diagnosis of mild cognitive impairment due to Alzheimer's disease or dementia due to Alzheimer's Disease with a Mini-Mental-State-Examination between 24 and 28 (inclusive) were involved in the DMapp development prototype during the Lab Trial (4 subjects) and Filed Trial (5 subjects) of the Memento project. Qualitative and quantitative data were collected to evaluate participants' opinions, the DMapp ability to perform the automatic analysis of the speech and participants' visible emotional state effective. Ad hoc interviews, the Observed Emotion Rating Scale and performance metrics to solve different tasks were used. The relation between cognitive measures (global cognitive measures) and linguistic indexes values was considered using Euclidean distances between the participants. RESULTS Linguistic indexes were calculated and seemed to classify the participants' performance as expected from cognitive measures. The DMapp was appreciated by people with cognitive impairment. Positive emotions were present. CONCLUSION DMapp seems an interesting approach to monitor dementia symptoms progression and stimulate memory. Possible developments and open questions are discussed.
Collapse
Affiliation(s)
- Martina Pigliautile
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli, 1, 06132, Perugia, Italy.
| | - Matteo Colombo
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli, 1, 06132, Perugia, Italy
| | | | | | - Maria Stillo
- Innovation Lab, Integris S.P.A, Rende and Pisa, Italy
| | - Rosario Curia
- Innovation Lab, Integris S.P.A, Rende and Pisa, Italy
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli, 1, 06132, Perugia, Italy.,Division of Clinical Geriatrics NVS Department Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
5
|
Price CN, Bidelman GM. Musical experience partially counteracts temporal speech processing deficits in putative mild cognitive impairment. Ann N Y Acad Sci 2022; 1516:114-122. [PMID: 35762658 PMCID: PMC9588638 DOI: 10.1111/nyas.14853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Mild cognitive impairment (MCI) commonly results in more rapid cognitive and behavioral declines than typical aging. Individuals with MCI can exhibit impaired receptive speech abilities that may reflect neurophysiological changes in auditory-sensory processing prior to usual cognitive deficits. Benefits from current interventions targeting communication difficulties in MCI are limited. Yet, neuroplasticity associated with musical experience has been implicated in improving neural representations of speech and offsetting age-related declines in perception. Here, we asked whether these experience-dependent effects of musical experience might extend to aberrant aging and offer some degree of cognitive protection against MCI. During a vowel categorization task, we recorded single-channel electroencephalograms (EEGs) in older adults with putative MCI to evaluate speech encoding across subcortical and cortical levels of the auditory system. Critically, listeners varied in their duration of formal musical experience (0-21 years). Musical experience sharpened temporal precision in auditory cortical responses, suggesting that musical experience produces more efficient processing of acoustic features by counteracting age-related neural delays. Additionally, robustness of brainstem responses predicted the severity of cognitive decline, suggesting that early speech representations are sensitive to preclinical stages of cognitive impairment. Our results extend prior studies by demonstrating positive benefits of musical experience in older adults with emergent cognitive impairments.
Collapse
Affiliation(s)
- Caitlin N. Price
- Department of Audiology & Speech Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Gavin M. Bidelman
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana, USA
| |
Collapse
|
6
|
Alzheimer disease stages identification based on correlation transfer function system using resting-state functional magnetic resonance imaging. PLoS One 2022; 17:e0264710. [PMID: 35413053 PMCID: PMC9004771 DOI: 10.1371/journal.pone.0264710] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/15/2022] [Indexed: 11/21/2022] Open
Abstract
Alzheimer’s disease (AD) affects the quality of life as it causes; memory loss, difficulty in thinking, learning, and performing familiar tasks. Resting-state functional magnetic resonance imaging (rs-fMRI) has been widely used to investigate and analyze different brain regions for AD identification. This study investigates the effectiveness of using correlated transfer function (CorrTF) as a new biomarker to extract the essential features from rs-fMRI, along with support vector machine (SVM) ordered hierarchically, in order to distinguish between the different AD stages. Additionally, we explored the regions, showing significant changes based on the CorrTF extracted features’ strength among different AD stages. First, the process was initialized by applying the preprocessing on rs-fMRI data samples to reduce noise and retain the essential information. Then, the automated anatomical labeling (AAL) atlas was employed to divide the brain into 116 regions, where the intensity time series was calculated, and the CorrTF features were extracted for each region. The proposed framework employed the SVM classifier in two different methodologies, hierarchical and flat multi-classification schemes, to differentiate between the different AD stages for early detection purposes. The ADNI rs-fMRI dataset, employed in this study, consists of 167, 102, 129, and 114 normal, early, late mild cognitive impairment (MCI), and AD subjects, respectively. The proposed schemes achieved an average accuracy of 98.2% and 95.5% for hierarchical and flat multi-classification tasks, respectively, calculated using ten folds cross-validation. Therefore, CorrTF is considered a promising biomarker for AD early-stage identification. Moreover, the significant changes in the strengths of CorrTF connections among the different AD stages can help us identify and explore the affected brain regions and their latent associations during the progression of AD.
Collapse
|
7
|
Li M, Kim H, Sereika SM, Nissley TJ, Lingler JH. Willingness to Participate in Clinical Research Among Individuals With Cognitive Impairment. Res Gerontol Nurs 2022; 15:76-84. [PMID: 35148207 PMCID: PMC9341492 DOI: 10.3928/19404921-20220131-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This secondary analysis examined (1) factors associated with willingness to participate in clinical research for cognitive health among individuals with cognitive impairment and their care partners, and (2) concordance regarding such willingness between individuals with cognitive impairment and their care partners (dyads). Neuropsychological factors and willingness to participate in clinical research were collected using self-reported questionnaires. Participants' sociodemographic and clinical information was extracted from the University of Pittsburgh Alzheimer's Disease Research Center record. Binary logistic regression and Cohen's kappa coefficient analyses were performed. Greater trust in medical researchers (p = 0.031, B = 0.127) and more severe cognitive impairment (p = 0.009, B = -0.289) were associated with willingness to participate in clinical research among individuals with cognitive impairment. Dyadic agreement on willingness to have the individual with cognitive impairment enroll in clinical research was poor to fair (κ = 0.380). Findings suggest that individuals with cognitive impairment with greater trust in health professionals are more likely to agree to clinical research participation. Nurses and other health care providers who counsel individuals with cognitive impairment and their care partners should work to build trusting relationships with participants and be mindful of how increased trust can alter power dynamics between participants and health care professionals. [Research in Gerontological Nursing, 15(2), 76-84.].
Collapse
Affiliation(s)
- Mengchi Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Hyejin Kim
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Susan M. Sereika
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | |
Collapse
|
8
|
Kim AS, Betz JF, Albert M, Deal JA, Faucette SP, Oh ES, Reed NS, Lin FR, Nieman CL. Accuracy of self- and proxy-rated hearing among older adults with and without cognitive impairment. J Am Geriatr Soc 2022; 70:490-500. [PMID: 34813080 PMCID: PMC8821325 DOI: 10.1111/jgs.17558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Hearing loss is highly prevalent among older adults with cognitive impairment and may exacerbate neuropsychiatric symptoms and affect interactions with others. Although audiometry is the gold standard for measuring hearing, it is not always used in research or clinical settings focused on the care of individuals with cognitive impairment. Subjective assessments of hearing, both self- and proxy-rated, are widespread but may not adequately capture the presence of hearing loss as compared to audiometry. This study investigates the concordance between subjective and objective hearing assessments among older adults with and without cognitive impairment and evaluates factors associated with concordance. METHODS Participants were a subset of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), a prospective cohort study representing four US communities with adjudicated cognitive diagnoses and audiometric data, totaling 3326 self-rated and 520 proxy-rated hearing assessments. Sensitivity and specificity were calculated, and multivariable logistic regression estimated the magnitude of the association between the concordance of hearing assessments and variables of interest. RESULTS Sensitivity and specificity for self-rated hearing status were 71.2% and 85.9% among cognitively normal older adults, 61.1% and 84.9% among persons with MCI, and 52.6% and 81.2% among persons with dementia, respectively. For proxy-rated hearing, sensitivity and specificity were 65.7% and 83.3% for persons with MCI and 73.3% and 60.3% for persons with dementia, respectively. Female sex was positively associated with concordance for self-rated hearing assessments. CONCLUSIONS The low sensitivity of self- and proxy-rated hearing assessments compared to audiometry suggests that hearing loss among older adults with cognitive impairment may go underreported and unaddressed in subjective assessments. Clinicians and researchers should recognize the limitations of using self- and proxy-rated hearing assessments as measures of hearing status and incorporate objective audiometric evaluation whenever possible.
Collapse
Affiliation(s)
- Alexander S Kim
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joshua F Betz
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sarah P Faucette
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Esther S Oh
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carrie L Nieman
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
9
|
Palana J, Schwartz S, Tager-Flusberg H. Evaluating the Use of Cortical Entrainment to Measure Atypical Speech Processing: A Systematic Review. Neurosci Biobehav Rev 2021; 133:104506. [PMID: 34942267 DOI: 10.1016/j.neubiorev.2021.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 12/12/2021] [Accepted: 12/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cortical entrainment has emerged as promising means for measuring continuous speech processing in young, neurotypical adults. However, its utility for capturing atypical speech processing has not been systematically reviewed. OBJECTIVES Synthesize evidence regarding the merit of measuring cortical entrainment to capture atypical speech processing and recommend avenues for future research. METHOD We systematically reviewed publications investigating entrainment to continuous speech in populations with auditory processing differences. RESULTS In the 25 publications reviewed, most studies were conducted on older and/or hearing-impaired adults, for whom slow-wave entrainment to speech was often heightened compared to controls. Research conducted on populations with neurodevelopmental disorders, in whom slow-wave entrainment was often reduced, was less common. Across publications, findings highlighted associations between cortical entrainment and speech processing performance differences. CONCLUSIONS Measures of cortical entrainment offer useful means of capturing speech processing differences and future research should leverage them more extensively when studying populations with neurodevelopmental disorders.
Collapse
Affiliation(s)
- Joseph Palana
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA; Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Harvard Medical School, Boston Children's Hospital, 1 Autumn Street, Boston, MA, 02215, USA
| | - Sophie Schwartz
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
| | - Helen Tager-Flusberg
- Department of Psychological and Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA.
| |
Collapse
|
10
|
Sigrist ADAF, Oliveira ACB, Fichman HC. Patterns of instrumental activities of daily living between community-dwelling older adults. Dement Neuropsychol 2021; 15:366-372. [PMID: 34630925 PMCID: PMC8485636 DOI: 10.1590/1980-57642021dn15-030009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/10/2021] [Indexed: 11/22/2022] Open
Abstract
The ability to perform instrumental activities of daily living (IADLs) is an important marker within the aging process, as it reflects the level of independence to perform in the real world. However, there is a scarcity of studies that investigate the different performance profiles among older adults. Objective To investigate the heterogeneity present in the community of elderly people, grouping them based on characteristics and patterns observed through an objective performance-based assessment. Methods Participants were selected according to the following inclusion criteria: fluency in Portuguese, 360 years, regular participation in a social program offered by the government of Rio de Janeiro, and absence of a caregiver. The evaluation of IADLs was determined by the total and brief version of the University of California, San Diego Performance-Based Skills Assessment (UPSA) and the Lawton and Brody IADL scale. The Brief Cognitive Screening Battery and the Mini-Mental State Examination were used to characterize the sample, in addition to the Geriatric Depression Scale. A total of 61 elderly people with an average age of 72.5 years, predominantly females (85.2%), and average education of 11.2 were evaluated and grouped according to their performance at UPSA through clustering analysis. Results The analysis revealed three grouping patterns, subdividing the sample into subgroups that differed significantly in terms of age, education, global cognition, and all instrumental activities assessed by UPSA - planning, finance, communication, transportation, and household chores. Conclusions This study was able to identify the heterogeneity present between the elderly people in the different factors that compose the IADLs through a performance-based assessment.
Collapse
Affiliation(s)
| | | | - Helenice Charchat Fichman
- Psychology Department, Pontifícia Universidade Católica do Rio de Janeiro - Rio de Janeiro, RJ, Brazil
| |
Collapse
|
11
|
Bell KL, Lister JJ, Conter R, Harrison Bush AL, O'Brien J. Cognitive Event-Related Potential Responses Differentiate Older Adults with and without Probable Mild Cognitive Impairment. Exp Aging Res 2020; 47:145-164. [PMID: 33342371 DOI: 10.1080/0361073x.2020.1861838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Older adults rarely seek cognitive assessment, but often visit other healthcare professionals (e.g., audiologists). Noninvasive clinical measures within the scopes of practice of those professions sensitive to cognitive impairment are needed. Purpose: This study examined the differences of probable mild cognitive impairment (MCI) on latency and mean amplitude of the P3b auditory event-related potential. Method: Fifty-four participants comprised two groups according to cognitive status (cognitively normal older adults [CNOA], n = 25; probable MCI, n = 29). P3b was recorded using an oddball paradigm for speech (/ba/, /da/) and non-speech (1000, 2000 Hz) stimuli. Amplitudes and latencies were compared from six electrodes (FPz, Fz, FCz, Cz, CPz, Pz) between groups across stimulus probability and type. Results: CNOA participants had larger P3b mean amplitudes for deviant stimuli than those with probable MCI. Group effects of latency were isolated to deviant stimuli at FCz only when those with unclear P3bs were included. Findings did not covary with age or education. Overall, CNOAs showed a large P3b oddball effect while those with probable MCI did not. Conclusions: P3b can be used to show electrophysiological differences between older adults with and without probable MCI. These results support the development of educational materials targeting professionals using auditory-evoked potentials.
Collapse
Affiliation(s)
- Karen L Bell
- Department of Communication Sciences and Disorders, University of South Florida , Tampa, Florida, USA
| | - Jennifer Jones Lister
- Department of Communication Sciences and Disorders, University of South Florida , Tampa, Florida, USA
| | - Rachel Conter
- Department of Communication Sciences and Disorders, University of South Florida , Tampa, Florida, USA
| | - Aryn L Harrison Bush
- Department of Communication Sciences and Disorders, University of South Florida , Tampa, Florida, USA.,Department of Brain Health and Cognition, Reliance Medical Centers , Lakeland, Florida, USA
| | - Jennifer O'Brien
- Department of Psychology, University of South Florida , Tampa, Florida, USA
| |
Collapse
|
12
|
Sobral AIGDP, de Araújo CMT, Sobral MFF. Mild cognitive impairment in the elderly Relationship between communication and functional capacity. Dement Neuropsychol 2018; 12:165-172. [PMID: 29988360 PMCID: PMC6022979 DOI: 10.1590/1980-57642018dn12-020009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 04/10/2018] [Indexed: 11/21/2022] Open
Abstract
Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. OBJECTIVE To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. METHODS A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody's Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. RESULTS There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). CONCLUSION Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.
Collapse
|
13
|
Segkouli S, Paliokas I, Tzovaras D, Lazarou I, Karagiannidis C, Vlachos F, Tsolaki M. A computerized test for the assessment of mild cognitive impairment subtypes in sentence processing. AGING NEUROPSYCHOLOGY AND COGNITION 2017; 25:829-851. [PMID: 28914150 DOI: 10.1080/13825585.2017.1377679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study examines thesentence processing ability of mild cognitive impairment (MCI) subtypes. In addition to standard MCI neuropsychological tests, an experimental approach was applied to assess language. 133 people (93 MCI/40 controls) participated in novel computerized sentence processing tasks. Results presented statistically significant differences between MCI/controls andMCI subtypes (ANOVA):(a) duration F(2,92) = 19.259,p < .001) in sentence construction; (b) correct answers (F(2, 89) = 8.560,p < .001) and duration (F2,89) = 15.525,p < .001)in text comprehension; (c) correct answers (F(2, 92) = 8.975,p < .001) andduration (F(2, 92) = 4.360,p = .016) in metaphoric sentences comprehension; (d) correct answers (F(2, 92) = 12.836,p < .001) andduration (F(2, 92) = 10.974,p < .001) in verb form generation. Subtle changes in MCIsubtypes could affect sentence processing and provide useful information for cognitive decline risk estimation and screening purposes.
Collapse
Affiliation(s)
- Sofia Segkouli
- a Information Technologies Institute-ITI , Centre for Research and Technology Hellas-CERTH , Thessaloniki , Greece.,b Department of Special Education , University of Thessaly , Volos , Greece
| | - Ioannis Paliokas
- a Information Technologies Institute-ITI , Centre for Research and Technology Hellas-CERTH , Thessaloniki , Greece
| | - Dimitrios Tzovaras
- a Information Technologies Institute-ITI , Centre for Research and Technology Hellas-CERTH , Thessaloniki , Greece
| | - Ioulietta Lazarou
- a Information Technologies Institute-ITI , Centre for Research and Technology Hellas-CERTH , Thessaloniki , Greece.,c 3rd Department of Neurology, General Hospital "G. Papanikolaou", Medical School , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | | | - Filippos Vlachos
- b Department of Special Education , University of Thessaly , Volos , Greece
| | - Magda Tsolaki
- c 3rd Department of Neurology, General Hospital "G. Papanikolaou", Medical School , Aristotle University of Thessaloniki , Thessaloniki , Greece.,d Alzheimer's Day Care Unit "Saint John" , Greek Association of Alzheimer's Disease and Related Disorders , Thessaloniki , Greece
| |
Collapse
|
14
|
Mild Cognitive Impairment Is Characterized by Deficient Brainstem and Cortical Representations of Speech. J Neurosci 2017; 37:3610-3620. [PMID: 28270574 DOI: 10.1523/jneurosci.3700-16.2017] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 11/21/2022] Open
Abstract
Mild cognitive impairment (MCI) is recognized as a transitional phase in the progression toward more severe forms of dementia and is an early precursor to Alzheimer's disease. Previous neuroimaging studies reveal that MCI is associated with aberrant sensory-perceptual processing in cortical brain regions subserving auditory and language function. However, whether the pathophysiology of MCI extends to speech processing before conscious awareness (brainstem) is unknown. Using a novel electrophysiological approach, we recorded both brainstem and cortical speech-evoked brain event-related potentials (ERPs) in older, hearing-matched human listeners who did and did not present with subtle cognitive impairment revealed through behavioral neuropsychological testing. We found that MCI was associated with changes in neural speech processing characterized as hypersensitivity (larger) brainstem and cortical speech encoding in MCI compared with controls in the absence of any perceptual speech deficits. Group differences also interacted with age differentially across the auditory pathway; brainstem responses became larger and cortical ERPs smaller with advancing age. Multivariate classification revealed that dual brainstem-cortical speech activity correctly identified MCI listeners with 80% accuracy, suggesting its application as a biomarker of early cognitive decline. Brainstem responses were also a more robust predictor of individuals' MCI severity than cortical activity. Our findings suggest that MCI is associated with poorer encoding and transfer of speech signals between functional levels of the auditory system and advance the pathophysiological understanding of cognitive aging by identifying subcortical deficits in auditory sensory processing mere milliseconds (<10 ms) after sound onset and before the emergence of perceptual speech deficits.SIGNIFICANCE STATEMENT Mild cognitive impairment (MCI) is a precursor to dementia marked by declines in communication skills. Whether MCI pathophysiology extends below cerebral cortex to affect speech processing before conscious awareness (brainstem) is unknown. By recording neuroelectric brain activity to speech from brainstem and cortex, we show that MCI hypersensitizes the normal encoding of speech information across the hearing brain. Deficient neural responses to speech (particularly those generated from the brainstem) predicted the presence of MCI with high accuracy and before behavioral deficits. Our findings advance the neurological understanding of MCI by identifying a subcortical biomarker in auditory-sensory processing before conscious awareness, which may be a precursor to declines in speech understanding.
Collapse
|
15
|
Floyd JA. A descriptive study of effect-size reporting in research reviews. J Adv Nurs 2016; 73:1467-1481. [PMID: 27987305 DOI: 10.1111/jan.13234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/29/2022]
Abstract
AIM To describe effect-size reporting in research reviews completed in support of evidence-based practice in nursing. BACKGROUND Many research reviews report nurses' critical appraisal of level, quality and overall strength of evidence available to address clinical questions. Several studies of research-review quality suggest effect-size information would be useful to include in these reviews, but none focused on reviewers' attention to effect sizes. DESIGN Descriptive. METHODS One hundred and four reviews indexed in CINAHL as systematic reviews and published from July 2012-February 2014 were examined. Papers were required to be peer-reviewed, written in English, contain an abstract and have at least one nurse author. Reviews were excluded if they did not use critical appraisal methods to address evidence of correlation, prediction or effectiveness. Data from remaining papers (N = 73) were extracted by three or more independent coders using a structured coding form and detailed codebook. Data were stored, viewed and analysed using Microsoft Office Excel® spreadsheet functions. RESULTS Sixteen percent (n = 12) of the sample contained effect-size information. Of the 12, six included all the effect-size information recommended by APA guidelines. Independent of completeness of reporting, seven contained discussion of effect sizes in the paper, but none included effect-size information in abstracts. CONCLUSION Research reviews available to practicing nurses often fail to include information needed to accurately assess how much improvement may result from implementation of evidence-based policies, programs, protocols or practices. Manuscript reviewers are urged to hold authors to APA standards for reporting/discussing effect-size information in both primary research reports and research reviews.
Collapse
Affiliation(s)
- Judith A Floyd
- College of Nursing, Wayne State University, Ann Arbor, MI, USA
| |
Collapse
|