Validation study of the Italian version of Communication Activities of the Daily Living (CADL 2) as an ecologic cognitive assessment measure in older subjects

The relation between cognitive functioning and activities of daily living in normal aging, mild cognitive impairment, and dementia: a meta-analysis

Literature suggests that dementia and, more generally, cognitive impairment affect the capacity to carry out activities of daily living (ADL) in aging. However, it is important to decipher the weight of specific cognitive domains and neurodegenerative profiles mainly related to ADL difficulties. A meta-analysis was conducted to investigate the nature and strength of the association between cognitive functioning and ADL in healthy older adults, mild cognitive impairment (MCI), and dementia. A comprehensive search of the PubMed, PsycINFO (PROQUEST), and Scopus databases for cross-sectional or longitudinal studies up until December 2022. Our meta-analytic results revealed that: overall, instrumental ADL (IADL) showed a significant association with executive functioning, in particular, abstraction ability/concept formation, set-shifting, and processing speed/complex attention/working memory, regardless of type of participants (i.e., healthy older adults, MCI, and dementia); whereas ADL (both basic ADL, BADL, and IADL) significantly correlated with global cognitive functioning and long-term verbal memory, with a moderator effect of clinical condition (e.g., increasing ES based on the level of cognitive impairment). Moreover, visuospatial and language abilities significantly correlated with ADL, mainly when performance-based tasks were used for ADL assessment. These findings emphasize the importance of neuropsychological assessment in aging to early identify people most at risk of functional decline and shed light on the need to consider specific cognitive abilities in rehabilitation programs.

Does Executive Function Training Impact on Communication? A Randomized Controlled tDCS Study on Post-Stroke Aphasia

New approaches in aphasia rehabilitation have recently identified the crucial role of executive functions (EFs) in language recovery, especially for people with severe aphasia (PWSA). Indeed, EFs include high-order cognitive abilities such as planning and problem solving, which enable humans to adapt to novel situations and are essential for everyday functional communication. In a randomized double-blind crossover design, twenty chronic Italian PWSA underwent ten days of transcranial direct current stimulation (tDCS) (20 min, 2 mA) over the right dorsolateral prefrontal cortex (DLPFC). Two conditions were considered, i.e., anodal and sham, while performing four types of cognitive training (alertness, selective attention, visuo-spatial working memory, and planning), all of which were related to executive functions. After anodal tDCS, a greater improvement in selective attention, visuospatial working memory and planning abilities was found compared to the sham condition; this improvement persisted one month after the intervention. Importantly, a significant improvement was also observed in functional communication, as measured through the Communication Activities of Daily Living Scale, in noun and verb naming, in auditory and written language comprehension tasks and in executive function abilities. This evidence emphasizes, for the first time, that tDCS over the right DLPFC combined with executive training enhances functional communication in severe aphasia.

The Modified Five-Point Test (MFPT): normative data for a sample of Italian elderly

INTRODUCTION

Non-verbal figural fluency is related to executive functions and specifically to the ability to create as many unique designs as possible, while minimizing their repetitions. An Italian version of figural fluency is the Modified Five-Point Test (MFPT), which is highly employed in the clinical practice of neuropsychologists. To date, reference data of Italian population are limited to a sample aged between 16 and 60 years old. Thus, the current study aims to provide normative data of the MFPT in the context of a population-based setting, conducted in Southern Italy.

MATERIAL AND METHODS

We collected N = 340 Italian healthy subjects, aged over 65 years old (range: 65-91), pooled across subgroups for age, sex, and education. Multiple regression analyses were performed to estimate the effect of age, education, and sex on the participant's performance. Equivalent scores and cut-off scores were also defined for the number of unique designs (UDs) and the number of strategies (CSs).

RESULTS

Multiple regression analyses revealed that UDs increase with decreasing age and increasing educational level. CSs are influenced by higher educational levels but neither by age nor sex. A significant inverse correlation between the UDs and percentage of errors occurred, suggesting that a higher number of UDs are associated with a fewer number of errors and higher CSs employed.

CONCLUSION

The MFPT provides a measure of cognitive functioning in terms of the ability to initiate and realize designs, affording useful hints for clinical settings. The MFPT may represent a handy and useful tool with a specific focus in the differentiation of healthy versus pathological aging.