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McPherson R, Resnick B, Boltz M, Kuzmik A, Galik E, Kim N, Zhu S. The association between patient engagement and quality of care interactions among acute care patients with dementia. Geriatr Nurs 2024; 57:117-122. [PMID: 38640645 DOI: 10.1016/j.gerinurse.2024.04.002] [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: 01/25/2024] [Revised: 03/08/2024] [Accepted: 04/03/2024] [Indexed: 04/21/2024]
Abstract
Effective staff-patient communication is critical in acute care settings, particularly for patients with dementia. Limited work has examined the impact of quality of staff-patient care interactions on patient engagement. The purpose of this study was to determine whether the quality of staff-patient care interactions were associated with active patient engagement during the interaction after controlling for relevant covariates. The study was a secondary data analysis using baseline data from the Function Focused Care for Acute Care intervention study, with a total sample of 286 patients. Descriptive statistics and a generalized linear mixed model were used. The findings indicated that there was a significant relationship between the quality of care interactions and patient engagement such that receiving positive care interactions resulted in higher odds of active patient engagement. These findings can inform future interventions and training for acute care staff to improve quality of care interactions and patient engagement.
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Affiliation(s)
- Rachel McPherson
- University of Maryland, University of Maryland School of Nursing, Baltimore, USA.
| | - Barbara Resnick
- University of Maryland, University of Maryland School of Nursing, Baltimore, USA
| | - Marie Boltz
- Penn State University Ross and Carol Nese College of Nursing, USA
| | - Ashley Kuzmik
- Penn State University Ross and Carol Nese College of Nursing, USA
| | - Elizabeth Galik
- University of Maryland, University of Maryland School of Nursing, Baltimore, USA
| | - Nayeon Kim
- University of Maryland, University of Maryland School of Nursing, Baltimore, USA
| | - Shijun Zhu
- University of Maryland, University of Maryland School of Nursing, Baltimore, USA
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Chandrashekar P, Nagaraj H. Assessment of dementia knowledge in Indian speech-language pathology students. DEMENTIA 2024:14713012241231145. [PMID: 38300146 DOI: 10.1177/14713012241231145] [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: 02/02/2024]
Abstract
OBJECTIVES Speech-language pathologists (SLPs) have a crucial role in assisting individuals with dementia due to the communication and swallowing challenges associated with the disease. As the number of dementia cases rises in India at an increasing rate, investigating the level of dementia knowledge of SLP students can offer insight into the preparedness of the healthcare system to meet this emerging demand. METHOD A cross-sectional survey was conducted on SLP students pursuing their final year undergraduate, postgraduate and doctoral degrees from four universities across India. Dementia knowledge was assessed using the Dementia Knowledge Assessment Scale (DKAS) and information about previous dementia exposure (both formal and informal) was collected. The collected data were analysed using quantitative methods. RESULTS A total of 220 students (64.70% response rate) completed the survey. Overall dementia knowledge was inadequate with an average score of 22.08 ± 10.06. Previous dementia exposure among the students was also found to be low and did not affect dementia knowledge scores. DISCUSSION Despite the fundamental role SLPs play in the care of individuals with dementia, the lack of knowledge in this area emphasizes the need for enhancing dementia training programs through educational curricula and clinical placements.
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Affiliation(s)
- Pooja Chandrashekar
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, India
| | - Hema Nagaraj
- Department of Speech-Language Sciences, All India Institute of Speech and Hearing, India
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Ahn K, Cho M, Kim SW, Lee KE, Song Y, Yoo S, Jeon SY, Kim JL, Yoon DH, Kong HJ. Deep Learning of Speech Data for Early Detection of Alzheimer's Disease in the Elderly. Bioengineering (Basel) 2023; 10:1093. [PMID: 37760195 PMCID: PMC10525115 DOI: 10.3390/bioengineering10091093] [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: 06/04/2023] [Revised: 08/16/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common form of dementia, which makes the lives of patients and their families difficult for various reasons. Therefore, early detection of AD is crucial to alleviating the symptoms through medication and treatment. OBJECTIVE Given that AD strongly induces language disorders, this study aims to detect AD rapidly by analyzing the language characteristics. MATERIALS AND METHODS The mini-mental state examination for dementia screening (MMSE-DS), which is most commonly used in South Korean public health centers, is used to obtain negative answers based on the questionnaire. Among the acquired voices, significant questionnaires and answers are selected and converted into mel-frequency cepstral coefficient (MFCC)-based spectrogram images. After accumulating the significant answers, validated data augmentation was achieved using the Densenet121 model. Five deep learning models, Inception v3, VGG19, Xception, Resnet50, and Densenet121, were used to train and confirm the results. RESULTS Considering the amount of data, the results of the five-fold cross-validation are more significant than those of the hold-out method. Densenet121 exhibits a sensitivity of 0.9550, a specificity of 0.8333, and an accuracy of 0.9000 in a five-fold cross-validation to separate AD patients from the control group. CONCLUSIONS The potential for remote health care can be increased by simplifying the AD screening process. Furthermore, by facilitating remote health care, the proposed method can enhance the accessibility of AD screening and increase the rate of early AD detection.
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Affiliation(s)
- Kichan Ahn
- Interdisciplinary Program in Medical Informatics Major, Seoul National University College of Medicine, Seoul 03080, Republic of Korea;
| | - Minwoo Cho
- Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea;
- Medical Big Data Research Center, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.K.); (K.E.L.)
- Department of Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Suk Wha Kim
- Medical Big Data Research Center, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.K.); (K.E.L.)
- Department of Plastic Surgery and Institute of Aesthetic Medicine, CHA Bundang Medical Center, CHA University, Seongnam 13496, Republic of Korea
| | - Kyu Eun Lee
- Medical Big Data Research Center, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.K.); (K.E.L.)
- Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul 03080, Republic of Korea
| | - Yoojin Song
- Department of Psychiatry, Kangwon National University, Chuncheon 24289, Republic of Korea;
| | - Seok Yoo
- Unidocs Inc., Seoul 03080, Republic of Korea;
| | - So Yeon Jeon
- Department of Psychiatry, Chungnam National University Hospital, Daejeon 30530, Republic of Korea; (S.Y.J.); (J.L.K.)
| | - Jeong Lan Kim
- Department of Psychiatry, Chungnam National University Hospital, Daejeon 30530, Republic of Korea; (S.Y.J.); (J.L.K.)
- Department of Psychiatry, Chungnam National University College of Medicine, Daejeon 30530, Republic of Korea
| | - Dae Hyun Yoon
- Department of Psychiatry, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 03080, Republic of Korea;
| | - Hyoun-Joong Kong
- Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea;
- Medical Big Data Research Center, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; (S.W.K.); (K.E.L.)
- Department of Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
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McPherson R, Resnick B, Galik E, Gruber-Baldini AL, Holmes S, Kusmaul N. The Association Between Engagement in Activities of Daily Living and Care Interactions for Residents Living With Dementia. J Nurs Care Qual 2023; 38:E18-E24. [PMID: 36730953 PMCID: PMC9974542 DOI: 10.1097/ncq.0000000000000675] [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: 02/04/2023]
Abstract
BACKGROUND Care interactions are essential to residents with dementia. PURPOSE The purpose of the study was to describe the characteristics and quality of staff-resident care interactions among nursing home residents living with dementia and to test whether the quality of staff-resident care interactions varied by resident level of engagement in the interaction. Specifically, it was hypothesized that controlling for age, gender, comorbidities, cognition, and function, actively engaged residents would have more positive care interactions with staff compared with passively engaged residents. METHODS This was a secondary data analysis using baseline data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia intervention study. RESULTS A total of 532 residents were included. Actively engaged residents had significantly more positive interactions compared to passively engaged residents. CONCLUSIONS Passively engaged residents may be at risk to receive poor quality care interactions. Strategies and interventions to optimize care interactions for these individuals are needed.
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Affiliation(s)
- Rachel McPherson
- University of Maryland School of Nursing, Baltimore MD 21201, United States
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore MD 21201, United States
| | - Elizabeth Galik
- University of Maryland School of Nursing, Baltimore MD 21201, United States
| | - Ann L. Gruber-Baldini
- University of Maryland School of Medicine, Department of Epidemiology, Baltimore, MD 21201, United States
| | - Sarah Holmes
- University of Maryland School of Nursing, Baltimore MD 21201, United States
| | - Nancy Kusmaul
- University of Maryland Baltimore County, School of Social Work, Baltimore, MD 21250, United States
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Krein L, Jeon Y, Miller Amberber A, Fethney J. Communication support needs assessment in dementia (CoSNAT-D): An international content validation study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4745-e4757. [PMID: 35698803 PMCID: PMC10084166 DOI: 10.1111/hsc.13881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 06/01/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
The decline of language and communication abilities is common among people living with dementia and impacts on many areas of everyday life, including active participation in social activities and decision-making. Despite a growing body of supporting evidence for approaches that address language and communication decline in dementia, the concept of communication rehabilitation is largely neglected in this population. This paper reports on the content validation of a novel tool, the Communication Support Needs Assessment Tool for Dementia (CoSNAT-D). The tool has been developed to assist in the initial identification of communication difficulties and related support needs of people living with dementia. Importantly, the CoSNAT-D is the only available tool that takes a three-way informed approach, considering the view of the person living with dementia, their carer and an administering healthcare professional. Content validity was established between September and December 2018 using a modified Delphi approach. An international expert panel rated 32 items of a face-validated item pool regarding their importance and relevance through an iterative feedback process. Consensus was pre-determined at 70% of agreement for both importance and relevance of an item. Data were analysed using descriptive statistics and qualitative content analysis of comments provided in each round. Twenty-eight experts working in dementia, language and communication participated in the Delphi survey. Qualitative analysis resulted in the addition of five items, of which three reached the required consensus in Round 3. Consensus was established for 35/37 items in three rounds. The pilot version of the CoSNAT-D demonstrates adequate content validity and face validity. The use of the CoSNAT-D may assist a range of healthcare professionals in the decision-making process about appropriate next management steps, and thereby improve the care path for people with dementia and language and communication impairment. The establishment of further psychometric properties is warranted.
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Affiliation(s)
- Luisa Krein
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Yun‐Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Amanda Miller Amberber
- School of Community Health, Faculty of ScienceCharles Sturt UniversitySydneyNew South WalesAustralia
| | - Judith Fethney
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
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Gong X, Wong PCM, Fung HH, Mok VCT, Kwok TCY, Woo J, Wong KH, Meng H. The Hong Kong Grocery Shopping Dialog Task (HK-GSDT): A Quick Screening Test for Neurocognitive Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13302. [PMID: 36293882 PMCID: PMC9603616 DOI: 10.3390/ijerph192013302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/02/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The Hong Kong Grocery Shopping Dialog Task (HK-GSDT) is a short and easy-to-administer cognitive test developed for quickly screening neurocognitive disorders (NCDs). In the test, participants are instructed to do a hypothetical instrumental activity of daily living task of purchasing ingredients for a dish from a grocery store and verbally describe the specific shopping procedures. The current study aimed to validate the test with a sample of 545 Hong Kong older adults (58.8% female; aged 73.4 ± 8.37 years), including 464 adults with normal cognitive function, 39 with mild NCD, and 42 with major NCD. Demographic characteristics (i.e., sex, age, education) and clinical diagnosis of cognitive states (i.e., major NCD, mild NCD, and normal aging) were collected. Cognitive functioning was measured using the HK-GSDT and several standardized NCD-screening tests. The results showed good reliability (i.e., internal consistency) and structural validity in the HK-GSDT. It discriminated among different cognitive conditions, particularly between major NCDs and the other conditions, as effectively as did the existing standardized neurocognitive tests (e.g., Montreal Cognitive Assessment, Hong Kong List Learning Test). Moreover, the HK-GSDT explained additional variance of cognitive condition on top of those standardized neurocognitive tests. These results indicate that the HK-GSDT can be used alone, or in combination with other tests, to screen for NCDs.
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Affiliation(s)
- Xianmin Gong
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick C. M. Wong
- Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Hong Kong, China
- Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Helene H. Fung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Vincent C. T. Mok
- Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Gerald Choa Neuroscience Centre, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Timothy C. Y. Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - Jean Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- Jockey Club Institute of Aging, The Chinese University of Hong Kong, Hong Kong, China
| | - Ka Ho Wong
- Department of Systems Engineering and Engineering Management, The Chinese University of Hong Kong, Hong Kong, China
| | - Helen Meng
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, China
- Department of Systems Engineering and Engineering Management, The Chinese University of Hong Kong, Hong Kong, China
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Identifying neurocognitive disorder using vector representation of free conversation. Sci Rep 2022; 12:12461. [PMID: 35922457 PMCID: PMC9349220 DOI: 10.1038/s41598-022-16204-4] [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: 12/18/2021] [Accepted: 07/06/2022] [Indexed: 11/17/2022] Open
Abstract
In recent years, studies on the use of natural language processing (NLP) approaches to identify dementia have been reported. Most of these studies used picture description tasks or other similar tasks to encourage spontaneous speech, but the use of free conversation without requiring a task might be easier to perform in a clinical setting. Moreover, free conversation is unlikely to induce a learning effect. Therefore, the purpose of this study was to develop a machine learning model to discriminate subjects with and without dementia by extracting features from unstructured free conversation data using NLP. We recruited patients who visited a specialized outpatient clinic for dementia and healthy volunteers. Participants’ conversation was transcribed and the text data was decomposed from natural sentences into morphemes by performing a morphological analysis using NLP, and then converted into real-valued vectors that were used as features for machine learning. A total of 432 datasets were used, and the resulting machine learning model classified the data for dementia and non-dementia subjects with an accuracy of 0.900, sensitivity of 0.881, and a specificity of 0.916. Using sentence vector information, it was possible to develop a machine-learning algorithm capable of discriminating dementia from non-dementia subjects with a high accuracy based on free conversation.
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8
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Vivas L, Manoiloff L, Linares N, Fernández Zaionz A, Montero L. Argentinean Psycholinguistic Picture Naming Test in color. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:527-535. [PMID: 32584150 DOI: 10.1080/23279095.2020.1780238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Color has demonstrated to have an influence on picture naming tasks. Objects with high color diagnosticity are recalled faster than objects with low value. That is why the Argentinean Psycholinguistic Picture Naming Test in color (PAPDIC in Spanish) was designed. The items and semantic cues were built considering local psycholinguistic norms. A series of psychometric analyses were performed on a sample of patients with focal brain damage with (n = 11) and without (n = 14) aphasia, a sample of patients with degenerative disease (n = 46) and two samples of healthy participants (young n = 27, old n = 50). Evidence of convergent validity was obtained through the correlation with the brief Boston Naming Test (r = 0.871; p < .001); of criteria validity by means of contrasted groups analysis (t = 4.059, p < .001), and through the ROC curve analysis (AUC = 0.993). Scores' reliability was explored by means of an internal consistency analysis (KR20 = 0.905). These results indicate that the PAPDIC is a promising color naming test which can be applied in the field of clinical neuropsychology to identify anomia. This test has several advantages in comparison with the available naming tests in Argentina.
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Affiliation(s)
- Leticia Vivas
- Basic and Applied Psychology and Technology Institute, National University of Mar del Plata, CONICET, Mar del Plata, Argentina
| | - Laura Manoiloff
- Equipo de Investigación de Psicología Cognitiva del Lenguaje y Psicolingüística. Centro de Investigación de la Facultad de Psicología (CIPsi), Universidad Nacional de Córdoba, Córdoba, Argentina
- Instituto Privado de Neurociencias Córdoba, Córdoba, Argentina
| | - Nicolás Linares
- Hospital Interzonal General de Agudos, Oscar Alende, Mar del Plata, Argentina
| | - Axel Fernández Zaionz
- Basic and Applied Psychology and Technology Institute, National University of Mar del Plata, CONICET, Mar del Plata, Argentina
| | - Lucía Montero
- Instituto Privado de Neurociencias Córdoba, Córdoba, Argentina
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
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9
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Communication, Feeding and Swallowing Disorders in Neurological Diseases. Behav Neurol 2022; 2022:9851424. [PMID: 35496769 PMCID: PMC9050309 DOI: 10.1155/2022/9851424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
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Garcia-Cifuentes E, Botero-Rodríguez F, Ramirez Velandia F, Iragorri A, Marquez I, Gelvis-Ortiz G, Acosta MF, Jaramillo-Jimenez A, Lopera F, Cano-Gutiérrez CA. Muscular Function as an Alternative to Identify Cognitive Impairment: A Secondary Analysis From SABE Colombia. Front Neurol 2022; 13:695253. [PMID: 35250796 PMCID: PMC8896314 DOI: 10.3389/fneur.2022.695253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 01/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background Identification of cognitive impairment is based traditionally on the neuropsychological tests and biomarkers that are not available widely. This study aimed to establish the association between motor function (gait speed and handgrip strength) and cognitive performance in the Mini-Mental State Examination, globally and by domains. A secondary goal was calculating a cut-off point for gait speed and handgrip strength to classify older adults as cognitively impaired. Methods This is a secondary analysis of SABE Colombia (Salud, Bienestar & Envejecimiento), a survey that was conducted in 2015 on health, wellbeing, and aging in Colombia. This study used linear regression models to search for an association between motor function and cognitive performance. The accuracy of motor function measurements in identifying cognitive impairment was assessed with receiver operating characteristic (ROC) curves. This study also analyzed other clinical and sociodemographical variables. Results Gait speed was associated with orientation (r2 = 0.16), language (r2 = 0.15), recall memory (r2 = 0.14), and counting (r2 = 0.08). Similarly, handgrip strength was associated with orientation (r2 = 0.175), language (r2 = 0.164), recall memory (r2 = 0.137), and counting (r2 = 0.08). To differentiate older adults with and without cognitive impairment, a gait speed cut-off point of 0.59 m/s had an area under the curve (AUC) of 0.629 (0.613–0.646), and a weak handgrip (strength below 17.5 kg) had an AUC of 0.653 (0.645-0.661). The cut-off points for handgrip strength and gait speed were significantly higher in male participants. Conclusions Gait speed and handgrip strength are similarly associated with the cognitive performance, exhibiting the most extensive association with orientation and language domains of the Mini-Mental State Examination. Gait speed and handgrip strength can easily be measured by any clinician, and they prove to be useful screening tools to detect cognitive impairment.
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Affiliation(s)
- Elkin Garcia-Cifuentes
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
- Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia
- *Correspondence: Elkin Garcia-Cifuentes
| | - Felipe Botero-Rodríguez
- Departamento de Epidemiologia Clínica y Bioestadística, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Felipe Ramirez Velandia
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Angela Iragorri
- Unidad de Neurología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Isabel Marquez
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Geronimo Gelvis-Ortiz
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - María-Fernanda Acosta
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Alberto Jaramillo-Jimenez
- Facultad de Medicina, Grupo Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Facultad de Medicina, Grupo Neuropsicología y Conducta, Universidad de Antioquia, Medellín, Colombia
- Facultad de Medicina, Semillero de Investigación SINAPSIS, Universidad de Antioquia, Medellín, Colombia
| | - Francisco Lopera
- Facultad de Medicina, Grupo Neurociencias de Antioquia, Universidad de Antioquia, Medellín, Colombia
| | - Carlos Alberto Cano-Gutiérrez
- Facultad de Medicina, Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Pontificia Universidad Javeriana, Bogotá, Colombia
- Unidad de Geriatría, Hospital Universitario San Ignacio, Bogotá, Colombia
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11
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Wasef S, Laksono I, Kapoor P, Tang-Wei D, Gold D, Saripella A, Riazi S, Islam S, Englesakis M, Wong J, Chung F. Screening for subjective cognitive decline in the elderly via subjective cognitive complaints and informant-reported questionnaires: a systematic review. BMC Anesthesiol 2021; 21:277. [PMID: 34753428 PMCID: PMC8579566 DOI: 10.1186/s12871-021-01493-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/28/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Subjective cognitive decline may represent at-risk persons progressing to mild cognitive impairment (MCI), which can be exacerbated by effects of anesthesia and surgery. The objective of this systematic review is to identify the most common questions in subjective cognitive complaint and informant-reported questionnaires used in assessing cognitive impairment of elderly patients that are correlated with standardized tests for cognitive impairment screening. METHODS We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database, Emcare Nursing, Web of Science, Scopus, CINAHL, ClinicalTrials.Gov, and ICTRP between September 20, 2005 to August 31, 2020. We included studies that evaluated subjective cognitive complaints and informant-reported questions in elderly patients. RESULTS AND CONCLUSION A total of 28,407 patients were included from 22 studies that assessed 21 subjective complaint questionnaires and nine informant-reported questionnaires. The most common subjective cognitive complaints were those assessing anterograde memory, closely followed by perceptual-motor function and executive function. The most common informant-reported questions were those assessing executive function, temporal orientation, and anterograde memory. Questions assessing learning and memory were most associated with results from standardized tests assessing cognitive impairment. Assessing learning and memory plays a key role in evaluating subjective cognitive decline in elderly patients. Delivering subjective cognitive complaints questions to elderly patient preoperatively may aid in screening for those exhibiting cognitive signs, and in turn are at risk of postoperative complications. Thus, the results from this review contribute to knowledge for healthcare professionals regarding the use of subjective cognitive complaints and informant-reported complaints in preoperative settings.
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Affiliation(s)
- Sara Wasef
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Isabelle Laksono
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Paras Kapoor
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - David Tang-Wei
- Department of Neurology, University Health Network, University of Toronto, Toronto, ON, Canada
| | - David Gold
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Aparna Saripella
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Sheila Riazi
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Sazzadul Islam
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Marina Englesakis
- Library & Information Services, University Health Network, Toronto, ON, Canada
| | - Jean Wong
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Women's College Hospital, University of Toronto, Toronto, ON, Canada
| | - Frances Chung
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
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12
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Oh C, Morris RJ, Wang X. A Systematic Review of Expressive and Receptive Prosody in People With Dementia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3803-3825. [PMID: 34529922 DOI: 10.1044/2021_jslhr-21-00013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This review was designed to provide a systematic overview of prosody in people with a primary diagnosis of dementia (PwD) and evaluate the potential use of prosodic features for diagnosis of dementia. Method A systematic search of five databases was conducted using Medical Subject Headings and keywords. Studies included in the review were evaluated for their methodological quality using the modified Joanna Briggs Institute checklist. Results A total of 14 articles were identified as being relevant for this review. Among the 14 articles, the methodological quality ranged, with eight rated as weak, four rated as moderate, and two rated as strong. Ten of the 14 articles had people with Alzheimer's disease (AD) as participants, and the remaining four had people with frontotemporal dementia as participants. Four articles focused on receptive prosody, another six focused on expressive prosody, and the remaining four articles were investigations into both. The 14 articles presented inconsistent findings, and various tasks were used to measure prosodic features in PwD in the articles. Prosody was studied as a diagnostic tool for dementia in four of the articles, all of which were based on expressive prosody in individuals with AD. Among the four articles, three proposed the use of automatic speech analysis for diagnosis of AD. Conclusions This review demonstrates that prosody in PwD is an underinvestigated area. In particular, it was concerning that most articles were of weak methodological quality. Nevertheless, it was found that prosody may be a potential diagnostic tool for assessing dementia. More studies that replicate the existing studies and those with stronger methodology are needed to confirm that receptive and/or expressive prosody can be used for dementia diagnosis.
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Affiliation(s)
- Chorong Oh
- School of Rehabilitation and Communication Sciences, Ohio University, Athens
| | - Richard J Morris
- School of Communication Science & Disorders, Florida State University, Tallahassee
| | - Xianhui Wang
- School of Rehabilitation and Communication Sciences, Ohio University, Athens
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13
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Paek EJ, Murray LL, Newman SD. Effects of concurrent action and object naming treatment on naming skills and functional brain activation patterns in primary progressive aphasia: An fMRI study with a case-series design. BRAIN AND LANGUAGE 2021; 218:104950. [PMID: 33836414 DOI: 10.1016/j.bandl.2021.104950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 11/18/2020] [Accepted: 03/28/2021] [Indexed: 06/12/2023]
Abstract
Individuals with primary progressive aphasia (PPA) exhibit differential impairment patterns in noun and verb naming, but it remains unclear whether anomia treatment results in similar improvements in noun and verb naming. Therefore, we examined the immediate and long-term (3-months post-treatment) behavioral and neural effects of an anomia treatment on object and action naming skills in PPA. A case-series design was utilized involving two individuals with PPA. Object and action words were trained concurrently and probed regularly using word lists matched on a number of lexical characteristics. One participant showed improvements in all word categories with different effect sizes whereas the other participant demonstrated improved naming only on trained object words. Treatment-induced fMRI changes were found in both hemispheres, with distinct patterns observed across participants. Further research is needed to better understand the effects of residual language and cognitive skills on behavioral and neurophysiological outcomes following anomia treatment for PPA.
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Affiliation(s)
- Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville, TN 37996, United States.
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, London, Ontario N6G 1H1, Canada.
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47401, United States; Department of Psychology, University of Alabama, Tuscaloosa, AL 35487, United States.
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14
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Martinc M, Haider F, Pollak S, Luz S. Temporal Integration of Text Transcripts and Acoustic Features for Alzheimer's Diagnosis Based on Spontaneous Speech. Front Aging Neurosci 2021; 13:642647. [PMID: 34194313 PMCID: PMC8236853 DOI: 10.3389/fnagi.2021.642647] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/11/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Advances in machine learning (ML) technology have opened new avenues for detection and monitoring of cognitive decline. In this study, a multimodal approach to Alzheimer's dementia detection based on the patient's spontaneous speech is presented. This approach was tested on a standard, publicly available Alzheimer's speech dataset for comparability. The data comprise voice samples from 156 participants (1:1 ratio of Alzheimer's to control), matched by age and gender. Materials and Methods: A recently developed Active Data Representation (ADR) technique for voice processing was employed as a framework for fusion of acoustic and textual features at sentence and word level. Temporal aspects of textual features were investigated in conjunction with acoustic features in order to shed light on the temporal interplay between paralinguistic (acoustic) and linguistic (textual) aspects of Alzheimer's speech. Combinations between several configurations of ADR features and more traditional bag-of-n-grams approaches were used in an ensemble of classifiers built and evaluated on a standardised dataset containing recorded speech of scene descriptions and textual transcripts. Results: Employing only semantic bag-of-n-grams features, an accuracy of 89.58% was achieved in distinguishing between Alzheimer's patients and healthy controls. Adding temporal and structural information by combining bag-of-n-grams features with ADR audio/textual features, the accuracy could be improved to 91.67% on the test set. An accuracy of 93.75% was achieved through late fusion of the three best feature configurations, which corresponds to a 4.7% improvement over the best result reported in the literature for this dataset. Conclusion: The proposed combination of ADR audio and textual features is capable of successfully modelling temporal aspects of the data. The machine learning approach toward dementia detection achieves best performance when ADR features are combined with strong semantic bag-of-n-grams features. This combination leads to state-of-the-art performance on the AD classification task.
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Affiliation(s)
- Matej Martinc
- Department of Knowledge Technologies, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Fasih Haider
- Usher Institute, Edinburgh Medical School, The University of Edinburgh, Edinburgh, United Kingdom
| | - Senja Pollak
- Department of Knowledge Technologies, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Saturnino Luz
- Usher Institute, Edinburgh Medical School, The University of Edinburgh, Edinburgh, United Kingdom
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15
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Fathy YY, Hoogers SE, Berendse HW, van der Werf YD, Visser PJ, de Jong FJ, van de Berg WDJ. Differential insular cortex sub-regional atrophy in neurodegenerative diseases: a systematic review and meta-analysis. Brain Imaging Behav 2021; 14:2799-2816. [PMID: 31011951 PMCID: PMC7648006 DOI: 10.1007/s11682-019-00099-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The insular cortex is proposed to function as a central brain hub characterized by wide-spread connections and diverse functional roles. As a result, its centrality in the brain confers high metabolic demands predisposing it to dysfunction in disease. However, the functional profile and vulnerability to degeneration varies across the insular sub-regions. The aim of this systematic review and meta-analysis is to summarize and quantitatively analyze the relationship between insular cortex sub-regional atrophy, studied by voxel based morphometry, with cognitive and neuropsychiatric deficits in frontotemporal dementia (FTD), Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB). We systematically searched through Pubmed and Embase and identified 519 studies that fit our criteria. A total of 41 studies (n = 2261 subjects) fulfilled the inclusion criteria for the meta-analysis. The peak insular coordinates were pooled and analyzed using Anatomic Likelihood Estimation. Our results showed greater left anterior insular cortex atrophy in FTD whereas the right anterior dorsal insular cortex showed larger clusters of atrophy in AD and PD/DLB. Yet contrast analyses did not reveal significant differences between disease groups. Functional analysis showed that left anterior insular cortex atrophy is associated with speech, emotion, and affective-cognitive deficits, and right dorsal atrophy with perception and cognitive deficits. In conclusion, insular sub-regional atrophy, particularly the anterior dorsal region, may contribute to cognitive and neuropsychiatric deficits in neurodegeneration. Our results support anterior insular cortex vulnerability and convey the differential involvement of the insular sub-regions in functional deficits in neurodegenerative diseases.
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Affiliation(s)
- Yasmine Y Fathy
- Department of Anatomy and Neurosciences, Section Clinical Neuroanatomy and Biobanking, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, Netherlands.
| | - Susanne E Hoogers
- Department of Neurology, Erasmus Medical Center, Postbus, 2040 3000, Rotterdam, CA, Netherlands
| | - Henk W Berendse
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HZ, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, Section Neuropsychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, The Netherlands
| | - Pieter J Visser
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HZ, Amsterdam, The Netherlands.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
| | - Frank J de Jong
- Department of Neurology, Erasmus Medical Center, Postbus, 2040 3000, Rotterdam, CA, Netherlands
| | - Wilma D J van de Berg
- Department of Anatomy and Neurosciences, Section Clinical Neuroanatomy and Biobanking, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1108, 1081 HZ, Amsterdam, Netherlands
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16
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Wisler AA, Fletcher AR, McAuliffe MJ. Predicting Montreal Cognitive Assessment Scores From Measures of Speech and Language. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1752-1761. [PMID: 32459131 DOI: 10.1044/2020_jslhr-19-00183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This study examined the relationship between measurements derived from spontaneous speech and participants' scores on the Montreal Cognitive Assessment. Method Participants (N = 521) aged between 64 and 97 years completed the cognitive assessment and were prompted to describe an early childhood memory. A range of acoustic and linguistic measures was extracted from the resulting speech sample. A least absolute shrinkage and selection operator approach was used to model the relationship between acoustic, lexical, and demographic information and participants' scores on the cognitive assessment. Results Using the covariance test statistic, four important variables were identified, which, together, explained 16.52% of the variance in participants' cognitive scores. Conclusions The degree to which cognition can be accurately predicted through spontaneously produced speech samples is limited. Statistically significant relationships were found between specific measurements of lexical variation, participants' speaking rate, and their scores on the Montreal Cognitive Assessment.
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Affiliation(s)
- Alan A Wisler
- New Zealand Institute of Language, Brain and Behaviour, Christchurch, New Zealand
| | - Annalise R Fletcher
- Department of Audiology and Speech-Language Pathology, University of North Texas, Denton
| | - Megan J McAuliffe
- Department of Communication Disorders, University of Canterbury, Christchurch, New Zealand
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17
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Chiou R, Lambon Ralph MA. Unveiling the dynamic interplay between the hub- and spoke-components of the brain's semantic system and its impact on human behaviour. Neuroimage 2019; 199:114-126. [PMID: 31132452 PMCID: PMC6693526 DOI: 10.1016/j.neuroimage.2019.05.059] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/26/2019] [Accepted: 05/23/2019] [Indexed: 01/05/2023] Open
Abstract
The neural architecture of semantic knowledge comprises two key structures: (i) A set of widely dispersed regions, located adjacent to the sensorimotor cortices, serve as spokes that represent various modality-specific and context-dependent contents. (ii) The anterior-temporal lobe (ATL) serves as a hub that computes the nonlinear mappings required to transform modality-specific information into pan-modality, multifaceted concepts. Little is understood regarding whether neural dynamics between the hub and spokes might flexibly alter depending on the nature of a concept and how it impinges upon behaviour. Using fMRI, we demonstrate for the first time that the ATL serves as a 'pivot' which dynamically forms flexible long-range networks with cortical modules specialised for different domains (in the present case, the knowledge about actions and places). In two experiments, we manipulated semantic congruity and asked participants to recognise visually presented items. In Experiment 1 (dual-object displays), the ATL increased its functional coupling with the bilateral frontoparietal action-sensitive system when the objects formed a pair that permitted semantically meaningful action. In Experiment 2 (objects embedded in a scene), the ATL augmented its coupling with the retrosplenial cortex of the place-sensitive system when the objects and scene formed a semantically coherent ensemble. Causative connectivity revealed that, while communication between the hub and spokes was bidirectional, the hub's directional impact on spokes dwarfed the strength of the inverse spoke-to-hub connectivity. Furthermore, the size of behavioural congruity effects co-varied with the strength of neural coupling between the ATL hub and action- / place-related spokes, evident both at the within-individual level (the behavioural fluctuation across scanning runs) and between-individual level (the behavioural variation of between participants). Together, these findings have important implications for understanding the machinery that links neural dynamics with semantic cognition.
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Affiliation(s)
- Rocco Chiou
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK.
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18
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Troche J, Willis A, Whiteside J. Exploring supported conversation with familial caregivers of persons with dementia: a pilot study. Pilot Feasibility Stud 2019; 5:10. [PMID: 30680224 PMCID: PMC6337868 DOI: 10.1186/s40814-019-0398-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background Dementia can lead to difficulties in communication between caregivers and patients. Teaching conversational strategies has been effective for a wide array of clients with acquired neurologic disorders and their caregivers. Research indicates positive results for Supported Conversation for adults with Aphasia (SCA) secondary to stroke. Applying this method to work with caregivers of individuals with dementia could prove to be a valid intervention tool. This investigation examined the applicability of SCA with individuals with dementia and their familial caregivers. Method Four dyads (caregiver and individual with dementia) participated in the SCA program with some adaptation for dementia. The program was 4 weeks with a pre-training and post training assessment. The Measure of Skill in Supported Conversation (MSC) and Measure of Level of Participation in Conversation (MPC) were given to measure the overall effectiveness of SCA at teaching and improving communication, respectively. A qualitative analysis of unproductive coping mechanisms also occurred. The Zarit Burden Interview (ZBI) was given to gauge caregiver burden from pre- to post-training. Results MSC and MPC scores were significantly improved from baseline to post training, and a significant reduction in unproductive coping behaviors also occured. ZBI scores were variable across participants. Conclusions Results suggest that the SCA has the potential to be used to improve communication between persons with dementia and their caregivers. Findings suggest that further research is warranted into the effectiveness of SCA in dementia. Trial registration Retrospectively registered 9/5/2018 ISRCTN17622451.
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Affiliation(s)
- Joshua Troche
- 1School of Communication Sciences and Disorders, University of Central Florida, P.O. Box 162215, Orlando, FL 32816 USA
| | - Arielle Willis
- 2Department of Communication Sciences and Disorders, Baylor University, Waco, TX USA
| | - Janet Whiteside
- 1School of Communication Sciences and Disorders, University of Central Florida, P.O. Box 162215, Orlando, FL 32816 USA
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19
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Pantsiou K, Sfakianaki O, Papaliagkas V, Savvoulidou D, Costa V, Papantoniou G, Moraitou D. Inhibitory Control, Task/Rule Switching, and Cognitive Planning in Vascular Dementia: Are There Any Differences From Vascular Aging? Front Aging Neurosci 2018; 10:330. [PMID: 30410439 PMCID: PMC6211074 DOI: 10.3389/fnagi.2018.00330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 09/28/2018] [Indexed: 01/06/2023] Open
Abstract
Recent studies have shown that patients diagnosed with Vascular Dementia (VaD) exhibit deficits in executive functions. According to “vascular hypothesis of cognitive aging,” community-dwelling older adults having risk factors for vascular disease development (RVD) may suffer from cognitive decline of the same type. The aim of the study was to assess the level of specific executive functions (EF) that have been revealed as most affected by vascular abnormalities, in older adults with incipient VaD and RVD. Subsequently specific ways of EF measuring could be suggested for more accurate diagnosis of early stage VaD. The study compared three adult groups (N = 60): (a) patients diagnosed with incipient VaD, according to DSM-5 criteria (n = 20); (b) community-dwelling older adults presenting cardiovascular risk factors (RVD; n = 20); (c) healthy young adult controls (n = 20). Three types of executive functions were examined: inhibitory control, cognitive flexibility as rule/task switching, and planning. The following D-KEFS subtests were administered for their evaluation: The ‘Color-Word Interference Test,’ the ‘Verbal Fluency Test,’ and the ‘Tower Test.’ Mixed-measures ANOVA, MANOVA, and one-way ANOVA as well as Scheffe post hoc test were applied to the data of the scores in each condition of each test. The results showed that VaD patients had significantly lower performance in test conditions requiring switching and planning, compared to RVD group and young controls. The specific deficits of VaD patients, compared to older adults presenting RVD according to multiple-group path analyses were: more uncorrected errors in inhibition, the use of semantic knowledge primarily instead of switching ability to switch between semantic categories, as well as a lower level of movement precision in planning.
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Affiliation(s)
- Krystallia Pantsiou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ourania Sfakianaki
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Laboratory of Clinical Neurophysiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitra Savvoulidou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassiliki Costa
- 1st Neurology Department, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Papantoniou
- Department of Early Childhood Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Despina Moraitou
- Lab of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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20
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Garcia PS, Rothman DL, Fitzpatrick SM. Waking Up to a New Model for Studying Neural Systems: What Emergence from Unconscious States Can Reveal about Brain Organization. Front Syst Neurosci 2017; 11:78. [PMID: 29089871 PMCID: PMC5651010 DOI: 10.3389/fnsys.2017.00078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/03/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Paul S Garcia
- Department of Anesthesiology, Emory University, Atlanta, GA, United States.,Anesthesiology and Research Divisions, Atlanta VA Medical Center, Atlanta, GA, United States
| | - Douglas L Rothman
- Department of Biomedical Engineering, Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States
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21
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Swinnen A, de Medeiros K. Participatory arts programs in residential dementia care: Playing with language differences. DEMENTIA 2017; 17:763-774. [PMID: 28905649 PMCID: PMC6068962 DOI: 10.1177/1471301217729985] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article examines connections between language, identity, and cultural difference in the context of participatory arts in residential dementia care. Specifically, it looks at how language differences become instruments for the language play that characterizes the participatory arts programs, TimeSlips and the Alzheimer’s Poetry Project. These are two approaches that are predominantly spoken-word driven. Although people living with dementia experience cognitive decline that affects language, they are linguistic agents capable of participating in ongoing negotiation processes of connection, belonging, and in- and exclusion through language use. The analysis of two ethnographic vignettes, based on extensive fieldwork in the closed wards of two Dutch nursing homes, illustrates how TimeSlips and the Alzheimer’s Poetry Project support them in this agency. The theoretical framework of the analysis consists of literature on the linguistic agency of people living with dementia, the notions of the homo ludens (or man the player) and ludic language, as well as linguistic strategies of belonging in relation to place.
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Affiliation(s)
- Aagje Swinnen
- Maastricht University, the Netherlands; University of Humanistic Studies, the Netherlands
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22
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Oswald F, Klöble P, Ruland A, Rosenkranz D, Hinz B, Butter F, Ramljak S, Zechner U, Herlyn H. The FOXP2-Driven Network in Developmental Disorders and Neurodegeneration. Front Cell Neurosci 2017; 11:212. [PMID: 28798667 PMCID: PMC5526973 DOI: 10.3389/fncel.2017.00212] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/04/2017] [Indexed: 12/24/2022] Open
Abstract
The transcription repressor FOXP2 is a crucial player in nervous system evolution and development of humans and songbirds. In order to provide an additional insight into its functional role we compared target gene expression levels between human neuroblastoma cells (SH-SY5Y) stably overexpressing FOXP2 cDNA of either humans or the common chimpanzee, Rhesus monkey, and marmoset, respectively. RNA-seq led to identification of 27 genes with differential regulation under the control of human FOXP2, which were previously reported to have FOXP2-driven and/or songbird song-related expression regulation. RT-qPCR and Western blotting indicated differential regulation of additional 13 new target genes in response to overexpression of human FOXP2. These genes may be directly regulated by FOXP2 considering numerous matches of established FOXP2-binding motifs as well as publicly available FOXP2-ChIP-seq reads within their putative promoters. Ontology analysis of the new and reproduced targets, along with their interactors in a network, revealed an enrichment of terms relating to cellular signaling and communication, metabolism and catabolism, cellular migration and differentiation, and expression regulation. Notably, terms including the words "neuron" or "axonogenesis" were also enriched. Complementary literature screening uncovered many connections to human developmental (autism spectrum disease, schizophrenia, Down syndrome, agenesis of corpus callosum, trismus-pseudocamptodactyly, ankyloglossia, facial dysmorphology) and neurodegenerative diseases and disorders (Alzheimer's, Parkinson's, and Huntington's diseases, Lewy body dementia, amyotrophic lateral sclerosis). Links to deafness and dyslexia were detected, too. Such relations existed for single proteins (e.g., DCDC2, NURR1, PHOX2B, MYH8, and MYH13) and groups of proteins which conjointly function in mRNA processing, ribosomal recruitment, cell-cell adhesion (e.g., CDH4), cytoskeleton organization, neuro-inflammation, and processing of amyloid precursor protein. Conspicuously, many links pointed to an involvement of the FOXP2-driven network in JAK/STAT signaling and the regulation of the ezrin-radixin-moesin complex. Altogether, the applied phylogenetic perspective substantiated FOXP2's importance for nervous system development, maintenance, and functioning. However, the study also disclosed new regulatory pathways that might prove to be useful for understanding the molecular background of the aforementioned developmental disorders and neurodegenerative diseases.
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Affiliation(s)
- Franz Oswald
- Center for Internal Medicine, Department of Internal Medicine I, University Medical Center UlmUlm, Germany
| | - Patricia Klöble
- Center for Internal Medicine, Department of Internal Medicine I, University Medical Center UlmUlm, Germany
| | - André Ruland
- Center for Internal Medicine, Department of Internal Medicine I, University Medical Center UlmUlm, Germany
| | - David Rosenkranz
- Institut für Organismische und Molekulare Evolutionsbiologie, Johannes Gutenberg-University MainzMainz, Germany
| | - Bastian Hinz
- Institut für Organismische und Molekulare Evolutionsbiologie, Johannes Gutenberg-University MainzMainz, Germany
- Institute of Human Genetics, University Medical Center MainzMainz, Germany
| | - Falk Butter
- Institute of Molecular BiologyMainz, Germany
| | | | - Ulrich Zechner
- Institute of Human Genetics, University Medical Center MainzMainz, Germany
- Dr. Senckenbergisches Zentrum für HumangenetikFrankfurt, Germany
| | - Holger Herlyn
- Institut für Organismische und Molekulare Evolutionsbiologie, Johannes Gutenberg-University MainzMainz, Germany
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23
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The impact of cognitive impairment on self-management in chronic obstructive pulmonary disease: A systematic review. Respir Med 2017; 129:130-139. [PMID: 28732820 DOI: 10.1016/j.rmed.2017.06.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 06/10/2017] [Accepted: 06/12/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine the characteristics of persons with cognitive impairment being able to self-manage in chronic obstructive pulmonary disease (COPD). METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance this systematic review examined all studies in English from 1st January 2000 to 20 February 2016, describing the relationship between cognition and COPD self-management domains in older community dwelling persons with dementia or cognitive impairment. RESULTS Of 4474 studies identified, thirteen studies were eligible for inclusion. No studies differentiated populations into recognized dementia subtypes. Study aims were variable; most (n = 7) examined inhaler competency alone. Studies identified a link between worsening cognition and the need for assistance in activities of daily living. Only one study evaluated the impact of cognition on overall self-management and found no association between cognitive impairment and self-rated self-management. Mild degrees of cognitive impairment were associated with reduced symptom recall. Cognitive impairment in COPD was associated with high degrees of inhaler incompetency. Basic cognitive screening tests were able to predict inhaler incompetence with reduced overall cognitive function, dyspraxia, and/or executive function identified as predictors of incompetency. CONCLUSIONS Multiple measures of disability consistently demonstrated that cognitive impairment in COPD significantly increased the need for assistance in many aspects of daily living, treatment adherence, and effective self-management. Given the nature of neuropsychological deficits seen in COPD, dedicated screening tools are required. Future research should investigate the impact of cognitive dysfunction in COPD and identify how to support those that lack capacity to self-manage.
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24
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Hung J, Bauer A, Grossman M, Hamilton RH, Coslett HB, Reilly J. Semantic Feature Training in Combination with Transcranial Direct Current Stimulation (tDCS) for Progressive Anomia. Front Hum Neurosci 2017; 11:253. [PMID: 28559805 PMCID: PMC5432627 DOI: 10.3389/fnhum.2017.00253] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 04/27/2017] [Indexed: 01/08/2023] Open
Abstract
We examined the effectiveness of a 2-week regimen of a semantic feature training in combination with transcranial direct current stimulation (tDCS) for progressive naming impairment associated with primary progressive aphasia (N = 4) or early onset Alzheimer's Disease (N = 1). Patients received a 2-week regimen (10 sessions) of anodal tDCS delivered over the left temporoparietal cortex while completing a language therapy that consisted of repeated naming and semantic feature generation. Therapy targets consisted of familiar people, household items, clothes, foods, places, hygiene implements, and activities. Untrained items from each semantic category provided item level controls. We analyzed naming accuracies at multiple timepoints (i.e., pre-, post-, 6-month follow-up) via a mixed effects logistic regression and individual differences in treatment responsiveness using a series of non-parametric McNemar tests. Patients showed advantages for naming trained over untrained items. These gains were evident immediately post tDCS. Trained items also showed a shallower rate of decline over 6-months relative to untrained items that showed continued progressive decline. Patients tolerated stimulation well, and sustained improvements in naming accuracy suggest that the current intervention approach is viable. Future implementation of a sham control condition will be crucial toward ascertaining whether neurostimulation and behavioral treatment act synergistically or alternatively whether treatment gains are exclusively attributable to either tDCS or the behavioral intervention.
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Affiliation(s)
- Jinyi Hung
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, PhiladelphiaPA, USA
- Department of Communication Sciences and Disorders, Temple University, PhiladelphiaPA, USA
| | - Ashley Bauer
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, PhiladelphiaPA, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, PhiladelphiaPA, USA
| | - Roy H. Hamilton
- Center for Cognitive Neuroscience, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, PhiladelphiaPA, USA
| | - H. B. Coslett
- Center for Cognitive Neuroscience, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, PhiladelphiaPA, USA
| | - Jamie Reilly
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, PhiladelphiaPA, USA
- Department of Communication Sciences and Disorders, Temple University, PhiladelphiaPA, USA
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25
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Hazif-Thomas C, Thomas P. [Are language disorders in Alzheimer's disease simply aphasia?]. SOINS. GERONTOLOGIE 2017; 22:41-43. [PMID: 28533046 DOI: 10.1016/j.sger.2017.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Alzheimer's disease is accompanied by gradual aphasia, becoming more severe when the cognitive disorders are more marked. However, the quality of care provided to the patient can modulate the evolution of these language difficulties. Aphasia is linked to a human communication deficiency and can be limited by taking into account the phatic function of language to keep the channels of communication open.
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Affiliation(s)
- Cyril Hazif-Thomas
- Intersecteur de psychiatrie de la personne âgée, EA 4686 éthique, professionnalisme et santé, CHRU de Brest, route de Ploudalmezeau, 29820 Bohars, France.
| | - Philippe Thomas
- Centre de recherches sémiotiques, CeReS, EA 3648, Université de Limoges, 39 rue Camille Guérin, 87000 Limoges, France
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26
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Orimaye SO, Wong JSM, Golden KJ, Wong CP, Soyiri IN. Predicting probable Alzheimer's disease using linguistic deficits and biomarkers. BMC Bioinformatics 2017; 18:34. [PMID: 28088191 PMCID: PMC5237556 DOI: 10.1186/s12859-016-1456-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 12/31/2016] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND The manual diagnosis of neurodegenerative disorders such as Alzheimer's disease (AD) and related Dementias has been a challenge. Currently, these disorders are diagnosed using specific clinical diagnostic criteria and neuropsychological examinations. The use of several Machine Learning algorithms to build automated diagnostic models using low-level linguistic features resulting from verbal utterances could aid diagnosis of patients with probable AD from a large population. For this purpose, we developed different Machine Learning models on the DementiaBank language transcript clinical dataset, consisting of 99 patients with probable AD and 99 healthy controls. RESULTS Our models learned several syntactic, lexical, and n-gram linguistic biomarkers to distinguish the probable AD group from the healthy group. In contrast to the healthy group, we found that the probable AD patients had significantly less usage of syntactic components and significantly higher usage of lexical components in their language. Also, we observed a significant difference in the use of n-grams as the healthy group were able to identify and make sense of more objects in their n-grams than the probable AD group. As such, our best diagnostic model significantly distinguished the probable AD group from the healthy elderly group with a better Area Under the Receiving Operating Characteristics Curve (AUC) using the Support Vector Machines (SVM). CONCLUSIONS Experimental and statistical evaluations suggest that using ML algorithms for learning linguistic biomarkers from the verbal utterances of elderly individuals could help the clinical diagnosis of probable AD. We emphasise that the best ML model for predicting the disease group combines significant syntactic, lexical and top n-gram features. However, there is a need to train the diagnostic models on larger datasets, which could lead to a better AUC and clinical diagnosis of probable AD.
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Affiliation(s)
- Sylvester O. Orimaye
- Intelligent Health Research Group, School of Information Technology, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Malaysia
| | - Jojo S-M. Wong
- Intelligent Health Research Group, School of Information Technology, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Malaysia
| | - Karen J. Golden
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Malaysia
| | - Chee P. Wong
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Malaysia
| | - Ireneous N. Soyiri
- Centre for Medical Informatics, Usher Institute for Population Health Sciences & Informatics, The University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG UK
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Neto E, Biessmann F, Aurlien H, Nordby H, Eichele T. Regularized Linear Discriminant Analysis of EEG Features in Dementia Patients. Front Aging Neurosci 2016; 8:273. [PMID: 27965568 PMCID: PMC5127828 DOI: 10.3389/fnagi.2016.00273] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/31/2016] [Indexed: 10/24/2022] Open
Abstract
The present study explores if EEG spectral parameters can discriminate between healthy elderly controls (HC), Alzheimer's disease (AD) and vascular dementia (VaD) using. We considered EEG data recorded during normal clinical routine with 114 healthy controls (HC), 114 AD, and 114 VaD patients. The spectral features extracted from the EEG were the absolute delta power, decay from lower to higher frequencies, amplitude, center and dispersion of the alpha power and baseline power of the entire frequency spectrum. For discrimination, we submitted these EEG features to regularized linear discriminant analysis algorithm with a 10-fold cross-validation. To check the consistency of the results obtained by our classifiers, we applied bootstrap statistics. Four binary classifiers were used to discriminate HC from AD, HC from VaD, AD from VaD, and HC from dementia patients (AD or VaD). For each model, we measured the discrimination performance using the area under curve (AUC) and the accuracy of the cross-validation (cv-ACC). We applied this procedure using two different sets of predictors. The first set considered all the features extracted from the 22 channels. For the second set of features, we automatically rejected features poorly correlated with their labels. Fairly good results were obtained when discriminating HC from dementia patients with AD or VaD (AUC = 0.84). We also obtained AUC = 0.74 for discrimination of AD from HC, AUC = 0.77 for discrimination of VaD from HC, and finally AUC = 0.61 for discrimination of AD from VaD. Our models were able to separate HC from dementia patients, and also and to discriminate AD from VaD above chance. Our results suggest that these features may be relevant for the clinical assessment of patients with dementia.
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Affiliation(s)
- Emanuel Neto
- Section for Clinical Neurophysiology, Haukeland University HospitalBergen, Norway; Institute of Biological and Medical Psychology, University of BergenBergen, Norway
| | | | - Harald Aurlien
- Section for Clinical Neurophysiology, Haukeland University Hospital Bergen, Norway
| | - Helge Nordby
- Institute of Biological and Medical Psychology, University of Bergen Bergen, Norway
| | - Tom Eichele
- Section for Clinical Neurophysiology, Haukeland University HospitalBergen, Norway; Institute of Biological and Medical Psychology, University of BergenBergen, Norway; K.G. Jebsen Center for Neuropsychiatric DisordersBergen, Norway
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28
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Abstract
Vascular dementia (VaD) is a major contributor to the dementia syndrome and is described as having problems with reasoning, planning, judgment, and memory caused by impaired blood flow to the brain and damage to the blood vessels resulting from events such as stroke. There are a variety of etiologies that contribute to the development of vascular cognitive impairment and VaD, and these are often associated with other dementia-related pathologies such as Alzheimer disease. The diagnosis of VaD is difficult due to the number and types of lesions and their locations in the brain. Factors that increase the risk of vascular diseases such as stroke, high blood pressure, high cholesterol, and smoking also raise the risk of VaD. Therefore, controlling these risk factors can help lower the chances of developing VaD. This update describes the subtypes of VaD, with details of their complex presentation, associated pathological lesions, and issues with diagnosis, prevention, and treatment.
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Affiliation(s)
- Ayesha Khan
- Wolfson Centre for Age Related Diseases, Guys Campus, London, United Kingdom of Great Britain and Northern Ireland Institute of NanoBioTechnology, Johns Hopkins University, Baltimore, MD, USA
| | - Raj N Kalaria
- Institute for Ageing and Health, Wolfson Research Centre, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Anne Corbett
- Wolfson Centre for Age Related Diseases, Guys Campus, London, United Kingdom of Great Britain and Northern Ireland
| | - Clive Ballard
- Wolfson Centre for Age Related Diseases, Guys Campus, London, United Kingdom of Great Britain and Northern Ireland
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29
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Key-DeLyria SE, Altmann LJP. Executive Function and Ambiguous Sentence Comprehension. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 25:252-267. [PMID: 27214025 DOI: 10.1044/2015_ajslp-14-0111] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 09/13/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE Sentence comprehension is a critical skill in today's literate society. Recent evidence suggests that processing and comprehending language taps cognitive as well as linguistic abilities, a finding that has critical import for clinicians who have clients with language disorders. To promote awareness of the impact of cognition, especially executive function (EF) and working memory (WM), this opinion article presents current views of how sentences are processed and links the various steps of the process to specific EF and WM subcomponents. METHOD The article focuses on ambiguous sentences, pointing out the similar types of processing needed when resolving an ambiguity and performing EF tasks. RESULTS We discuss the potential overlap between the neurobiology of sentence processing and EF and the evidence supporting a link between EF and sentence processes. CONCLUSION Awareness of the potential role of EF and WM in sentence comprehension will help clinicians be more aware of potential cognitive-linguistic deficits in their clients. Future research will help to clarify the link between EF and sentence comprehension.
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Kamsu-Foguem B, Tiako P, Mutafungwa E, Foguem C. Knowledge-based modelling applied to synucleinopathies. Eur Geriatr Med 2015. [DOI: 10.1016/j.eurger.2015.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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31
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Smits LL, van Harten AC, Pijnenburg YAL, Koedam ELGE, Bouwman FH, Sistermans N, Reuling IEW, Prins ND, Lemstra AW, Scheltens P, van der Flier WM. Trajectories of cognitive decline in different types of dementia. Psychol Med 2015; 45:1051-1059. [PMID: 25229325 DOI: 10.1017/s0033291714002153] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND To investigate trajectories of cognitive decline in patients with different types of dementia compared to controls in a longitudinal study. METHOD In 199 patients with Alzheimer's disease (AD), 10 with vascular dementia (VaD), 26 with dementia with Lewy bodies (DLB), 20 with behavioural variant frontotemporal dementia (bvFTD), 15 with language variant frontotemporal dementia (lvFTD) and 112 controls we assessed five cognitive domains: memory, language, attention, executive and visuospatial functioning, and global cognition (Mini-Mental State Examination, MMSE). All subjects had at least two neuropsychological assessments (median 2, range 2-7). Neuropsychological data were standardized into z scores using baseline performance of controls as reference. Linear mixed models (LMMs) were used to estimate baseline cognitive functioning and cognitive decline over time for each group, adjusted for age, gender and education. RESULTS At baseline, patients with dementia performed worse than controls in all cognitive domains (p < 0.05) except visuospatial functioning, which was only impaired in patients with AD and DLB (p < 0.001). During follow-up, patients with AD declined in all cognitive domains (p < 0.001). DLB showed decline in every cognitive domain except language and global cognition. bvFTD showed rapid decline in memory, language, attention and executive functioning (all p < 0.01) whereas visuospatial functioning remained fairly stable. lvFTD declined mostly in attention and executive functioning (p < 0.01). VaD showed decline in attention and executive functioning. CONCLUSIONS We show cognitive trajectories of different types of dementia. These estimations of natural disease course have important value for the design of clinical trials as neuropsychological measures are increasingly being used as outcome measures.
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Affiliation(s)
- L L Smits
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - A C van Harten
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - Y A L Pijnenburg
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - E L G E Koedam
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - F H Bouwman
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - N Sistermans
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - I E W Reuling
- Department of Medical Psychology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - N D Prins
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - A W Lemstra
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - P Scheltens
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
| | - W M van der Flier
- Department of Neurology and Alzheimer Centre,VU University Medical Centre,Amsterdam,The Netherlands
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32
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Reilly J. How to constrain and maintain a lexicon for the treatment of progressive semantic naming deficits: Principles of item selection for formal semantic therapy. Neuropsychol Rehabil 2015; 26:126-56. [PMID: 25609229 PMCID: PMC4760110 DOI: 10.1080/09602011.2014.1003947] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The progressive degradation of semantic memory is a common feature of many forms of dementia, including Alzheimer's disease and the semantic variant of primary progressive aphasia (svPPA). One of the most functionally debilitating effects of this semantic impairment is the inability to name common people and objects (i.e., anomia). Clinical management of a progressive, semantically based anomia presents extraordinary challenges for neurorehabilitation. Techniques such as errorless learning and spaced-retrieval training show promise for retraining forgotten words. However, we lack complementary detail about what to train (i.e., item selection) and how to flexibly adapt the training to a declining cognitive system. This position paper weighs the relative merits of several treatment rationales (e.g., restore vs. compensate) and advocates for maintenance of known words over reacquisition of forgotten knowledge in the context of semantic treatment paradigms. I propose a system for generating an item pool and outline a set of core principles for training and sustaining a micro-lexicon consisting of approximately 100 words. These principles are informed by lessons learned over the course of a Phase I treatment study targeting language maintenance over a 5-year span in Alzheimer's disease and SvPPA. Finally, I propose a semantic training approach that capitalises on lexical frequency and repeated training on conceptual structure to offset the loss of key vocabulary as disease severity worsens.
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Affiliation(s)
- Jamie Reilly
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, Pennsylvania USA
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, Pennsylvania USA
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33
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Abstract
Semantic dementia is characterized by fluent, phonologically adequate speech with
various anomias and semantic paraphasias. Performance on semantic tasks is well
documented in these patients, although little is known regarding performance on
more complex language tasks, such as those involving non-literal language
(interpretation of metaphors and proverbs and recognition of irony).
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Affiliation(s)
- Mariana Ribeiro Hur
- Speech and Hearing Therapist, Master's Student in Health Sciences at the Federal University of Goiás - UFG, Goiânia GO, Brazil
| | - Leonardo Caixeta
- Medical Doctor, PhD, Assistant Professor of Neuropsychiatry of the School of Medicine of the Federal University of Goiás, UFG, Coordinator of the Cognitive and Behavioral Neurology Unit of the Clinicas Hospital of the UFG, Goiânia GO, Brazil
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34
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van Vliet D, de Vugt ME, Bakker C, Pijnenburg YAL, Vernooij-Dassen MJFJ, Koopmans RTCM, Verhey FRJ. Time to diagnosis in young-onset dementia as compared with late-onset dementia. Psychol Med 2013; 43:423-432. [PMID: 22640548 DOI: 10.1017/s0033291712001122] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The extent to which specific factors influence diagnostic delays in dementia is unclear. Therefore, the aim of the present study was to compare duration from symptom onset to diagnosis for young-onset dementia (YOD) and late-onset dementia (LOD) and to assess the effect of age at onset, type of dementia, gender, living situation, education and family history of dementia on this duration. METHOD Data on 235 YOD and 167 LOD patients collected from caregivers from two prospective cohort studies were used. Multiple linear regression analysis was performed. RESULTS The duration between symptom onset and the diagnosis of YOD exceeded that of LOD by an average of 1.6 years (2.8 v. 4.4 years). Young age and being diagnosed with frontotemporal dementia were related to increases in the time to diagnosis. Subjects with vascular dementia experienced shorter time to diagnosis. CONCLUSIONS There is a need to raise special awareness of YOD to facilitate a timely diagnosis.
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Affiliation(s)
- D van Vliet
- School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, The Netherlands
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35
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Abstract
Increasing age and dementia are accompanied by an increased risk for undertreatment of pain owing to difficulty in assessing pain. Registration of autonomic responses to pain may contribute to a more reliable pain assessment. The aim of this review was to gain more insight into autonomic responses to pain in older persons with and without dementia. Literature searches were performed in the online databases MEDLINE and Web of Science. Seven studies on autonomic responses to pain in older people with or without dementia were included in the review. Autonomic responses to pain are present in older people with and without dementia, although they may be attenuated. Because no distinction could be made between different dementia subtypes based on these studies, predictions of changes in autonomic responses to pain have been made based on neuropathological changes. It can be concluded that autonomic responses to pain are attenuated in older people with and without dementia. Studies to specify the changes in the different autonomic responses for the different dementia subtypes are needed.
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Affiliation(s)
- Bart Plooij
- Department of Clinical Neuropsychology, VU University, 1081 BT Amsterdam, The Netherlands.
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36
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Carmona P, Molina M, Calero M, Bermejo-Pareja F, Martínez-Martín P, Alvarez I, Toledano A. Infrared spectroscopic analysis of mononuclear leukocytes in peripheral blood from Alzheimer’s disease patients. Anal Bioanal Chem 2012; 402:2015-21. [DOI: 10.1007/s00216-011-5669-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 12/12/2011] [Accepted: 12/15/2011] [Indexed: 10/14/2022]
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