Effects of health status on word finding in aging

Ageing of grammatical advance planning in spoken sentence production: an eye movement study

This study used an image-description paradigm with concurrent eye movement recordings to investigate differences of grammatical advance planning between young and older speakers in spoken sentence production. Participants were asked to produce sentences with simple or complex initial phrase structures (IPS) in Experiment 1 while producing individual words in Experiment 2. Young and older speakers showed comparable speaking latencies in sentence production task, whereas older speakers showed longer latencies than young speakers in word production task. Eye movement data showed that compared with young speakers, older speakers had higher fixation percentage on object 1, lower percentage of gaze shift from object 1 to 2, and lower fixation percentage on object 2 in simple IPS sentences, while they showed similar fixation percentage on object 1, similar percentage of gaze shift from object 1 to 2, and lower fixation percentage on object 2 in complex IPS sentences, indicating a decline of grammatical encoding scope presenting on eye movement patterns. Meanwhile, speech analysis showed that older speakers presented longer utterance duration, slower speech rate, and longer and more frequently occurred pauses in articulation, indicating a decline of speech articulation in older speakers. Thus, our study suggests that older speakers experience an ageing effect in the sentences with complex initial phrases due to limited cognitive resources.

Association Between Individual Components of Metabolic Syndrome and Cognitive Function in Northeast Rural China

AIM

The aim of this article was to examine associations between metabolic syndrome and its individual components with cognitive function among rural elderly population in northeast China.

METHODS

Our study included 1047 residents aged older than 60 years in a northeast rural area. All were interviewed and data were obtained including sociodemographic and medical histories. Cognitive function was assessed by Mini-Mental State Examination. Metabolic syndrome was defined by NCEP-ATP III.

RESULTS

After adjusted for confounding factors, metabolic syndrome was inversely associated with cognitive function (odds ratio [OR] = 1.79; 95% confidence interval [CI]: 1.06-3.01) especially in participants aged less than 70 years old (OR = 2.60; 95% CI: 1.27-5.26). In addition, participants with metabolic syndrome had worse language function, which is a part of cognitive function (OR = 2.64; 95% CI: 1.39-5.00). Individual metabolic syndrome components, especially abdominal obesity and hyperglycemia, had significant association with cognitive function (OR = 0.72, 95% CI: 0.56-0.92 and OR = 1.41; 95% CI: 1.12-1.78, respectively).

CONCLUSIONS

Abdominal obesity might be a protective factor for cognitive function. However, hyperglycemia might be a risk factor.

Breathe Easy, Speak Easy: Pulmonary Function and Language Performance in Aging

BACKGROUND

This study explored the association between pulmonary function (PF) and older adults' language performance accuracy. Study rationale was anchored in aging research reporting PF as a reliable risk factor affecting cognition among the elderly.

METHODS

180 adult English native speakers aged 55 to 84 years participated in the study. PF was measured through forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio (FFR). Language performance was assessed with an action naming test and an object naming test, and two tests of sentence comprehension, one manipulating syntactic complexity and the other, semantic negation. Greater PF was predicted to be positively associated with all tasks.

RESULTS

Unadjusted models revealed FVC and FEV1 effects on language performance among older adults. Participants with higher FVC showed better naming on both tasks and those with higher FEV1 had better object naming only. In covariate-adjusted models, only a positive FVC-object naming association remained.

CONCLUSION

Findings were discussed in terms of brain oxygenation mechanisms, whereby good PF may implicate efficient oxygenation, supporting neurotransmitter metabolism that protects against neural effects of cerebrovascular risk. Effects on object naming were linked to putative differential oxygenation demands across language tasks.

Arriving old: A qualitative study of elder refugee women's self-perceptions of the first year of resettlement

This qualitative study examines eight elder women's experiences of resettling with their family and the protective factors that enhanced their resiliency. The implications for social work include the need to assess elder refugees' strengths, resilience, pre-resettlement functioning instead of services that might encourage integration into the dominant culture and community, and that the refugee experience is a lifelong experience that shapes and informs various stages of life.

Demographic factors and retrieval of object and proper names after age 70

Purpose

This research aimed to investigate whether demographic factors are similarly related to retrieval of object and proper names.

Methods

The sample included 5,907 individuals above age 70 who participated in the Health and Retirement Study between 2004 and 2012. Participants were asked to name two objects as well as the US President and Vice President. Latent growth curve models examined the associations of age, education, and self-rated health with baseline levels and change trajectories in retrieval.

Results

Age and education were more strongly related to retrieval of proper names than to retrieval of object names, both for baseline scores and for change trajectory. Similar effects of self-rated health emerged for both types of stimuli.

Conclusions

The results show that examining object names and proper names together as indication of cognitive status in the HRS might overlook important differences between the two types of stimuli, in both baseline performance and longitudinal change.

Usefulness of investigating error profiles in diagnosis of naming impairments

BACKGROUND

Word-retrieval difficulties are commonly experienced by people with aphasia (PwA) and also by typically ageing persons. Differentiation between true naming impairments and naming difficulties found in healthy persons may, therefore, be challenging.

AIMS

To investigate the extent to which the Maltese adaptation of the Boston Naming Test (BNT) can identify people with lexical retrieval difficulties and to differentiate them from people with unimpaired word finding.

METHODS & PROCEDURES

Naming performance of a group of PwA was compared with the performance of a control group. Performance on the Maltese adaptation of the BNT was investigated in terms of scores, range of scores and error profiles of the two groups.

OUTCOMES & RESULTS

All PwA scored below the mean score of the controls, indicating that persons who scored above the mean score may be considered as unimpaired. However, a number of the controls obtained very low scores that overlapped with the scores obtained by the PwA. This indicated that scores alone cannot be used to differentiate between impaired and unimpaired people. Some types of errors were only produced by people with impaired naming, and did not appear at all in error profiles of unimpaired individuals.

CONCLUSIONS & IMPLICATIONS

Mild-moderate anomic impairments may be missed if naming impairment is assessed and diagnosed using a cut-off score. In order to differentiate between people with impaired and unimpaired naming, it is necessary to look at error profiles, apart from the number of errors, as the presence of atypical errors may be an important indicator of naming impairments.

Behavioral evidence for a differential modulation of semantic processing and lexical production by aging: a full linear mixed-effects modeling approach

The effect of normal aging on lexical production and semantic processing was evaluated in 72 healthy participants. Four tasks were used, picture naming (PN), picture categorization (PC), numerical judgment (NJ), and color judgment (CJ). The dependence of reaction time (RT) and correct responses with age was accounted by mixed-effects models. Participants underwent neuropsychological testing for verbal, executive, and memory functions. The RTs increase significantly with age for all tasks. After parceling out the non-specific cognitive decline, as reflected by the NJ task, the RT for the PN task decreases with age. Behavioral data were interpreted in relation with neuropsychological scores. Our results suggest that (a) naming becomes more automatic and semantic processing slightly more difficult with age, and (b) a non-specific general slowdown of cognitive processing occurs with age. Lexical production remained unaltered, based on compensatory automatic processes. This study also suggests a possible slowdown of semantic processing, even in normal aging.

Effects of metabolic syndrome on language functions in aging

This study explored effects of the metabolic syndrome (MetS) on language in aging. MetS is a constellation of five vascular and metabolic risk factors associated with the development of chronic diseases and increased risk of mortality, as well as brain and cognitive impairments. We tested 281 English-speaking older adults aged 55-84, free of stroke and dementia. Presence of MetS was based on the harmonized criteria (Alberti et al., 2009). Language performance was assessed by measures of accuracy and reaction time on two tasks of lexical retrieval and two tasks of sentence processing. Regression analyses, adjusted for age, education, gender, diabetes, hypertension, and heart disease, demonstrated that participants with MetS had significantly lower accuracy on measures of lexical retrieval (action naming) and sentence processing (embedded sentences, both subject and object relative clauses). Reaction time was slightly faster on the test of embedded sentences among those with MetS. MetS adversely affects the language performance of older adults, impairing accuracy of both lexical retrieval and sentence processing. This finding reinforces and extends results of earlier research documenting the negative influence of potentially treatable medical conditions (diabetes, hypertension) on language performance in aging. The unanticipated finding that persons with MetS were faster in processing embedded sentences may represent an impairment of timing functions among older individuals with MetS.

Language dominance and inhibition abilities in bilingual older adults

This study aimed to examine the so-called bilingual advantage in older adults' performance in three cognitive domains and to identify whether language use and bilingual type (dominant vs. balanced) predicted performance. The participants were 106 Spanish-English bilinguals ranging in age from 50 years to 84 years. Three cognitive domains were examined (each by a single test): inhibition (the Simon task), alternating attention (the Trail Making test), and working memory (Month Ordering). The data revealed that age was negatively correlated to performance in each domain. Bilingual type - balanced vs. dominant - predicted performance and interacted with age only on the inhibition measure (the Simon task). Balanced bilinguals showed age-related inhibition decline (i.e., greater Simon effect with increasing age); in contrast, dominant bilinguals showed little or no age-related change. The findings suggest that bilingualism may offer cognitive advantage in older age only for a subset of bilinguals.

The processing of lexical ambiguity in healthy ageing and Parkinson׳s disease: role of cortico-subcortical networks

Previous neuroimaging studies showed that correct resolution of lexical ambiguity relies on the integrity of prefrontal and inferior parietal cortices. Whereas prefrontal brain areas were associated with executive control over semantic selection, inferior parietal areas were linked with access to modality-independent representations of semantic memory. Yet insufficiently understood is the contribution of subcortical structures in ambiguity processing. Patients with disturbed basal ganglia function such as Parkinson׳s disease (PD) showed development of discourse comprehension deficits evoked by lexical ambiguity. To further investigate the engagement of cortico-subcortical networks functional Magnetic Resonance Imaging (fMRI) was monitored during ambiguity resolution in eight early PD patients without dementia and 14 age- and education-matched controls. Participants were required to relate meanings to a lexically ambiguous target (homonym). Each stimulus consisted of two words arranged on top of a screen, which had to be attributed to a homonym at the bottom. Brain activity was found in bilateral inferior parietal (BA 39), right middle temporal (BA 21/22), left middle frontal (BA 10) and bilateral inferior frontal areas (BA 45/46). Extent and amplitude of activity in the angular gyrus changed depending on semantic association strength that varied between conditions. Less activity in the left caudate was associated with semantic integration deficits in PD. The results of the present study suggest a relationship between subtle language deficits and early stages of basal ganglia dysfunction. Uncovering impairments in ambiguity resolution may be of future use in the neuropsychological assessment of non-motor deficits in PD.

Verbal play as a discourse resource in the social interactions of older and younger communication pairs

Verbal play, or the playful manipulation of elements of language, is a pervasive component of social interaction, serving important interpersonal functions. We analyzed verbal play in the interactional discourse of ten healthy younger pairs and ten healthy older pairs as they completed a collaborative referencing task. A total of 1,893 verbal play episodes were coded. While there were no group differences in verbal play frequency, age-related differences in the quality and function of these episodes emerged. While older participants engaged in more complex, extended, and reciprocal episodes that supported the social nature of communicative interactions (e.g., teasing), younger participants were more likely to engage in verbal play episodes for the purpose of successful task completion. Despite these age-related variations in the deployment of verbal play, verbal play is a robust interactional discourse resource in healthy aging, highlighting an element of human cognition that does not appear to decline with age.

Neuropsychologic assessment in collaborative Parkinson's disease research: a proposal from the National Institute of Neurological Disorders and Stroke Morris K. Udall Centers of Excellence for Parkinson's Disease Research at the University of Pennsylvania and the University of Washington

Cognitive impairment (CI) and behavioral disturbances can be the earliest symptoms of Parkinson's disease (PD), ultimately afflict the vast majority of PD patients, and increase caregiver burden. Our two Morris K. Udall Centers of Excellence for Parkinson's Disease Research were supported by the National Institute of Neurological Disorders and Stroke (NINDS) in an effort to recommend a comprehensive yet practical approach to cognitive and behavioral assessment to further collaborative research. We recommend a stepwise approach with two levels of standardized evaluation to establish a common battery, as well as an alternative testing recommendation for severely impaired subjects, and review supplemental tests that may be useful in specific research settings. Our flexible approach may be applied to studies with varying emphasis on cognition and behavior, does not place undue burden on participants or resources, and has a high degree of compatibility with existing test batteries to promote collaboration.

Memory compensation in older adults: the role of health, emotion regulation, and trait mindfulness

OBJECTIVES

The current study examined associations between everyday memory compensation and 3 person-level resource domains (i.e., health, emotion regulation, and trait mindfulness) in older adults.

METHOD

In this cross-sectional study, 89 healthy, community-dwelling older adults (ages 51-85 years) completed the multidimensional Memory Compensation Questionnaire, along with measures of self-reported health status, emotion regulation strategies, and trait mindfulness.

RESULTS

Hierarchical regressions (covarying for age, gender, and education) showed that poorer mental health (especially for older adults) and physical health functioning were related to using compensatory strategies (e.g., reliance on others and investment of time and effort) more frequently. Cognitive reappraisers reported using more internal mnemonic strategies. Conversely, having a more mindful predisposition was associated with less frequent use of compensatory strategies, especially for middle-aged adults.

DISCUSSION

The results suggest that health-related quality of life, adaptive strategies to regulate emotions, and trait mindfulness are additional contexts that determine the degree of engagement in everyday memory compensation and ultimately to successful aging.

Changes in naming and semantic abilities with aging from 50 to 90 years

The aim of this study was to determine whether naming difficulties arise in individuals as young as their 50s. Participants of 25-35, 50-59, 60-69, and above 70 years of age were given a picture naming task. To uncover subtle naming difficulties, latencies were analyzed in addition to accuracy. To control whether the expected slower naming latencies could be due to a general slowing affecting all cognitive tasks, participants were also given an odd/even judgment task to assess cognitive processing speed. The results confirmed that participants in their 50s presented decline in naming performance, reflected by an increase in naming latencies, whereas adults in their 60s and their 70s showed both a decrease in accuracy and an increase in latency. Moreover, the increase in naming latencies remained significant even after controlling for odd/even judgment latencies, suggesting a degradation specific to the picture naming task. We assumed that these slower latencies may result from a language-specific impairment. As a further test for language-specific degradation, participants' semantic capacities were also assessed with a synonym judgment task and the Pyramids and Palm Trees test. The above-70 group showed semantic degradation. The contributions of multiple factors to naming difficulties in aging are discussed.

Effects of hypertension and diabetes on sentence comprehension in aging

OBJECTIVES

To assess the impact of hypertension and diabetes mellitus on sentence comprehension in older adults.

METHOD

Two hundred and ninety-five adults aged 55 to 84 (52% men) participated in this study. Self-report mail survey combined with medical evaluations were used to determine eligibility. Multiple sources were used to determine whether hypertension and diabetes were present or absent and controlled or uncontrolled. Sentence comprehension was evaluated with two tasks: embedded sentences (ES) and sentences with multiple negatives (MN). Outcome measures were percent accuracy and mean reaction time of correct responses on each task.

RESULTS

Regression models adjusted for age, gender, and education showed that the presence of hypertension impaired comprehension on the multiple negatives task (p < .01), whereas the presence of diabetes impaired the comprehension of embedded sentences (p < .05). Uncontrolled diabetes significantly impaired accurate comprehension of sentences with multiple negatives (p < .05). No significant patterns were found for reaction time.

DISCUSSION

The presence of hypertension and diabetes adversely affected sentence comprehension, but the relative contribution of each was different. These findings support the researchers' earlier speculations on the neurobiological mechanisms underlying the effects of hypertension and diabetes on language and cognition in aging. Uncontrolled disease status demonstrated more complicated age-related effects on sentence processing, highlighting the clinical importance for cognitive aging of identifying and managing vascular risk factors.

Naming ability changes in physiological and pathological aging

Over the last two decades, age-related anatomical and functional brain changes have been characterized by evidence acquired primarily by means of non-invasive functional neuroimaging. These functional changes are believed to favor positive reorganization driven by adaptations to system changes as compensation for cognitive decline. These functional modifications have been linked to residual brain plasticity mechanisms, suggesting that all areas of the brain remain plastic during physiological and pathological aging. A technique that can be used to investigate changes in physiological and pathological aging is non-invasive brain stimulation (NIBS). The present paper reviews studies that have applied NIBS in younger and older adults and in patients with dementia to track changes in the cerebral areas involved in a language task (naming). The results of this research suggest that the left frontal and temporal areas are crucial during naming. Moreover, it is suggested that in older adults and patients with dementia, the right prefrontal cortex is also engaged during naming tasks, and naming performance correlates with age and/or the degree of the pathological process. Potential theories underlying the bilateral involvement of the prefrontal cortex are discussed, and the relationship between the bilateral engagement of the prefrontal cortex and the age or degree of pathology is explored.

An overview of nonpathological geroneuropsychology: implications for nursing practice and research

One aspect of successful aging is maintaining cognitive functioning, which includes both subjective cognitive functioning and objective cognitive functioning even in lieu of subtle cognitive deficits that occur with normal, nonpathological aging. Age-related cognitive deficits emerge across several domains including attention, memory, language, speed of processing, executive, and psychomotor, just to name a few. A primary theory explaining such cognitive deficits is cognitive reserve theory; it posits that biological factors such as demyelination and oxidative stress interfere with neuronal communication, which eventually produces observable deficits in cognitive functioning. Therefore, it is important to maintain or improve cognitive reserve to augment cognitive functioning in later life. This article provides a general overview of the principles of geroneuropsychology along with implications for nursing practice and research.

A systematic review of the neurobiological aspects of memory in the aging process

A systematic review of the neuroanatomical literature was performed to determine the neuropharmacological aspects most relevant to the study of memory processes. Articles were retrieved using the search terms "biology of memory", "memory and aging", "memory impairment", "elderly and memory," and their equivalents in Portuguese. Of the studies surveyed, five studies dealt with epidemiological and demographic issues, 12 were clinical trials i.e. were based on testing and implementation of instruments in human subjects, 33 studies were basic research involving studies of mice, rats and non-human primates, and biochemical and in vitro trials and finally, 52 studies were literature reviews or book chapters which in our view, fell into this category.

Conclusions

The work sought to highlight which neural networks are most involved in processing information, as well as their location within brain regions and the way in which neurotransmitters interact with each other for the formation of these memories. Moreover, it was shown how memory changes during the normal human aging process, both positively and negatively, by analyzing the morphological alterations that occur in the brain of aging individuals.

Integrating health into cognitive aging: toward a preventive cognitive neuroscience of aging

OBJECTIVES

We argue that age is a descriptive, and not explanatory, variable and consequently cannot account for the cognitive changes that often occur with aging. Once age is removed from consideration, other truly causal explanations for "cognitive aging" must be identified. We argue that health and disease represent an important class of explanatory variables for age-related cognitive changes.

METHODS/RESULTS

We make this argument first by reviewing the prevalence of risk factors, disability, and subclinical and frank disease in the elderly population. We emphasize that the complexity of health effects rivals that of age on cognition while noting that most studies of cognitive aging rarely consider this complexity fully. We then consider in more detail the "vascular hypothesis," which proposes that vascular diseases (e.g., stroke, heart disease) and their risk factors (e.g., hypertension) can explain aspects of cognitive decline in aging through their impact on circulatory and brain functions. Clinical implications of this hypothesis suggest that treatment of vascular risk factors might well reduce the incidence or severity of dementia syndromes.

DISCUSSION

We conclude with a brief summary of approaches to further integrate aspects of health and disease into the study of "cognitive aging."

Tracking cognition-health changes from 55 to 95 years of age

OBJECTIVES

Among the key targets of inquiry in cognitive aging are (1) the description of cognitive changes with advancing age and (2) the association of such cognitive changes with modulating factors in the changing epidemiological context.

METHODS

In the current study, we assemble multi-occasion (up to 12 years) cognitive (speed, episodic memory, and semantic memory) and self-reported health data from the Victoria Longitudinal Study (n = 988; ages 55-95 years).

RESULTS

The results from piecewise random effects models using age as a basis indicated that only selected measures of episodic memory and semantic memory showed evidence of significant declines prior to age 75. After age 75, all cognitive abilities showed evidence for statistically significant declines, although the magnitude of these changes varied considerably. Performance at age 75 was correlated with self-reported health for measures of processing speed and episodic memory. Changes in health status were related to changes in some aspects of processing speed.

DISCUSSIONS

The results indicated that (1) for many cognitive abilities declines in performance did not manifest until after age 75 and (2) self-reported health was related to level of performance more than changes over age.

Bilateral brain regions associated with naming in older adults

To determine structural brain correlates of naming abilities in older adults, we tested 24 individuals aged 56-79 on two confrontation-naming tests (the Boston Naming Test (BNT) and the Action Naming Test (ANT)), then collected from these individuals structural Magnetic-Resonance Imaging (MRI) and Diffusion Tensor Imaging (DTI) data. Overall, several regions showed that greater gray and white matter volume/integrity measures were associated with better task performance. Left peri-Sylvian language regions and their right-hemisphere counterparts, plus left mid-frontal gyrus correlated with accuracy and/or negatively with response time (RT) on the naming tests. Fractional anisotropy maps derived from DTI showed robust positive correlations with ANT accuracy bilaterally in the temporal lobe and in right middle frontal lobe, as well as negative correlations with BNT RT, bilaterally, in the white matter within middle and inferior temporal lobes. We conclude that those older adults with relatively better naming skills can rely on right-hemisphere peri-Sylvian and mid-frontal regions and pathways, in conjunction with left-hemisphere peri-Sylvian and mid-frontal regions, to achieve their success.