Acquired language impairments may accompany different conditions. Most recent studies have shown that there is an important relationship between language and cognitive functions, such as executive functions (EF). Therefore, we aimed to investigate which main EF components appear to have the greatest impact in the most prevalent acquired communication disorders in adults, and which neuropsychological tests are being used to evaluate them. In addition, we sought to characterize the relationship between the executive functions and language in these conditions. Working memory (WM) was the most frequently chosen cognitive measure, being evaluated by different span tasks. A relationship between WM and narrative and conversational discourse, writing abilities and grammatical comprehension was found. Other currently used cognitive tests included the Trail Making, Wisconsin, Stroop and Verbal Fluency tests. Language and EF have a complex relationship; hence, a complete assessment should reflect the dynamic processing of cognitive brain functions.

ABSTRACT. Conversational discourse (CD) is among the most complex tasks in everyday life and relies on multiple cognitive domains (communicative and executive abilities). Alterations in discourse comprehension and production are often present in pathological aging. However, there is still a need to identify changes in healthy aging. Objective: This study aimed to compare young and older adults for the frequency of impaired communicative behaviors on a CD task. Performance was scored according to the Complementary Procedure of Conversational Discourse Analysis (CPCDA), developed based on the CD task from the Montreal Communication Evaluation Battery. Methods: A total of 95 participants (54 young-adults and 41 older adults) were evaluated. The frequency of communicative behaviors was compared between groups using MANCOVA and Chi-square tests. Results: Young adults showed fewer impairments in expression, pragmatics, cohesion, coherence, comprehension and emotional prosody. Older adults showed higher levels of verbal initiative and had fewer word finding difficulties. Communicative behaviors associated with planning and self-monitoring (e.g. repetition of information and syllabic false starts) appear to be common in the speech of healthy individuals in general. Conclusion: Studies which evaluate both discursive and cognitive skills are required to identify age-related changes. This would allow for the development of screening tools for CD assessment and preventive programs.

Studies of mild cognitive impairment (MCI) still describes executive functions (EF) in a general way rather than focusing on the multiple executive components and their differences. EF entail multiple higher cognitive components, such as cognitive flexibility (CF) and inhibitory control (IC). It is still unclear which specific EF components are impaired in MCI patients, and how best to assess and discriminate those components whether they are verbal, visual or multiple input/outputs. Therefore, we aimed to evaluate if elderly controls and single- and multiple-domain MCI differ as to CF and IC executive components. Additionally, we aimed to verify which instrument used to evaluate these components is more discriminative. A total of 64 elderly adults (14 controls, 19 single-domain MCI, and 31 multiple-domain MCI) were evaluated using the Trail Making Test (TMT), Five-Digit Test, and Hayling Test. We performed a multivariate analysis of covariance to compare the groups regarding cognitive performance. Receiver operating characteristic curves were used to establish which test was more discriminative between control and MCI groups. The groups differed in IC (Time B) and in CF (Time B – Time A) of the TMT, with multiple-domain MCI group having worse performance than the control one. TMT proved to be the most discriminative among the three instruments for elderly with MCI. No differences were found between single- and multiple-domain in CF and IC executive components, probably due to interindividual heterogeneity even in their subtypes. Visuospatial executive skills appear to have greater impact on MCI.

OBJECTIVE: The burden felt by informal caregivers of patients with dementia is a source of physical, emotional, and financial problems. Face-to-face interventions for caregivers have accessibility limitations that may prevent them from receiving adequate care. Telehealth tools can be a solution to this problem. We will compare a telephone psychoeducational and support intervention protocol to usual care for informal female caregivers of patients with dementia treated at specialized outpatient clinics. METHODS: In this single-blind randomized clinical trial, the intervention group will receive one weekly call for 8 weeks that addresses issues such as disease education, communication with the patient, and problematic behaviors. The control group will receive printed material on problematic behaviors in dementia. The primary outcome will be the difference in caregiver burden between baseline and 8 weeks, which will be assessed by blinded investigators through the Zarit Burden Interview scale. Caregiver burden at 16 weeks after baseline, depression, anxiety, and quality of life at 8 and 16 weeks are secondary outcomes. CONCLUSIONS: We expect the intervention to reduce caregiver burden. These results could lead to public health programs for improving dementia care in lower-middle-income countries. Ethics and dissemination: This trial was approved by an independent ethics committee. The results will be published in an international peer-reviewed medical journal. Trial registration number: NCT03260608.