Performance in microlinguistics at the lexical and syntactic levels was lower than expected in participants with AD.

Alzheimer's disease (AD) is characterized by impairments in memory and other cognitive functions such as language, which can be affected in all aspects including discourse. A picture description task is considered an effective way of obtaining a discourse sample whose key feature is the ability to retrieve appropriate lexical items. There is no consensus on findings showing that performance in content processing of spoken discourse deteriorates from the mildest phase of AD.ObjectiveTo compare the quantity and quality of discourse among patients with mild to moderate AD and controls.MethodsA cross-sectional study was designed. Subjects aged 50 years and older of both sexes, with one year or more of education, were divided into three groups: control (CG), mild AD (ADG1) and moderate AD (ADG2). Participants were asked to describe the "cookie theft" picture. The total number of complete words spoken and information units (IU) were included in the analysis.ResultsThere was no significant difference among groups in terms of age, schooling and sex. For number of words spoken, the CG performed significantly better than both the ADG 1 and ADG2, but no difference between the two latter groups was found. CG produced almost twice as many information units as the ADG1 and more than double that of the ADG2. Moreover, ADG2 patients had worse performance on IUs compared to the ADG1.ConclusionDecreased performance in quantity and content of discourse was evident in patients with AD from the mildest phase, but only content (IU) continued to worsen with disease progression.

ObjectivePurpose of this study is to evaluate the effects of training with six commercial Xbox KinectTM games on cognitive and motor aspects in Parkinson's disease (PD) patients and to compare the effects with a group of paired healthy subjects.MethodsThis study was a quasi‐experimental, controlled trial. Eight individuals with PD (mean age 68.9 ± 7.9) and eight older adults without PD, matched by age (mean age 67.6 ± 7.3) were enrolled in the study. Ten sessions of six Xbox 360 KinectTM commercial games were performed for 5 weeks. Subjects were evaluated before and 7 and 30 days after intervention. They were assessed using Montreal Cognitive Assessment, Frontal Assessment Battery (FAB), Timed Up and Go test, Ten Meters Walking test, and Balance Berg Scale. The Freezing of Gait Questionnaire, the Movement Disorder Society Unified Parkinson Disease Rating Scale, and the Parkinson's disease Questionnaire were also applied to PD group.ResultsSignificant improvement was found for cognitive aspects measured by Montreal Cognitive Assessment and FAB in both groups but without retention on FAB in PD group. No significant improvements were found for motor aspects in none group.ConclusionMotor–cognitive training using Xbox KinectTM games is a feasible resource to improve executive functions in PD patients and in older healthy people.

Introduction:Alzheimer’s disease (AD) is a degenerative syndrome that impairs cognitive functioning, including speech and language. Discourse can be used to analyze language processing, which is organized into microlinguistic and macrolinguistic dimensions.Objectives:To identify the occurrence of changes in the macrolinguistic dimension of oral discourse in AD patients. Design: This was developed as a cross-sectional study. Setting: Outpatient clinic of the Behavioural Neurology Division of São Paulo Federal University.Participants:121 elderly patients, with ≥ 4 years of education, divided into AD and comparison groups.Measurements:The subjects were asked to create a narrative based on seven figures that made up a story. The macrolinguistic aspects of the narratives were analyzed.Results:The performance of the AD group was inferior to that of the comparison group on content-related, no-content-related complete and incomplete propositions as well as macropropositions, main information units, appropriated local and global coherence, cohesive devices and all subtypes, cohesive errors and some of their subtypes. Global coherence, macropropositions and ellipsis subtype of cohesive devices were the variables that best differentiated the groups.Conclusions:Changes were observed in most aspects of the macrolinguistic dimension of oral discourse in patients with AD.

INTRODUÇÃO: Com o envelhecimento, pode ocorrer um declínio cognitivo. Sabe-se que melhorar o desempenho das funções cognitivas em idosos tem consequências importantes em sua qualidade de vida. A literatura sugere que o treinamento pode aprimorar as funções cognitivas em idosos saudáveis. OBJETIVO: Verificar o efeito de grupo de estimulação cognitiva em idosos saudáveis. MÉTODOS: Estudo longitudinal no qual foram avaliados 32 participantes escolarizados, com idade acima de 60 anos, divididos em dois grupos. O grupo-caso participou de 10 sessões de estimulação cognitiva em grupo. O grupo-controle foi formado por 15 indivíduos, com idade e escolaridade similares. A amostra foi avaliada antes e após a intervenção, através de uma versão adaptada da bateria CERAD, teste do relógio e check-list de queixas cognitivas. Foi usada uma análise descritiva, bem como o teste t-pareado, com o intuito de observar as diferenças entre os grupos após a estimulação. RESULTADOS: Não houve diferenças entre os grupos quanto à idade, gênero e escolaridade. Na avaliação inicial, os grupos não apresentaram diferenças no desempenho dos testes aplicados. Na testagem após a intervenção, foi observada melhora apenas no grupo-caso nas tarefas de nomeação, fluência semântica, fluência total (bateria CERAD) e desenho do relógio, assim como na check-list de queixas cognitivas. CONCLUSÃO: A estimulação cognitiva realizada diminuiu as queixas cognitivas dos idosos participantes e melhorou seu desempenho em testes cognitivos.

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Background: During the moderate stage of dementia due to Alzheimer’s disease (AD), language disorder is more evident and it impacts on communication. An overview of language impairment could be helpful to find compensatory communication strategies for these patients. Objective: To identify all language impairments among patients with moderate-stage of AD. Methods: 20 patients diagnosed with probable AD based on the criteria of the NINCDS-ARDRA, with a MMSE score of 13-23 points and CDR=2, who were undergoing treatment for AD with therapeutic doses of acetyl cholinesterase inhibitors, were assessed using the Boston Diagnostic Aphasia Examination (BDAE), a test that provides a broad assessment of language. The results were compared with the performance of a normal population. Results: The patients assessed in this study presented normal scores for oral and written word recognition, repetition, mechanics of writing, primer-level dictation and spelling to dictation but also had impairment at most levels of linguistic processing, in oral and written comprehension and production. In general, as expected, the tasks relying on access to the mental lexicon were most significantly affected. However, they performed well in the naming task, in which semantic cues were presented. Moreover, the patients assessed in this study had better performance in written comprehension tasks than in oral ones. Conclusion: The severity of the language impairments was not homogenous, with some linguistic abilities more impaired than others. The abilities that were found to be preserved can help to guide strategies for aiding in communication at this stage of AD.

RESUMO A doença de Machado-Joseph é a forma de ataxia espinocerebelar de maior prevalência no Brasil e tem como alguns dos principais sinais clínicos a disfagia e a disartria. Este relato de caso objetivou verificar os efeitos da intervenção intensiva fonoaudiológica em um paciente com a doença de Machado-Joseph. A coleta de dados foi realizada a partir de protocolos de avaliação de fala e deglutição e protocolos de autoavaliação de qualidade de vida, em relação à deglutição e comunicação. Também foram realizadas avaliações quantitativas de parâmetros acústicos. A intervenção foi administrada por meio do método Lee Silverman, programa intensivo que visa ao aumento da intensidade vocal. A partir das avaliações clínicas e instrumentais, os resultados demonstraram melhora em todas as bases motoras de fala, respiratória, fonatória, ressonantal, articulatória e a prosódia, além da diminuição dos sinais disfágicos. Na qualidade vocal, houve diminuição de rouquidão e instabilidade, regularização de jitter e shimmer, aumento da intensidade vocal, melhora na coordenação de palavras e frases por expiração e, ainda, melhora discreta da diadococinesia. Após intervenção, a autoavaliação de qualidade de vida relacionada à deglutição apresentou valores iguais ou maiores nos domínios diretamente ligados à alimentação, porém, os domínios emocionais diminuíram. O paciente relatou satisfação em todos os domínios da qualidade de vida em voz e foram obtidos valores maiores em todos os domínios. Concluiu-se que a intervenção intensiva beneficiou o participante e impactou positivamente sua qualidade de vida.