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.
ABSTRACT.Background:White matter hyperintensities (WMH) are commonly associated with vascular dementia and poor executive functioning. Notwithstanding, recent findings have associated WMH with Alzheimer's disease as well as other cognitive functions, but there is no consensus.Objective:This study aimed to verify the relationship between WMH and cognitive performance in Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) patients. The study also sought to identify cognitive and demographic/cultural factors that might explain variability of WMH.Methods:The sample was composed of 40 participants (18 MCI and 22 AD patients) aged ≥ 65 years. Spearman's correlation was performed among cognitive performance (memory, language, visuospatial ability, and executive function) and WMH evaluated by the Fazekas and ARWMC scales. Two stepwise linear regressions were carried out, one with cognitive and the other with demographic/cultural variables as predictors.Results:Only naming showed significant correlation with ARWMC. Fazekas score exhibited significant correlation with all cognitive domains evaluated. Fazekas score was better predicted by episodic visual memory and age.Conclusion:This study found that the most relevant cognitive profile in MCI and AD patients with WMH was related to episodic memory. And, without taking clinical aspects into consideration, age was the best predictor of WMH.
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.
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