Alterações de linguagem em pacientes idosos portadores de demência avaliados com a Bateria MAC

Abstract

Purpose: To identify language deficits in a group of elderly patients with dementia in tasks of free lexical retrieval, lexical retrieval with orthographic and semantic criteria, interpretation of metaphors and of narrative discourse, from the Montreal Communication Evaluation Battery -MAC Battery, as well as to verify the frequency of deficits. Methods: Participants were 13 patients with mild to moderate dementia, treated at the Neurology sector of the Ambulatory of Movement Disorders and Dementia of the Hospital Santa Clara of the Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA). The neuropsychological assessment instrument was the MAC Battery, and the tasks were applied in the following order: free lexical retrieval, lexical retrieval based on orthographic criteria, lexical retrieval based on semantic criteria, interpretation of metaphors, and interpretation of narrative discourse. Results:The group of patients with dementia showed impaired performance in all tasks from MAC Battery that were evaluated, with significant difference. Furthermore, participants presented higher frequency of deficits, in descending order, in partial retelling of narrative discourse tasks (essential and present information), followed by the tasks of lexical retrieval with orthography and semantic criteria, and full retelling of narrative discourse. At least two patients showed deficits in some of the five tasks performed from the MAC battery. Conclusion: Language evaluation using the MAC Battery allowed the verification of language processing deficits in elderly with dementia, characterizing that this instrument is also applicable to this clinical population.

The scope of using pragmatic language tests for early detection of dementia: A systematic review of investigations using figurative language

“…Although standard neuropsychological instruments are not sensitive to the early stages of dementia, recent studies suggest that impaired figurative language might be an early cognitive marker. [42][43][44][45] Rapp and…”

“…In their seminal work, Winner and Gardner 59 found that AD patients were impaired in the metaphor comprehension task. Since then, several studies 20,42,43,45,47,54,[60][61][62][63][64] have investigated metaphorcomprehension deficits in patients with dementia. Most of these studies, except some recent ones 44,45,47,60,63 focused only on people with AD.…”

“…As already stated, metaphor comprehension is a complex cognitive process involving several cognitive abilities and the brain areas TA B L E 1 Studies on figurative language impairment in dementia. 43 argued that metaphor processing requires greater cognitive resources of working memory for the construction of meaning, and consequently, patients with dementia have poor metaphor-comprehension abilities.…”

“…Some of these studies indicated that semantic-pragmatic dysfunction might precede literal language dysfunction in patients with dementia. 42,43,60 Fujimoto et al 42 found patients with very mild AD to be impaired in the simile comprehension task compared to the token test. Standardized tests for executive functions often fail to detect the higher-order executive dysfunctions that lead to pragmatic deficits.…”

Análise de aspectos micro e macrolinguísticos da narrativa de indivíduos com doença de Alzheimer, comprometimento cognitivo leve e sem comprometimentos cognitivos

“…A literatura aponta que as dificuldades de nomeação podem estar associadas a deficiências na recuperação lexical e dificuldade da representação semântica (Balthazar, 2008;Grossman, 2008;Almor et al, 2009 As dificuldades no processamento do conteúdo podem estar relacionadas à deterioração no "estoque semântico" ou ser interpretada como falha de acesso a esse estoque, que permaneceria intacto, relacionado a processos atencionais e executivos (Moreaud et al, 2001;Koehler, 2012;Ahmed et al, 2013 (Chapman et al, 2002).…”