Declines in Connected Language Are Associated with Very Early Mild Cognitive Impairment: Results from the Wisconsin Registry for Alzheimer’s Prevention

Abstract

Changes to everyday spoken language (“connected language”) are evident in persons with AD dementia, yet little is known about when these changes are first detectable on the continuum of cognitive decline. The aim of this study was to determine if participants with very early, subclinical memory declines were also showing declines in connected language. We analyzed connected language samples obtained from a simple picture description task at two time points in 264 participants from the Wisconsin Registry for Alzheimer’s Prevention (WRAP). In parallel, participants were classified as either “Cognitively Healthy” or “Early Mild Cognitive Impairment” based on longitudinal neuropsychological test performance. Linear mixed effects models were used to analyze language parameters that were extracted from the connected language samples using automated feature extraction. Participants with eMCI status declined faster in features of speech fluency and semantic content than those who were cognitively stable. Measures of lexical diversity and grammatical complexity were not associated with eMCI status in this group. These findings provide novel insights about the relationship between cognitive decline and everyday language, using a quick, inexpensive, and performance-based method.

Is cognitive impairment associated with reduced syntactic complexity in writing? Evidence from automated text analysis

“…Despite the lack of significant group differences on individual measures, the complete model showed a discriminative function and was able to distinguish MCI from SCI and MCI from HC, but not SCI from HC. Other studies have reported similar results (Ahmed et al, 2013;Mueller et al, 2018Mueller et al, , 2016Roark et al, 2011).…”

Language Performance of Individuals at Risk for Mild Cognitive Impairment

“…The findings of Snowdon and colleagues stimulated interest in the relation of language performance to onset of dementia-producing diseases, and the literature contains many reports of language performance deficits in individuals with confirmed MCI (Asgari, Kaye, & Dodge, 2017;Bertola et al, 2014;Cardoso, Silva, Maroco, Mendonça, & Guerreiro, 2014;Choi, Kim, Lee, & Kim, 2013;Costa et al, 2014;Kim, Sung, & Jeong, 2012;Mueller et al, 2018Mueller et al, , 2015Nutter-Upham et al, 2008;Payne & Stine-Morrow, 2016;Smolik et al, 2016;Tsantali et al, 2013;Vaughan, Coen, Kenny, & Lawlor, 2016;Weakley, Schmitter-Edgecombe, & Anderson, 2013) and those with clinically diagnosed dementia (Bayles, McCullough, & Tomoeda, 2018;Bayles, Tomoeda, & Trosset, 1992;Tomoeda, Bayles, Trosset, Azuma, & McGeagh, 1996). The most commonly reported language performance deficit in individuals with MCI is impaired verbal fluency as measured by having individuals name as many items as possible in a category (Albert et al, 2011;Clark et al, 2013;Irish et al, 2011;Malek-Ahmadi, Raj, & Small, 2011;Tsantali et al, 2013;Weakley et al, 2013).…”

“…The rationale for this hypothesis was based on reports of very early changes in language abilities, even decades before other clinical symptoms appear (Mueller et al, 2018;Ohm et al, 1995;Snowdon et al, 1996;Tsantali et al, 2013) and the fact that successful completion of language tasks requires integrity of myriad cognitive operations as well as language knowledge and processing (Dell & O'Seaghdha, 1992;Fleming, 2014;Kirova et al, 2015;MacDonald & Christiansen, 2002;Malek-Ahmadi et al, 2011;Martin & Gupta, 2004;Oulhaj et al, 2009). Of the 14 ABCD subtests, the four that elicited the poorest performance were, in order, Repetition, Following Commands, Concept Definition, and Object Description.…”

“…Although researchers have identified biomarkers of early disease, testing for them is not routine and has limited impact on the course of an individual's care (Dubois et al, 2016;Hane et al, 2017;Jack et al, 2018;Sperling et al, 2013). Of keen interest, therefore, is identification of the earliest neuropsychological impairments associated with dementing diseases and neuropsychological methods that can detect them (Albert et al, 2011;Chen & Wang, 2013;Chong & Sahadevan, 2005;Dubois et al, 2016;Loftus, 2017;Mueller, Koscik, Hermann, Johnson, & Turkstra, 2018).…”

Updated Information on Some Cognitive Disorders

“…Mueller et al [29] have documented spoken language as a noninvasive, multidimensional, and informative biological sample for the early diagnosis of AD, primary progressive aphasia, and other cognitive disorders. They also confirmed that connected language analysis is one of the most promising state-of-the-art diagnostic tools for MCI.…”