Investigating speech and language impairments in delirium: a preliminary case-control study

Green, Samantha; Reivonen, Satu; Rutter, Lisa-Marie; Nouzova, Eva; Duncan, Nikki; Clarke, Caoimhe; MacLullich, Alasdair M.J.; Tieges, Zoë

doi:10.1101/351007

Cited by 9 publications

(9 citation statements)

References 36 publications

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“…In addition, the loss of orientation is congruent with the existing literature (Balas et al, 2012; Marcantonio, 2017). Furthermore, the impaired ability to communicate needs is supported by acute brain failure: delirium affects speech, including speech content, the production of spontaneous speech, language fluency, and word count, even in comparison with dementia (Balas et al, 2012; Green et al, 2018). Not differentiating the ability to communicate needs from dementia, the impairment was substantial.…”

Section: Discussionmentioning

confidence: 99%

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Assessing delirium with nursing care instruments: Evaluation of the cognitive and associated domains

et al. 2020

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Objective Nursing instruments have the potential for daily screening of delirium; however, they have not yet been evaluated. Therefore, after assessing the functional domains of the electronic Patient Assessment — Acute Care (ePA-AC), this study evaluates the cognitive and associated domains. Methods In this prospective cohort study in the intensive care unit, 277 patients were assessed and 118 patients were delirious. The impacts of delirium on the cognitive domains, consciousness and cognition, communication and interaction, in addition to respiration, pain, and wounds were determined with simple logistic regressions and their respective odds ratios (ORs). Results Delirium was associated with substantial impairment throughout the evaluated domains. Delirious patients were somnolent (OR 6), their orientation (OR 8.2–10.6) and ability to acquire knowledge (OR 5.5–11.6) were substantially impaired, they lost the competence to manage daily routines (OR 8.2–22.4), and their attention was compromised (OR 12.8). In addition, these patients received psychotropics (OR 3.8), were visually impaired (OR 1.8), unable to communicate their needs (OR 5.6–7.6), displayed reduced self-initiated activities (OR 6.5–6.9) and challenging behaviors (OR 6.2), as well as sleep–wake disturbances (OR 2.2–5), Furthermore, delirium was associated with mechanical ventilation, abdominal/thoracic injuries or operations (OR 4.2–4.4), and sensory perception impairment (OR 3.9–5.8). Significance of results Delirium caused substantial impairment in cognitive and associated domains. In addition to the previously described functional impairments, these findings will aid the implementation of nursing instruments in delirium screening.

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Section: Discussionmentioning

confidence: 99%

“…Not differentiating the ability to communicate needs from dementia, the impairment was substantial. And last, the inability to acquire knowledge: delirium can cause reduced language comprehension (Green et al, 2018) and affects memory (Brown and Boyle, 2002; Marcantonio, 2017).…”

Section: Discussionmentioning

confidence: 99%

Assessing delirium with nursing care instruments: Evaluation of the cognitive and associated domains

et al. 2020

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“…These tools can detect language disorders, incoherent speech, tangentiality and grammatical error, lexical retrieval difficulties, auditory comprehension difficulties, grammatical and spelling failures [43,44,45] in the subjects. These signs are associated to Language and Communication Impairment (LCI) in patients with dementia.…”

Section: Language Assessment Toolsmentioning

confidence: 99%

Machine Learning to Assess Language Impairments in Older Adults

Parsa¹,

Alam²,

Mihailidis³

2020

Preprint

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Objectives: The main objective of this paper is to propose a methodology based on machine learning classifiers for assessing language impairments associated with dementia in older adults. To do so, we compare the impact of different types of language tasks, features, and recording media on our ML-based methodology’s efficiency. Methodology: The methodology encompasses the following steps: 1) Extracting linguistic and acoustic features from subjects’ speeches which have been collected from subjects with dementia ( N =9) and subjects without dementia ( N =13); 2) Employing feature selection methods to rank informative features; 3) Training ML classifiers using extracted features to recognize subjects with dementia from subjects without dementia; 4) Evaluating the classifiers; 5) Selecting the most accurate classifiers to develop the languages assessment tools. Results: Our results indicate that 1) we can find more predictive linguistic markers to distinguish language impairment associated with dementia from participants’ speech produced during the picture description language task than the story recall task. 2) a phone-based recording interface provides a more high-quality language dataset than the web-based recording systems; 3) classifiers trained with selected features from acoustic features or linguistic features show higher performance than the classifiers trained with pure features. Conclusion: Our results show that the tree-based classifiers that have been trained using the PD dataset can be used to develop an ML-based language assessment tool that can detect language impairment associated with dementia as quickly as possible.

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“…11,12 Links have been identified between patients with communication impairments and delirium. 13 SLTs carry out formal and informal assessments of receptive and expressive language (verbal and non-verbal), speech, voice and cognitive communication function. On occasion, communication facilitation may begin when a patient is still intubated but awake and attempting to communicate.…”

Section: The Current Impact In Icumentioning

confidence: 99%

The role of speech and language therapists in the intensive care unit

McRae

Montgomery

Garstang

et al. 2019

Journal of the Intensive Care Society

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National guidance recommends the involvement of speech and language therapists in intensive care particularly for those requiring tracheostomy and ventilation. However, the role of speech and language therapists is poorly understood especially in the context of critical care. This article aims to increase awareness of the background training and skills development of speech and language therapists working in this context to demonstrate their range of specialist abilities. Speech and language therapists support and enhance the process of laryngeal weaning alongside the rehabilitation of speech and swallowing as part of the multidisciplinary team. Examples are provided of the types of interventions that are used and technological innovations that may enhance rehabilitation of oropharyngeal impairments.

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Investigating speech and language impairments in delirium: a preliminary case-control study

Cited by 9 publications

References 36 publications

Assessing delirium with nursing care instruments: Evaluation of the cognitive and associated domains

Assessing delirium with nursing care instruments: Evaluation of the cognitive and associated domains

Machine Learning to Assess Language Impairments in Older Adults

The role of speech and language therapists in the intensive care unit

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