Tracking Discourse Complexity Preceding Alzheimer's Disease Diagnosis: A Case Study Comparing the Press Conferences of Presidents Ronald Reagan and George Herbert Walker Bush

Berisha, Visar; Wang, Shuai; LaCross, Amy; Liss, Julie

doi:10.3233/jad-142763

Cited by 76 publications

(81 citation statements)

References 18 publications

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“…Our results suggested that the pMCI group expressed fewer semantic units and fewer unique words than the cognitively healthy group, which is a similar finding to that seen in studies with persons with MCI and AD [20, 21, 27, 28]. Recently, Berisha [28] found that former President Ronald Reagan's use of unique words declined over time, prior to his diagnosis of Alzheimer's Disease.…”

Section: Discussionsupporting

confidence: 86%

“…Language measures were chosen based on previous literature that focused on discourse analysis in MCI or preclinical AD [18-20, 27, 28]. …”

Section: Methodsmentioning

confidence: 99%

“…Specifically, we hypothesized that participants who were cognitively healthy would differ on connected language outcomes from a subset with psychometric evidence of aMCI (i.e., the subset did not have a clinical diagnosis of MCI, but did meet statistical criteria for early decline as described in the methods). While evidence for early language change exists based on retrospective analysis [26, 28], to our knowledge no studies have examined connected speech and language prospectively in an at-risk cohort.…”

Section: Introductionmentioning

confidence: 99%

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Connected Language in Late Middle-Aged Adults at Risk for Alzheimer’s Disease

Mueller

Koscik

Turkstra

et al. 2016

JAD

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Connected language is often impaired among people with Alzheimer's Disease (AD), yet little is known about when language difficulties first emerge on the path to a clinical diagnosis. The objective of this study was to determine whether individuals with psychometric (preclinical) evidence of amnestic Mild Cognitive Impairment (MCI) (pMCI) showed deficits in connected language measures. Participants were 39 pMCI and 39 cognitively healthy (CH) adults drawn from the Wisconsin Registry for Alzheimer's Prevention, who were matched for age, literacy, and sex. Participants completed a connected language task in which they described the Cookie Theft picture from the Boston Diagnostic Aphasia Examination. Language samples were analyzed across 3 language domains: content, syntactic complexity, and speech fluency. Paired t-tests were used to compare CH and pMCI groups on all variables, and Cohen's d effect sizes were calculated for each comparison. The CH and pMCI groups differed significantly on measures of content (e.g., CH group produced more semantic units, more unique words and had larger idea density, on average, than the pMCI group). The picture description findings are consistent with previous retrospective studies showing semantic language differences in adults with autopsy-confirmed AD. Given that these comparisons are between cognitively healthy and pMCI individuals (before a clinical MCI diagnosis), these findings may represent subtle language difficulty in spontaneous speech, and may be predictive of larger language changes over time.

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Section: Discussionsupporting

confidence: 86%

“…Language measures were chosen based on previous literature that focused on discourse analysis in MCI or preclinical AD [18-20, 27, 28]. …”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Connected Language in Late Middle-Aged Adults at Risk for Alzheimer’s Disease

Mueller

Koscik

Turkstra

et al. 2016

JAD

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“…A similar pattern is found in AD; a comparison of the language production of Ronald Reagan – later diagnosed with AD – and George H.W. Bush – aging normally – uncovered that Reagan used words lower in imageabilty and used more indefinite nouns (e.g., anything, someone; Berisha et al, 2015). Patients with AD and individuals with hippocampal amnesia have similarities in their memory impairment and in MTL pathology.…”

Section: Introductionmentioning

confidence: 64%

The influence of the hippocampus and declarative memory on word use: Patients with amnesia use less imageable words

2017

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Hippocampal functioning contributes to our ability to generate multifaceted, imagistic event representations. Patients with hippocampal damage produce event narratives that contain fewer details and fewer imagistic features. We hypothesized that impoverished memory representations would influence language at the word level, yielding words lower in imageability and concreteness. We tested this by examining language produced by patients with bilateral hippocampal damage and severe declarative memory impairment, and brain-damaged and healthy comparison groups. Participants described events from the real past, imagined past, imagined present, and imagined future. We analyzed the imageability and concreteness of words used. Patients with amnesia used words that were less imageable than those of comparison groups across time periods, even when accounting for the amount of episodic detail in narratives. Moreover, all participants used words that were relatively more imageable when discussing real past events than other time periods. Taken together, these findings suggest that the memory that we have for an event affects how we talk about that event, and this extends all the way to the individual words that we use.

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“…Garrard, Maloney, Hodges, and Patterson (2005) found a longitudinal decline in the ratio of unique words to total word output in the writings of a renowned author who was subsequently diagnosed with AD. Similarly, Berisha, Wang, LaCross, and Liss (2015) documented a reduction in the number of unique words over time, along with an increase in conversational fillers and non-specific nouns in speeches delivered by President Reagan. Other studies have recorded an increase in the use of pronouns in language samples of individuals with AD (e.g., Ahmed, Haigh, de Jager, & Garrard, 2013; Almor, Kempler, MacDonald, Andersen, & Tyler, 1999).…”

mentioning

confidence: 92%

Word retrieval in picture descriptions produced by individuals with Alzheimer’s disease

Kavé

Goral

2016

Journal of Clinical and Experimental Neuropsychology

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What can tests of single-word production tell us about word retrieval in connected speech? We examined this question in 20 people with Alzheimer's disease (AD) and in 20 cognitively intact individuals. All participants completed tasks of picture naming and semantic fluency, and provided connected speech through picture descriptions. Picture descriptions were analyzed for total word output, percentages of content words, percentages of nouns, and percentages of pronouns out of all words, type-token ratio of all words and type-token ratio of nouns alone, mean frequency of all words and mean frequency of nouns alone, and mean word length. Individuals with AD performed worse than did cognitively intact individuals on the picture naming and semantic fluency tasks. They also produced a lower proportion of content words overall, a lower proportion of nouns, and a higher proportion of pronouns, as well as more frequent and shorter words on picture descriptions. Group differences in total word output and type-token ratios did not reach significance. Correlations between scores on tasks of single-word retrieval and measures of retrieval in picture descriptions emerged in the AD group but not in the control group. Scores on a picture naming task were associated with difficulties in word retrieval in connected speech in AD, while scores on a task of semantic verbal fluency were less useful in predicting measures of retrieval in context in this population.

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Tracking Discourse Complexity Preceding Alzheimer's Disease Diagnosis: A Case Study Comparing the Press Conferences of Presidents Ronald Reagan and George Herbert Walker Bush

Cited by 76 publications

References 18 publications

Connected Language in Late Middle-Aged Adults at Risk for Alzheimer’s Disease

Connected Language in Late Middle-Aged Adults at Risk for Alzheimer’s Disease

The influence of the hippocampus and declarative memory on word use: Patients with amnesia use less imageable words

Word retrieval in picture descriptions produced by individuals with Alzheimer’s disease

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