Narrative Production Ability in Patients with Dementia of the Alzheimer’s Type According to Story Familiarity and Disease Severity

Objectives: Anomia is the primary language symptom in patients with mild cognitive impairment (MCI) and dementia of Alzheimer’s type (DAT). The purpose of this study was to examine the correlation between the ratios of word-finding behavior and Correct information Unit (CIU) through spontaneous speech task in patients with MCI and DAT. Methods: The participants of this study were 31 healthy elderly, 29 patients with MCI, and 27 patients with mild DAT. The picture description tasks were used, and word-finding behaviors and CIU ratio analysis were used. Results: First, it was found that there were significant differences according to groups in the ratio of empty words, repetitions, insertions, and global index. Second, there was no significant correlation between the ratio of word-finding behavior and the CIU ratio in the healthy elderly, but there were significant correlations between the ratios of the word-finding behavior and the CIU ratio in patients with MCI and DAT. Finally, according to the regression analysis results, it was found that the ratio of the global index significantly predicted the CIU ratio in the MCI and DAT groups. Conclusion: From the results of this study, it can be seen that the ratios of word-finding behavior through spontaneous speech tasks in patients with MCI and DAT is related to information delivery ability.

Ideational and semantic contributions to narrative production in adults with dementia of the Alzheimer's type

Dementia of Alzheimer's type (DAT) is marked by executive control deficit which allows monitoring and resolution of conflict between different stimuli and responses. The possible underlying cause of executive control deficit may be the dysfunction of inhibitory mechanisms due to the reduced availability of attentional resources early in the course of the disease. Literature have evidenced of deficit in executive control as an early diagnosis to DAT before memory impairment which indicate that as the disease progresses early onset of executive deficit may lead to conversion of patient with amnestic mild cognitive impairment (aMCI) to DAT. The early diagnosis of DAT may reduce its devastating effects. The current research converging on executive control function as an earlier indicator of DAT in patients with mild cognitive impairment (MCI) at preclinical stage. The present study examined the executive control in attentional function among people with aMCI, mild and moderate levels of DAT compared with age-matched healthy controls (HC) by using the attentional network paradigm. The flanker paradigm of Attentional Network Task (ANT) was used to assess executive control effect. The reaction time and performance accuracy of the participants were recorded. The result showed that the inhibitory control function was less efficient in DAT as compared to HC. The aMCI group differed to mild and moderate DAT in response time measure. Further, the post-hoc analysis showed significantly slower performance of aMCI and mild DAT with HC group, the performance of patients with mild DAT was also significantly faster than moderate DAT, however, it was seen that aMCI group showed a non-significant difference with mild DAT group on executive control performance. This non-significant result suggests that the few patients with aMCI who performed significantly different at congruent and incongruent condition may progresses to DAT in comparison to those who don't face difficulty in resolving conflict among responses. The impairment in executive control network in aMCI revealed by difference in performance of response inhibition task could be proven as an early diagnostic to DAT which could further delay the onset of symptoms.

Background: Memory is profoundly impaired in patients with dementia of Alzheimer's type (DAT). However, the study of priming, which is thought to be implicit memory, is relatively scarce in DAT. In Japan there is only one study, which investigated repetition priming in DAT and the relationship between the severity of dementia and repetition priming in DAT has never been examined. Therefore, we studied repetition priming in patients with various severity of DAT from the standpoint of familiarity of words. Method: A new repetition priming task, which is constructed of 3 syllable Japanese Kana nouns and which contains high familiarity words and low familiarity words according to Chihara was used for an implicit memory task. The task was carried out by normal controls and patients with DAT. Each group was matched by age, sex, and educational level. Results: A clear repetition priming effect was found among the control and dementia groups both in low and high familiarity words. The priming effects of a high familiarity task demonstrated no statistical differences among the control and dementia group. However, the priming effect of the low familiarity task in the severe dementia group was revealed to be significantly low compared with that of the control group (p<0.01), mild (p<0.01) and moderate group (p<0.05), and there was also statistical significance between the normal control and moderate dementia group (p<0.05). Conclusion: These results indicate that dementia severity and word familiarity influences repetition priming in DAT.

T2-weighted (0.5 T) magnetic resonance images were used to study the prevalence of subcortical white matter hyperintensities (WMHIs) in 22 patients with dementia of Alzheimer's type (DAT), 20 age-matched older healthy control subjects, and 10 younger healthy control subjects. Exclusionary criteria for all groups included cerebrovascular risk factors. All subjects had Hachinski Ischemic Index scores of less than 2 and computed tomographic scans showing no infarct. The WMHIs were classified as periventricular WMHIs or deep WMHIs and graded 0 through 3 (0 indicated absent, and 3, severe). For the group with DAT and older control subjects, periventricular WMHIs and deep WMHIs were graded 2 or 3 in fewer than 17% and 27% of subjects, respectively, whereas in the younger control subjects, all ratings were grade 1 or less. Serum cholesterol and systolic blood pressure values, although within the normal range, were elevated significantly in older control subjects when compared with those in younger control subjects. No significant differences in WMHI ratings, blood pressure, cholesterol, or triglyceride levels were found between patients with DAT and age-matched control subjects. Systolic blood pressure levels correlated with the severity of periventricular WMHIs only in older control subjects. Age correlated with periventricular WMHIs and deep WMHIs within both the older control subjects and the patients with DAT. There was no significant correlation between WMHIs and the severity of dementia in the group with DAT. These results suggest that, in subjects screened for cerebrovascular risk factors, WMHIs are rare and occur with identical frequency in patients with DAT as in age-matched healthy control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Development and validation of a novel dementia of Alzheimer's type (DAT) score based on metabolism FDG-PET imaging

Objectives: Naming tasks are widely used to assess semantic memory and word retrieval abilities, and are considered a sensitive tool for detecting lexical deficits in Dementia of Alzheimer’s Type (DAT). This study aimed to compare naming performance between healthy elderly adults and individuals with DAT, focusing on the effects of word frequency and cue type. In addition, response times and error patterns were analyzed to provide a more detailed understanding of lexical retrieval processes in both groups.Methods: Participants included 54 elderly adults (27 healthy and 27 with DAT). A picture naming task was administered, consisting of high- and low-frequency words. When participants failed to respond correctly, semantic or phonological cues were provided. Accuracy, response time, and error types were systematically analyzed.Results: Healthy elderly adults showed significantly higher accuracy and shorter response times than individuals with DAT. Both groups performed better on high-frequency words than on low-frequency words. After semantic cueing, healthy elderly adults exhibited greater performance improvement compared to the DAT group, whereas no significant group difference emerged after phonological cueing. In terms of error types, the DAT group produced a higher proportion of no-response errors, while both groups frequently exhibited semantic and visual errors.Conclusion: The findings highlight distinct lexical retrieval difficulties in DAT, particularly in the use of semantic cues and the tendency toward no-response errors. These results suggest that naming tasks can provide valuable clinical information for early detection of DAT and inform intervention strategies tailored to cueing methods.

Purpose: Dementia of Alzheimer's type (DAT) is a major cognitive communication disorder. The present study attempted to analyse communication disorders in DAT in the International Classification of Functions (ICF) framework. The study investigated the impact of the severity of communication disorders in persons with DAT on activity participation and environment components of the ICF. Method: Thirty bilingual individuals with DAT in the age range of 65-88 years were classified into three groups of mild, moderate and severe degree of dementia. Forty-three items of the American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS) were linked to the ICF framework. A few additional items were also added for a complete profiling of DAT. A total of 50 (ASHA FACS + ICF) items were rated and administered for the purpose of the study. Results: The study revealed a disproportionate impact of the severity of DAT on activity participation and environment components of the ICF. Conclusion: The present study investigated the utility of the ICF framework for profiling the functionality of persons with DAT. This profiling highlighted the need for ensuring effective communication and quality of life in the DAT population.

Background: Many published studies on dementia of Alzheimer’s type (DAT) have utilized event‐related potentials (ERP) and the Stroop test. However, most of this research has performed these analyses separately. Therefore, in the present research, these two examinations were carried out together following the same paradigm in order to clarify the characteristics of visual dysfunction in DAT patients.Methods: Subjects included 30 normal adults, 10 normal elderly and 10 DAT patients. A visual categorically deviant paradigm was utilized during ERP measurement. The target stimulus was red and non‐target stimuli were blue, yellow and green. The stimuli were displayed as square figures. During the Stroop test, the subjects read color names from word cards, named colors from color cards, and the text color of a printed color word. Reading times and differences in reading times were measured for each task.Results: Regarding ERP, the normal elderly and DAT groups displayed increased latencies and decreased amplitudes compared to the normal adult group. The normal elderly and DAT groups displayed no significant differences in N100 latencies and amplitudes. However, for P300, the DAT group displayed significantly decreased amplitudes in comparison to the normal elderly group. On the Stroop test, the normal elderly and DAT groups displayed significantly extended differences in reading times compared to the normal adult group. No significant differences were observed between the normal elderly and DAT groups.Conclusion: Age‐related changes were observed in the latency of ERP and the increase of the Stroop effect. Characteristic changes in DAT were indicated by latencies and amplitudes of P300, but were not indicated by the Stroop test. Characteristic abnormalities in the stimulation evaluation process were observed for DAT; however, changes other than those related to aging were not apparent in the selection process reaction.

Insulin degrading enzyme (IDE) degrades amyloid β (Aβ), which may inhibit the accumulation of Aβ in a brain affected with dementia of Alzheimer's type (DAT). A decrease in the activity of IDE results in changes in glucose utilization in the brain, which could affect the cognitive and psychiatric symptoms of DAT. We investigated a possible association of IDE gene polymorphism and the behavioral and psychological symptoms of dementia (BPSD) in mild DAT. The genotyping for IDE and apolipoprotein E (ApoE) was determined in 207 patients with mild DAT and 215 controls. The occurrence of BPSD was demonstrated using the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). IDE gene polymorphism is unlikely to play a substantial role in conferring susceptibility to DAT, but it may be involved in the development of affective disturbance through the course of mild DAT, regardless of the presence of an ApoE ε4 allele. The present data could be the result of a small sample size. Further investigations using larger samples are thus required to clarify the correlation between IDE gene polymorphism, susceptibility to DAT, and emergence of BPSD.

Ninety-five normal controls divided into three subgroups (55-64 yrs, 65-74 yrs, and 75-84 yrs) and 11 subjects with early dementia of Alzheimer's type (DAT) were given a line orientation judgment task (Benton, Varney, & Hamsher, 1978). No difference appeared between the three control subgroups in global score but the difference between controls and DAT subjects was significant. However, some DAT subjects had a global score overlapping the scores of controls. Error types were also analyzed. Results of this analysis showed that some errors appeared in all subjects, normal and DAT, while others were specific to DAT subjects. It was speculated that these error types were a manifestation of a deeper visuospatial deficit, revealing a major problem of the DAT in spatial organization. Thus, this study suggests that an analysis of the error types observed in the line orientation judgment task may be helpful in differentiating normal elderly from early DAT.

Objectives: This study aimed to establish evidence for effective (Augmentative and Alternative Communication) AAC intervention approaches for patients with dementia of Alzheimer’s type (DAT) by examining whether the severity of dementia and the symbol type used in AAC tools affect symbol selection. Additionally, we aimed to investigate the relationship between symbol selection ability and language and cognitive abilities. Methods: Twenty-one normal elderly individuals, 17 patients diagnosed with mild DAT, and 20 patients with moderate to severe DAT were recruited. A symbol selection task was conducted using the Augmentative and Alternative Communication Symbol Assessment Tool (AAC-SAT). Participants selected target symbols on the screen consisting of graphic symbols, photos, and written words in response to auditory prompts given by the examiner. Data from the tasks were statistically analyzed for accuracy and response time, and correlation analyses were conducted for cognitive and language abilities. Results: The moderate to severe DAT group showed significantly lower accuracy and longer response times in symbol selection compared to the mild DAT group and normal elderly group. Upon examining each group separately, both mild and moderate to severe DAT groups showed no symbol type that was advantageous for symbol selection. However, the rapid response to photos observed in mild DAT group disappeared in the moderate to severe DAT group. Additionally, the symbol selection ability of DAT patients significantly deteriorated as language and cognitive abilities declined. Conclusion: Appropriate symbol types for AAC aimed at facilitating effective communication considering the language and cognitive abilities of DAT patients were suggested, and the findings of this study were compared with the claims made by previous research.

OBJECTIVETo test the hypothesis that semantic impairment is present in both patients with dementia with Lewy bodies (DLB) and those with dementia of Alzheimer's type (DAT).METHODSA comprehensive battery of neuropsychological...

The lack of coherence in the narrative discourse of patients with dementia of Alzheimer's type (DAT) is attributed to the presence of irrelevant information. The definition of irrelevant information, however, varies across studies. For some authors, any utterance is considered as irrelevant, whether or not it is linked to the topic. In this study, we distinguished Relevant (expected), Related (unexpected but linked to the topic) and Irrelevant (unexpected not linked to the topic) utterances. We hypothesized that DAT patients produce more Irrelevant utterances than controls. We administered a narrative discourse test to 29 DAT and 29 controls. Results revealed that controls produced more Relevant than Irrelevant utterances whereas the proportions for these two utterance types did not differ in the DAT group. We conclude that the lack of coherence in the narrative discourse of DAT patients is due to the lower proportion of relevant information it contains.

Validity of the ischemic score in degenerative and vascular dementia and depression in old age