P2-236: Functional assessment of communication skills for Alzheimer's disease

Abstract

Limitation on ability to utter and understand a message independently and efficiently in response to everyday demand is one of the most important complaints of Alzheimer's disease relatives/caregivers. Those language problems intervene in engagement, social life and have impact on one's independence. There is a need for providing an instrument in Portuguese that assess communication in a natural context for diagnosing and following patients with AD and their relatives/caregivers. This study aimed to validate the Functional Assessment of Communication Skills – ASHA FACS for a Brazilian population and verify the influence of age and education on ASHA FACS performance. The ASHA FACS is composed of four domains: Social Communication, Communication of Basic Needs, Reading, Writing and Number Concepts and Daily Planning. The scale was translated and adapted into Portuguese. Thirty two mild AD patients, 25 moderate AD patients and 51 elderly without dementia were examined. The AD patients and the control group answered the Minimental State Examination (MMSE), the Geriatric Depression Scale (GDS) and Alzheimer's disease Assessment Scale (ADAS-cog). The ASHA FACS was answered by their relative/caregiver. The scale internal consistency, its inter and intra-examiners reproducibility and scale's criterion validity were researched. The effect of education and age in functional communication performance were analyzed. Statistical analyses indicated that the ASHA FACS has excellent internal consistency (Cronbach's Alpha=0,955), test-retest reliability (interclass correlation coefficient [ICC] = 0,995; p<0,001) and inter-examiners (ICC=0,998; p<0,001). Besides, it showed excellent criterion validity when correlated with Adas-cog. The ASHA FACS scale showed good sensitivity (81.4%) and specificity (84.3%) values once it is an ecological and broad evaluation. It was verified that years of education intervened in functional communication performance of healthy elderly and ones with AD, but the age did not have the same influence on functional communication performance in both groups. The ASHA FACS Portuguese version is a valid and reliable instrument to verify communication alterations in AD patients. It is useful for diagnosis and track alterations along the disease aiming patient's treatment and relative's and caregiver's orientation. It fills an important gap of efficiency indicators for speech language therapy.