Assessment of Cognitive-Communicative Functions in Persons With Mild Cognitive Impairment and Dementia of Alzheimer's Type

Assessment of Cognitive-Communicative Functions in Persons With Mild Cognitive Impairment and Dementia of Alzheimer's Type

Reuben Thomas Varghese (All India Institute of Speech and Hearing, India) and S. P. Goswami (All India Institute of Speech and Hearing, India)
DOI: 10.4018/978-1-5225-4955-0.ch014

Abstract

According to world population prospects data report, older individuals, especially those aged 60 years and above, have increased substantially over the recent year, which is going to accelerate in the coming decades. The most common problems the aging population faces are dementia of the Alzheimer's type (DAT) and mild cognitive impairment (MCI). Assessment of cognitive-communicative markers is essential for persons with MCI and DAT. Furthermore, it can help in the differential diagnosis of DAT and MCI. Proper assessment by speech-language pathologists is warranted in this area as it will throw light on the differential diagnosis of MCI and DAT, the clinical description of the characteristics between the two clinical groups, the prognosis for improved outcomes, recommendations for intervention and support, and referral for other professionals for assessments or services.
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Mild Cognitive Impairment (Mci)

According to the Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (DSM-IV) American Psychiatric Association (1994), Mild Cognitive Impairment (MCI) is defined as an intermediary stage between the cognitive stages of normal elderly aging and the mild degree of dementia. Petersen et al. (2001a) reported that persons with MCI have more risk of progressing to clinically probable DAT.

Sub-Types of MCI

According to Petersen et al. (2001b), based on cognitive features MCI can be divided into

  • 1.

    Amnestic MCI: These individuals have impairment predominantly in memory.

  • 2.

    Multiple Domain MCI: These individuals have impairments noticed in more than one cognitive domain which can include memory.

  • 3.

    Single Domain Non-Amnestic MCI: These individuals have impairment in any one cognitive domain apart from memory.

Dementia

Dementia describes a group of brain disorders which can progressively lead to brain damage, and subsequently lead to gradual deterioration of a person’s functional capacity and socio-cultural relations. The term dementia is originally derived from Latin word ‘de mens’ meaning a decline in mental abilities. Cummings, Benson, and LoVerme (1980) reported that at least three out of the following five areas- memory, language, visuospatial skills, emotional skills, personality and cognition must be disrupted in persons with dementia. The definition according to Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (DSM-IV) (1994) states that the most prominent feature among dementia is the impairments in both short-term (STM) and long-term memories (LTM). These memory deficits may also be associated with one or more concomitant features like agnosia, aphasia, apraxia, impairment in abstract thinking, and personality changes. The salient features for diagnosis of dementia are

  • 1.

    Impairment in both short term and long-term memory.

  • 2.

    Impairment in abstract thinking and judgment.

  • 3.

    Personality changes.

  • 4.

    Specific organic factor.

  • 5.

    The absence of a non-organic factor as a reason for the symptoms like depression.

Key Terms in this Chapter

Memory: It is defined as the power or process of reproducing or recalling what has been learned and retained especially through associative mechanisms.

Executive Function: It is a set of mental skills that help you get things done. These skills are controlled by an area of the brain called the frontal lobe.

Dementia of Alzheimer’s Type (DAT): It is the most common cause of dementia, affecting memory, language, thinking, and behavior of an individual in middle or older age groups. The pathological conditions reveal plaque formations and tangles which progressively affects the individual’s daily living activities.

Communication: It is the act of the imparting or exchanging information by means of speaking, writing, or using some other medium.

Mild Cognitive Impairment (MCI): It is a condition characterized by significant cognitive impairment in the absence of dementia. It primarily affects memory, but it might cause changes in daily function in subtle ways. MCI is different from Alzheimer’s disease or other dementias. It does not typically affect a person’s ability to complete daily tasks or cause general confusion.

Diagnosis: It is the identification of the nature and cause of a certain phenomenon.

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