Estudio comparativo y relacional del lenguaje y la audición de acuerdo al estado cognitivo en una muestra de personas mayores de 65 años

[Resumen] Objetivo: Analizar las características del lenguaje y de la audición en el envejecimiento normal y en el deterioro cognitivo/demencia; así como determinar las posibles interrelaciones entre ambos aspectos comunicativos. Material y métodos: Los sujetos, todos de edad =65 años, se distribuyeron en dos subgrupos de acuerdo al estadiaje del GDS. Grupo NO DEM, formado por 40 sujetos en los estadios GDS 1-3 y Grupo DEM, 42 sujetos GDS 4-5. Se administraron pruebas de estadiaje cognitivo (GDS y MMSE); pruebas de lenguaje (Test de Fluencia Verbal, Test de Denominación de Boston Abreviado y Token Test); pruebas auditivas (otoscopia, audiometría tonal aérea, Test de Weber y Test de Rinne) y de valoración del impacto de la pérdida auditiva (Hearing Handicap Inventory for the Elderly-Screening version) en ambos grupos. Resultados: El rendimiento en las pruebas de lenguaje fue superior en el grupo NO DEM con respecto al DEM. En la audición no hubo diferencias entre ambos grupos. Entre las pruebas de lenguaje y auditivas, sólo se encontró correlación con el Token Test. Conclusiones: Las pruebas del lenguaje fueron identificadoras de deterioro cognitivo/demencia. El tipo y el grado de pérdida auditiva se correspondieron con el patrón característico en este subtipo poblacional. La pérdida auditiva y el deterioro cognitivo parecen ser aspectos independientes, con excepción de la comprensión verbal que sí se ha visto comprometida por la percepción auditiva.[Resumo] Obxectivo: Analizar as características da linguaxe e da audición no envellecemento normal e na deterioración cognitiva/demencia; así como determinar as posibles interrelacións entre ambos os dous aspectos comunicativos. Material e métodos: Os suxeitos, todos de idade =65 anos, se distribuiron en dous subgrupos de acordo ao estadiaje do GDS. Grupo NON DEM, formado por 40 suxeitos nos estadios GDS 1-3 e Grupo DEM, 42 suxeitos GDS 4-5. Administráronse probas de estadiaje cognitivo (GDS e MMSE); probas de linguaxe (Test de Fluencia Verbal, Test de Denominación de Boston Abreviado e Token Test); probas auditivas (otoscopia, audiometría tonal aérea, Test de Wéber e Test de Rinne) e de valoración do impacto da perda auditiva (Hearing Handicap Inventory for the Elderly-Screening version) en ambos os dous grupos. Resultados: O rendemento nas probas de linguaxe foi superior no grupo NON DEM con respecto ao DEM. Na audición non houbo diferenzas entre ambos os dous grupos. Entre as probas de linguaxe e auditivas, só se encontrou correlación co Token Test. Conclusións: As probas da linguaxe foron identificadoras de deterioración cognitiva/demencia. O tipo e o grao de perda auditiva correspondeuse co patrón característico neste subtipo poboacional. A perda auditiva e a deterioración cognitiva parecen ser aspectos independentes, con excepción da comprensión verbal que si se viu comprometida pola percepción auditiva.[Abstract] Objective: To analyze the characteristics of speech and hearing in normal aging and cognitive decline/dementia, as well as determine possible relationships between both aspects of communication. Methods: Participants, all = 65 years, were divided into two subgroups according to GDS scale: NO DEM Group, consisting of 40 subjects in GDS stages 1-3 and DEM group, 42 subjects in GDS 4-5. We administered cognitive status tests (MMSE and GDS), language tests (Verbal Fluency Test, an abbreviated version of Boston Naming Test and Token Test), hearing tests (otoscopy, tone audiometry (air conduction), Test of Weber and Rinne test) and also assessment tests of hearing loss impact (Hearing Handicap Inventory for the Elderly-Screening version) in both groups. Results: Performance on language tests was higher in the NO DEM group compared to the DEM group, while no differences were found between groups as regards hearing. Only the Token Test showed correlations between auditory and language tests. Conclusions: Language tests were indicative of cognitive decline/dementia. The type and degree of hearing loss corresponded to the characteristic pattern in this subtype population. Hearing loss and cognitive impairment appeared to be independent aspects, except for verbal comprehension, which has been compromised by auditory perception

Papel del logopeda en un centro gerontológico de estancias diurnas

[Resumen] El aumento de población anciana en nuestra sociedad es un hecho que ha provocado la aparición de nuevos recursos socio-sanitarios que cubran sus necesidades. El Centro Gerontológico de Estancias Diurnas es un servicio multidisciplinar diurno que se ocupa de la atención social y sanitaria, con actuación terapéutica y preventiva, de los mayores facilitando la vida laboral de las personas que se ocupan ordinariamente de su cuidado. Los centros de día deben proporcionar una atención integral debiendo, por tanto, estar constituidos por un equipo profesional multidisciplinar en el que la figura del logopeda esté presente desarrollando una labor específica. Parece, por tanto, interesante delimitar las funciones básicas a desempeñar, los trastornos más comunes susceptibles de intervención, así como, algunas directrices a tener en cuenta.[Abstract] The increase of the senior population in our society is an event that has provoked the appeareance of a new sort of social and sanitary recource, a structure that has to be concerned with the needs of this population. The gerontologic day-center is in brief a multidisciplinar service, that works during day time, treating the social and sanitary occupation of our elder with both therapeutic and preventive acts. This to provide a normal working life for the people who are usually taking care of these people. Day-centers have to answer these needs with a complete service, and for that reason they have to apile to a multidisciplinar staff in wich the speech-therapist develops a specific role. It seems though interesting to define the basic functions that a professional speech-therapist has to perform, such as the most common disorders capable of treatment and general intervention, as well derectives to bear in mind

Verbal fluency, naming and verbal comprehension: three aspects of language as predictors of cognitive impairment

[Abstract] Objectives: To establish the possible relationship among three components of language (verbal fluency, naming and comprehension) and cognitive impairment as well as to determine the usefulness of language assessment tests to predict or monitor the development of cognitive impairment. Method: A comparative, descriptive and cross-sectional study was performed on 82 subjects 65 years of age who were cognitively assessed with the Mini Mental State Examination and were divided into two groups: Group A comprised of subjects classified as levels 1, 2 and 3 on the Reisberg’s Global Deterioration Scale (GDS) and group B comprised of subjects at levels 4 and 5 of the GDS. Language skills were assessed by the Verbal Fluency Test, Boston Naming Test and Token Test. Results: An inverse relationship between performance on language tests and cognitive impairment level was observed with a more pronounced effect observed on fluency and comprehension tests. Conclusion: Language assessments, especially fluency and comprehension, were good indicators of cognitive impairment. The use of these assessments as predictors of the degree of cognitive impairment is discussed in-depth

The impact of hearing loss on language performance in older adults with different stages of cognitive function

[Abstract] Purpose. The possible relationship between audiometric hearing thresholds and cognitive performance on language tests was analyzed in a cross-sectional cohort of older adults aged ≥65 years (N=98) with different degrees of cognitive impairment. Materials and methods. Participants were distributed into two groups according to Reisberg’s Global Deterioration Scale (GDS): a normal/predementia group (GDS scores 1–3) and a moderate/moderately severe dementia group (GDS scores 4 and 5). Hearing loss (pure-tone audiometry) and receptive and production-based language function (Verbal Fluency Test, Boston Naming Test, and Token Test) were assessed. Results. Results showed that the dementia group achieved significantly lower scores than the predementia group in all language tests. A moderate negative correlation between hearing loss and verbal comprehension (r=−0.298; P<0.003) was observed in the predementia group (r=−0.363; P<0.007). However, no significant relationship between hearing loss and verbal fluency and naming scores was observed, regardless of cognitive impairment. Conclusion. In the predementia group, reduced hearing level partially explains comprehension performance but not language production. In the dementia group, hearing loss cannot be considered as an explanatory factor of poor receptive and production-based language performance. These results are suggestive of cognitive rather than simply auditory problems to explain the language impairment in the elderly

Cognitive and affective assessment in day care versus institutionalized elderly patients: a 1-year longitudinal study

[Abstract] Purpose: Cognitive decline and depression are two common mental health problems that may create a need for long-term care among the elderly. In the last decade, the percentage of older adults who receive health care in nursing homes, day care centers, or home support services has increased in Europe. The objectives of this descriptive and nonrandomized longitudinal study were to evaluate and to compare the cognitive and affective evolution of day care versus institutionalized older patients through a 1-year period, and to assess the presence of cognitive and affective impairment as a function of the care setting. Patients and methods: Ninety-four patients were assessed at baseline, and 63 (67.0%) were reassessed 1 year later. Neuropsychological assessment included measures of cognitive performance (general cognitive status, visuospatial, and language abilities) and affective status (depressive symptoms). Results: Our findings indicated that the majority of the participants (day care and institutionalized patients) had mild–moderate cognitive impairment at baseline, which significantly increased in both groups after 1-year follow-up. However, the rate of change in global cognitive function did not significantly differ between groups over time. Regarding language abilities, naming function maintained among day care patients in comparison with institutionalized patients, who showed worse performance at follow-up. As regards to affective status, results revealed that institutionalized patients had a significant reduction in depressive symptoms at follow-up, when compared to day care patients. Results also highlight the high frequency of cognitive impairment and depressive symptoms regardless of the care setting. Conclusion: Our findings revealed a similar global cognitive decline rate between patients receiving day care services and those residing in a nursing home at the 1-year follow-up, and slightly different trajectories in other outcomes such as naming function and depressive symptoms