1
Q
positive impacts of aging on speech
A
- vocabulary
- better use of context
- better application
- use more abstract words
- “wisdom”
2
Q
t or f: word retrieval gets easier with age
A
false
3
Q
Effects of aging on speech include (6)
A
- dysfluencies (hesitant)
- more fillers
- TOTs
- using more indefinite words
- less complex grammar
- short sentences
4
Q
t or f: there is no loss of competency in relaying information as we age
A
true
5
Q
age-related changes that may impact comm
A
- hearing
- vision
- reduced articulatory accuracy
- decreased speed of mental processes
- decreased ability to multitask
- changes in memory
6
Q
what might contribute to reduced articulatory accuracy?
A
decreased mandibular ROM
7
Q
change does not equal _____
A
decline
8
Q
what is a subjective cognitive complaint
A
report of cognitive struggles, but no impairment shown on tests
9
Q
what is a mild cog impairment
A
greater than age-expected cognitive decline, but not significant enough to result in marked loss of functional independence
10
Q
characteristics of MCI
A
- report of a cog complaint (self or other)
- objective cog impairment (on testing)
- no dementia
- generally intact functional abilities (ADLs)
11
Q
4 types of MCI
A
- amnestic single-domain
- amnestic multiple domain
- non-amnestic single-domain
- non-amnestic multiple domain
12
Q
types of MCI not affecting memory
A
non-amnestic types (single & multi domain)
13
Q
types of MCI affecting memory
A
amnestic types (single & multi domain)
14
Q
what is meant by single domain
A
affecting only one area/skill
15
Q
what is meant by multi-domain
A
affecting only more than one area/skill
16
Q
what is DAT
A
dementia of Alzheimer’s type
17
Q
what is phonemic fluency
A
ability to generate list of words beginning with specific letter (e.g., T, L)
18
Q
what is semantic fluency
A
ability to generate a list of items within a category (e.g., animals, fruit)
19
Q
discuss the comparison of language abilities in normed population vs amnestic MCI, and AD
A
- skills that are similar: oral reading regular spelling, lexical semantics, nonverbal semantics
- N & aMCI are better than DAT at orientation
- N > aMCI > DAT: naming, irregular spelling, semantic fluency, general cognitive ability, MMSE
- N performs best, but aMCI and DAT are equal in complex grammar, word recognition, story recall, phonemic fluency
20
Q
what is the MMSE
A
mini mental state examination: an 11-question measure that tests five areas of cognitive function: orientation, registration, attention and calculation, recall, and language.
21
Q
What is dementia
A
and umbrella term used to describe a range of symptoms associated with cognitive impairment
22
Q
% of patients with alzheimer’s
A
50-75%
23
Q
% of patients with vascular dementia
A
20-30%
24
Q
% of patients with lewy body dementia
A
10-25%
25
% of patients with FTD
10-15%
26
dementia types
alzheimers
vascular
lewy body
frontotemporal
parkinson's disease
progressive supranuclear palsy
huntington's disease
corticobasal syndrome
primary progressive aphasia
27
t or f: alzheimers and vascular dementia cannot co-exist
false
28
describe dementia
loss of mental functions; acquired persistent impairment in multiple areas of intellectual function
29
the deficits of dementia are beyond that of ______ _______ _____
mild cognitive impairment
30
one key difference btwn dementia and MCI?
patients w MCI can still perform ADLs
31
characteristics of dementia & how they are assessed
- can't perform usual activities (work/ADLs)
- declining from previous levels of functioning
- cannot be explained by delirium or major psychiatric disorder
- are diagnosed through: case hx from pt & informant, and an object cognitive ax.
32
t or f: self-report on functioning status is sufficient for an ax
false, best to get information from another party; patient may not be aware of severity or impact of condition
33
5 areas often impacted by dementia
1) memory
2) executive functioning
3) visuo-spatial function
4) language
5) personality/behaviour
34
examples of how can dementia may impact one's memory (4)
- repeating questions
- misplacing items
- forgetting events/apts
- getting lost in familiar space
35
how can dementia impact one's executive functioning
error in reasoning and judgement due to:
- poor understanding of safety risks
- unable to manage finances
- poor decision making
- unable to plan complex or sequential activities
36
how can dementia impact one's visuo-spatial function
unable to recognize faces or objects
unable to operate simple tools
unable to get dressed
37
how can dementia impact one's language
word-finding difficulties
hesitations
spelling and writing errors
38
what dementia type impacts language-only
PPA
39
t or f: FTD has word retrieval difficulties in early stages
false, may not be evident initially
40
t or f: FTD impacts executive functioning
true
41
what is the most common initial sign of alzheimer's?
memory deficits
42
how many Canadians living with dementia?
565 000
43
how many Canadians directly or indirectly impacted by dementia?
1.1 million
44
how many Canadians under 65 living with dementia?
16 000
45
number of new dementia cases diagnosed each year
76 000
46
the annual cost of caring for living with dementia
$10 billion
47
what is the role of the SLP in dementia?
- identification
- assessment
- intervention
- counselling
- collaboration
- case management
- education
- advocacy
- research
48
Dementia's of Alzheimer's type has a(n) _____ onset and a(n) _______ progression
insidious (slow), gradual
49
Those with Alzheimer's have no evidence of:
- cerebrovascular disease
- core features of other dementias
- another neurological disease or medication impacting cognition
50
dementia with evidence of cerebrovascular disease is likely to be which type?
vascular dementia
51
Alzheimer's has impairments in at least ______ cognitive domains
two
(e.g., memory, behaviour, visuo-spatial, language, executive functions)
52
Alzheimer's impact on language
- naming difficulties
- paraphasias
- impaired comprehension
- reading and writing disorder
53
prevalence of Alzheimer's in people aged 65-70
2.3%
54
prevalence of Alzheimer's in people aged 70-80
3.9%
55
prevalence of Alzheimer's in people aged 80+
22%
56
ratio of Alzheimer's in men vs women
1 (men) : 2 (women)
57
what contributes to the differences in Alzheimer's incidence between men and women
differences in cells and longer life span (for women)
58
duration of Alzheimer's
average of 6-12 years
overall range of 1-20 years
59
role of the hippocampus
responsible for memory and new learning
processes and stores new memories before sending them to long term storage
60
how does Alzheimer's impact neurons and the brain
neurons have neurofibrillary tangles
presence of amyloid plaques between/around neurons
61
what are amyloid plaques
clumps of protein (beta-amyloid) that form i between neurons
62
t or f: Alzheimer's is sometimes misdiagnosed as hydrocephalus
true; due to large appearance of ventricles - however, the large appearance is due brain shrinkage
63
typical brain volume is ____________cm^3
brain volume in those with Alzheimer's Disease is ____________cm^3
1200-1500
< 1000
64
common characteristics of mild AD (Cookie Theft example video)
slow rate of speech
difficulty word-finding
requiring reminders (e.g., putting glasses on)
disfluencies
hesitancies
may miss overall theme of photo
65
t or f: patients with AD may present with word-finding difficulties
true
66
t or f: stage III is used to describe descriptive and fluent speech
false
67
describe expressive language in Alzheimer's (in picture description task)
- fewer units of information
- decreased cohesion
- poor organization
- simple or nonspecific vocabulary
- paraphasias
- wfp
- repeating ideas
- missing the central idea
68
describe expressive language in Alzheimer's (in naming task)
Semantic and phonemic paraphasias & circumlocutions
69
describe expressive language in Alzheimer's (in connected speech task)
- poor cohesion
- wfp
- paraphasias
- losing train of thought
- unfinished sentences
- reduced rate
70
describe receptive language skills in Alzheimer's
- Increased processing time
- Difficulty in noisy environments
- Problems with multi-partner convos
- Poor comprehension of complex sentences
- Reduced receptive vocabulary
- Difficulty w figurative language
- Poor sensitivity to context
- Trouble following conversations/plots
71
linguistic areas to consider when assessing language processing in Alzheimer's
- Prosody
- Phonology
- Semantic knowledge/semantic memory
- Naming/word retrieval
- Syntax
- Discourse
38 D
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