Narrative Discourse in Young and Older Adults: Behavioral and NIRS Analyses.

Discourse comprehension is at the core of communication capabilities, making it an important component of elderly populations' quality of life. The aim of this study is to evaluate changes in discourse comprehension and the underlying brain activity. Thirty-six participants read short stories and answered related probes in three conditions: micropropositions, macropropositions and situation models. Using near-infrared spectroscopy (NIRS), the variation in oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) concentrations was assessed throughout the task. The results revealed that the older adults performed with equivalent accuracy to the young ones at the macroproposition level of discourse comprehension, but were less accurate at the microproposition and situation model levels. Similar to what is described in the compensation-related utilization of neural circuits hypothesis (CRUNCH) model, older participants tended to have greater activation in the left dorsolateral prefrontal cortex while reading in all conditions. Although it did not enable them to perform similarly to younger participants in all conditions, this over-activation could be interpreted as a compensation mechanism.

Lateralized Affective Word Priming and Gender Effect.

Affective priming research suggests that processing of affective words is a quick and short lived process. Using the divided visual field (DVF) paradigm, investigations of the lateralization of affective word processing have yielded inconsistent results. However, research on semantic processing of words generally suggests that the left hemisphere (LH) is the location where rapid processing occurs. We investigated the processing of affective (emotional) words using a combination of the DVF and affective priming paradigms, and four stimulus onset asynchronies (SOAs)-0, 150, 300, and 750 ms. The priming pattern yielded by males (n = 32) showed quick priming (at 0-ms SOA) of affective words in the LH; there was slower right hemisphere (RH) priming of affective words (at 750-ms SOA). In females (n = 28), both hemispheres were associated with quick priming of affective words (at 300-ms SOA in the LH and at 150-ms SOA in the RH). Results demonstrate the capability of both cerebral hemispheres in the processing of words with affective meaning, along with leading role of the left hemisphere in this process. This is similar to the results of semantic research that suggest access to word meanings occurs in both hemispheres, but different mechanisms might be involved. While the LH seems to prime affective words quickly regardless of gender, gender differences are likely in the RH in that affective word processing probably occurs slowly in males but rapidly in females. This gender difference may result from increased sensitivity to the emotional feature of affective words in females.

Verbal fluency in right brain damage: dissociations among production criteria and duration.

This study aimed to verify dissociations in the performance of verbal fluency tasks with different production criteria and duration following vascular right-hemisphere damage. We tested the hypothesis that longer fluency tasks would be more sensitive in identifying deficits in the sample. The relationship between verbal fluency performance and sustained attention was also investigated. Forty adults with vascular right-hemisphere damage were assessed using verbal fluency tasks with three different production criteria (unconstrained, phonemic, and semantic fluencies from the Montreal Communication Evaluation Battery). Performance deficits in 1-min and 2-min fluency tasks were calculated (Z score) and compared (chi-square). Results did not suggest a difference in sensitivity between the task lengths in detecting cognitive impairment. However, double dissociations were found, highlighting the contribution of extended verbal fluency tasks to neuropsychological assessment. Analyses also showed that participants exhibited greater levels of impairment in the semantic fluency task. No relationship was identified between performance in sustained attention tasks and verbal fluency tasks, regardless of the latter's duration. The combined use of longer and shorter fluency tasks in the assessment of patients with right brain damage may contribute to the identification of different executive function impairments in this sample.

Working memory training and poetry-based stimulation programs: are there differences in cognitive outcome in healthy older adults?

BACKGROUND: Neuropsychological interventions have been mainly applied with clinical populations, in spite of the need of preventing negative changes across life span. Among the few studies of cognitive stimulation in elderly, surprisingly there is no enough research comparing direct and indirect active stimulation programs. OBJECTIVE: This study aims to verify wheter there are differences between two cognitive interventions approaches in older adults: a structured Working Memory (WM) Training Program versus a Poetry-based Stimulation Program. METHODS: Fourteen older adults were randomly assigned to participate into one of the two intervention groups. The assessed neurocognitive components were attention, episodic and working memory, communicative and executive functions. WM Training activities were based on Baddeley's model; Poetry-based Stimulation Program was composed by general language activities. Data were analyzed with one-way ANCOVA with Delta scores and pre and post-training tests raw scores. RESULTS: WM group improved performance on WM, inhibition, and cognitive flexibility measures, while Poetry group improved on verbal fluency and narrative discourse tasks. DISCUSSION: Both approaches presented benefits; however WM Training improved its target function with transfer effects to executive functions, being useful for future studies with a variety of dementias. Poetry-based Stimulation also improved complex linguistic abilities. Both approaches may be helpful as strategies to prevent dysfunctional aging changes.

Adaptação de uma tarefa de discurso narrativo infantil e dados quanto ao tipo de escola / Adaptation of a discourse narrative task for children and data regarding school type / Adaptación de una tarea de discurso narrativo para niños y datos referentes al tipo de escuela

Objetivou-se apresentar o processo de adaptação da tarefa do Discurso Narrativo da Bateria MAC para crianças, verificando-se, ainda, se a tarefa diferencia o desempenho de crianças quanto ao tipo de escola. A adaptação ocorreu em quatro etapas: 1) adaptação de instrução e de termos; 2) análise comparada de proposições por neuropsicolinguista; 3) análise por juízes especialistas; 4) estudo piloto com 14 crianças entre 6 e 12 anos de idade. Compararam-se dois grupos de crianças saudáveis de 7 a 9 anos de idade, 15 de escola pública e 16, de privada. Realizaram-se mudanças terminológicas na narrativa e na instrução, sendo a análise de juízes e o estudo piloto fundamentais. O número de informações presentes do reconto parcial foi superior em crianças de escola privada. A tarefa pode auxiliar na identificação de um perfil desenvolvimental de algumas funções neuropsicológicas na infância...

The aim in the study was to present the process of adapting the task Narrative Discourse of the MAC Battery for application to children, also verifying whether the task distinguishes children’s performance regarding the type of school. The adaptation process subsumed four steps: 1) instructions and terminology adaptation; 2) compared analysis of propositions by a neuropsycholinguist; 3) specialized judges’ analysis; 4) pilot study with 14 children aged 6 to 12 years. Two groups of healthy children aged 7 to 9 (15 from a public school and 16 from a private school) were compared. Word changes in the narrative and in instructions were developed, a process grounded on the judge’s analyses and on the pilot study. The amount of information present in the partial retelling of the narrative was superior in children from private schools. The task is apt to aid in the identification of the developmental profile of some neuropsychological functions in childhood...

El objetivo fue presentar la adaptación de tarea de Discurso Narrativo de la Batería MAC infantil, además de verificar si el desempeño en la tarease diferencia por el tipo de escuela de los niños. La adaptación se realizó en cuatro etapas: 1) adaptación de la instrucción ytérminos, 2) análisis comparativo de las proposiciones por neuropsicolinguista, 3) análisis de jueces expertos, 4) estudio piloto con 14 niños de 6 y 12 años de edad. Se compararon dos grupos de niños saludables de 7-9 años, de 15 escuelas públicas y 16 privadas. Se realizaron cambios en la terminología de la narración y la instrucción, siendo fundamentales los análisis de los jueces y el estudio piloto. La cantidad de la información proporcionada en el recuento parcial fue mayor en los niños de escuela privada. Latarea puede ayudar a identificar un perfil de desarrollo en algunas funciones neuropsicológicas en la infancia...

Adaptação de uma tarefa de discurso narrativo infantil e dados quanto ao tipo de escola / Adaptation of a discourse narrative task for children and data regarding school type / Adaptación de una tarea de discurso narrativo para niños y datos referentes al tipo de escuela

Objetivou-se apresentar o processo de adaptação da tarefa do Discurso Narrativo da Bateria MAC para crianças, verificando-se, ainda, se a tarefa diferencia o desempenho de crianças quanto ao tipo de escola. A adaptação ocorreu em quatro etapas: 1) adaptação de instrução e de termos; 2) análise comparada de proposições por neuropsicolinguista; 3) análise por juízes especialistas; 4) estudo piloto com 14 crianças entre 6 e 12 anos de idade. Compararam-se dois grupos de crianças saudáveis de 7 a 9 anos de idade, 15 de escola pública e 16, de privada. Realizaram-se mudanças terminológicas na narrativa e na instrução, sendo a análise de juízes e o estudo piloto fundamentais. O número de informações presentes do reconto parcial foi superior em crianças de escola privada. A tarefa pode auxiliar na identificação de um perfil desenvolvimental de algumas funções neuropsicológicas na infância.(AU)

The aim in the study was to present the process of adapting the task Narrative Discourse of the MAC Battery for application to children, also verifying whether the task distinguishes children’s performance regarding the type of school. The adaptation process subsumed four steps: 1) instructions and terminology adaptation; 2) compared analysis of propositions by a neuropsycholinguist; 3) specialized judges’ analysis; 4) pilot study with 14 children aged 6 to 12 years. Two groups of healthy children aged 7 to 9 (15 from a public school and 16 from a private school) were compared. Word changes in the narrative and in instructions were developed, a process grounded on the judge’s analyses and on the pilot study. The amount of information present in the partial retelling of the narrative was superior in children from private schools. The task is apt to aid in the identification of the developmental profile of some neuropsychological functions in childhood.(AU)

El objetivo fue presentar la adaptación de tarea de Discurso Narrativo de la Batería MAC infantil, además de verificar si el desempeño en la tarease diferencia por el tipo de escuela de los niños. La adaptación se realizó en cuatro etapas: 1) adaptación de la instrucción ytérminos, 2) análisis comparativo de las proposiciones por neuropsicolinguista, 3) análisis de jueces expertos, 4) estudio piloto con 14 niños de 6 y 12 años de edad. Se compararon dos grupos de niños saludables de 7-9 años, de 15 escuelas públicas y 16 privadas. Se realizaron cambios en la terminología de la narración y la instrucción, siendo fundamentales los análisis de los jueces y el estudio piloto. La cantidad de la información proporcionada en el recuento parcial fue mayor en los niños de escuela privada. Latarea puede ayudar a identificar un perfil de desarrollo en algunas funciones neuropsicológicas en la infancia.(AU)

Adaptação do Protocole MEC de Poche e da Bateria Mac Expandida: Bateria Mac Breve / Adaptation of Protocole MEC de Poche and of the Extended MAC Battery: Brief MAC Battery / Adaptación del protocole MEC Poche y de la Batería MAC Ampliada: Batería MAC Breve

Este estudo apresenta procedimentos teóricos e empíricos da adaptação da versão expandida da Bateria MAC e do Protocole MEC de Poche para uma versão breve brasileira – Bateria MAC Breve. Participaram quatro tradutores, 308 juízes não especialistas, 14 juízes especialistas e 36 adultos saudáveis. Seis etapas foram conduzidas: (1) comparação entre MAC expandida e MEC de Poche, (2) tradução, (3) desenvolvimento de novos estímulos, (4) análise de critérios psicolinguísticos por juízes não especialistas e (5) especialistas e (6) estudos pilotos. A versão adaptada mostrou-se adequada e apresentou evidência de validade de conteúdo para avaliar processamentos comunicativos discursivo, pragmático-inferencial, léxico¬semântico e prosódico. Estudos futuros com populações clínicas tornam-se necessários para que se possa utilizá-la para o diagnóstico funcional de dificuldades comunicativas...

This study presents the theoretical and empirical procedures involved in the process of adaptating the extended version of the MAC Battery and of Protocole MEC de Poche to a brief Brazilian version – Brief MAC Battery. The sample was comprised of four translators, 308 non-expert judges, 14 expert judges and 36 healthy adults. Six phases were conducted: (1) comparison between expanded MAC Battery and MEC de Poche, (2) translation, (3) development of new stimuli, (4) psycholinguistic analysis by non-experts and (5) by experts and (6) pilot studies. The adapted version appeared valid to assess communication processes such as discursive, inferential-pragmatic, lexical-semantic and prosodic, and was able to contribute to the functional diagnosis of patients with cerebrovascular disease, brain injury, dementia and schizophrenia...

Este estudio presenta los procedimientos empíricos y teóricos de adaptación de la versión extendida de la bateria MAC y del Protocole MEC de Poche, para lograr una versión breve brasileña , la Batería MACbreve. Participaron cuatro traductores, 308 jueces no especializados, 14 jueces expertos y 36 adultos sanos. El trabajo se llevó a cabo en seis pasos: (1) comparación entre la Batería MAC ampliada y la MEC de Poche, (2) traducción (3) desarrollo de nuevos estímulos, (4) análisis psicolinguísticos de jueces no expertos y (5) expertos y (6) estudios piloto. La versión adaptada parece ser adecuada y válida para evaluar procesos comunicacionales como el discursivo, pragmático-inferencial , léxico-semántico y prosódico. Este instrumento podrá contribuir al diagnóstico funcional de pacientes con enfermedad cerebrovascular , traumatismo de cráneo, demencia y esquizofrenia...

Adaptação do Protocole MEC de Poche e da Bateria Mac Expandida: Bateria Mac Breve / Adaptation of Protocole MEC de Poche and of the Extended MAC Battery: Brief MAC Battery / Adaptación del protocole MEC Poche y de la Batería MAC Ampliada: Batería MAC Breve

Este estudo apresenta procedimentos teóricos e empíricos da adaptação da versão expandida da Bateria MAC e do Protocole MEC de Poche para uma versão breve brasileira – Bateria MAC Breve. Participaram quatro tradutores, 308 juízes não especialistas, 14 juízes especialistas e 36 adultos saudáveis. Seis etapas foram conduzidas: (1) comparação entre MAC expandida e MEC de Poche, (2) tradução, (3) desenvolvimento de novos estímulos, (4) análise de critérios psicolinguísticos por juízes não especialistas e (5) especialistas e (6) estudos pilotos. A versão adaptada mostrou-se adequada e apresentou evidência de validade de conteúdo para avaliar processamentos comunicativos discursivo, pragmático-inferencial, léxico¬semântico e prosódico. Estudos futuros com populações clínicas tornam-se necessários para que se possa utilizá-la para o diagnóstico funcional de dificuldades comunicativas.(AU)

This study presents the theoretical and empirical procedures involved in the process of adaptating the extended version of the MAC Battery and of Protocole MEC de Poche to a brief Brazilian version – Brief MAC Battery. The sample was comprised of four translators, 308 non-expert judges, 14 expert judges and 36 healthy adults. Six phases were conducted: (1) comparison between expanded MAC Battery and MEC de Poche, (2) translation, (3) development of new stimuli, (4) psycholinguistic analysis by non-experts and (5) by experts and (6) pilot studies. The adapted version appeared valid to assess communication processes such as discursive, inferential-pragmatic, lexical-semantic and prosodic, and was able to contribute to the functional diagnosis of patients with cerebrovascular disease, brain injury, dementia and schizophrenia.(AU)

Este estudio presenta los procedimientos empíricos y teóricos de adaptación de la versión extendida de la bateria MAC y del Protocole MEC de Poche, para lograr una versión breve brasileña , la Batería MACbreve. Participaron cuatro traductores, 308 jueces no especializados, 14 jueces expertos y 36 adultos sanos. El trabajo se llevó a cabo en seis pasos: (1) comparación entre la Batería MAC ampliada y la MEC de Poche, (2) traducción (3) desarrollo de nuevos estímulos, (4) análisis psicolinguísticos de jueces no expertos y (5) expertos y (6) estudios piloto. La versión adaptada parece ser adecuada y válida para evaluar procesos comunicacionales como el discursivo, pragmático-inferencial , léxico-semántico y prosódico. Este instrumento podrá contribuir al diagnóstico funcional de pacientes con enfermedad cerebrovascular , traumatismo de cráneo, demencia y esquizofrenia.(AU)

Communicative clusters after a right-hemisphere stroke: are there universal clinical profiles?.

OBJECTIVE: The current research aimed at classifying communication profiles among right-brain-damaged adults with an intercultural perspective, and so begins to fill in a long-standing gap in the literature. METHOD: The sample was made up of 112 right-brain-damaged individuals from three nationalities (Canadians, Brazilians and Argentineans). They were assessed using 13 language tasks from the Protocol MEC in Spanish, Brazilian Portuguese and French. RESULTS: A hierarchical cluster analysis led to four distinct clinical profiles of communication. Since only a few distinctions between nationalities were observed, the results suggest that there probably is a partial universality of clinical profiles of communication impairments after a right brain damage. CONCLUSIONS: This study proposes a preliminary taxonomy of communication disorders among right-brain-damaged individuals with cross-cultural implications. The exploration of associated stroke sites and neuropsychological concomitant deficits would contribute to the eventual development of a more accurate clinical intervention.

The profile of executive functioning in amnestic mild cognitive impairment: disproportionate deficits in inhibitory control.

Amnestic mild cognitive impairment (aMCI) represents a group of individuals who are highly likely to develop Alzheimer's disease (AD). Although aMCI is typically conceptualized as involving predominantly deficits in episodic memory, recent studies have demonstrated that deficits in executive functioning may also be present, and thorough categorization of cognitive functioning in MCI may improve early diagnosis and treatment of AD. We first provide an extensive review of neuropsychology studies that examined executive functioning in MCI. We then present data on executive functioning across multiple sub-domains (divided attention, working memory, inhibitory control, verbal fluency, and planning) in 40 aMCI patients (single or multiple domain) and 32 normal elderly controls (NECs). MCI patients performed significantly worse than NECs in all 5 sub-domains, and there was impairment (>1.0 SD below the mean of NECs) in all sub-domains. Impairment on each test was frequent, with 100% of MCI patients exhibiting a deficit in at least one sub-domain of executive functioning. Inhibitory control was the most frequently and severely impaired. These results indicate that executive dysfunction in multiple sub-domains is common in aMCI and highlights the importance of a comprehensive neuropsychological evaluation for fully characterizing the nature and extent of cognitive deficits in MCI.

Contribution of NIRS to the study of prefrontal cortex for verbal fluency in aging.

Healthy aging is characterized by a number of changes on brain structure and function. Several neuroimaging studies have shown an age-related reduction in hemispheric asymmetry on various cognitive tasks, a phenomenon captured by Cabeza (2002) in the Hemispheric Asymmetry Reduction in Older Adults (HAROLD) model. Although this phenomenon is supported by a range of neuroimaging data on memory and inhibitory processes, there is little evidence concerning changes in hemispheric asymmetry for language processing, and particularly word retrieval, which is assessed with verbal fluency task (VFT). This study aimed to investigate the age-related changes in cerebral oxygenation in the prefrontal cortex for both letter and category VFT, varying the complexity of the criteria (i.e., degree of productivity) and using near-infrared spectroscopy (NIRS). Sixteen younger and 16 older adults participated in this study. For both VF conditions, participants were instructed to pronounce as many nouns as possible as a function of high-productivity (e.g., "animals" or "L") or low-productivity (e.g., "flowers" or "V") criteria. Behavioral data (i.e., accuracy responses) showed comparable performance in younger and older adults for both VF conditions. However, NIRS data showed more reduced activation (i.e., significantly reduced increase in [O(2)Hb] and reduced decrease in [HHb]) in older than younger adults for both VFT. In addition, a bilateral effect was found for both groups, suggesting that VFT requires both executive and language functions. The results are discussed in the context of the current theories of aging.

Neurofunctional (re)organization underlying narrative discourse processing in aging: evidence from fNIRS.

Relatively few studies have analyzed the mechanisms underlying the cognitive changes that affect language in the elderly, and fewer have done so for narrative discourse. The goal of this study was to explore the neurofunctional changes associated with aging for different components of narrative discourse. Functional near-infrared spectroscopy (fNIRS) and behavioral data on 10 younger adults and 10 healthy elderly participants were collected. Ten younger adults in a non-proficient second language condition were included to explore the possibility that the age-related neurofunctional reorganization partly expresses demanding resource allocation. Results show within- and across-hemispheric differences in the neurofunctional pattern of activation in the older participants with reference to the younger ones, partially shared with the low-proficiency young adults, providing support for the recognized mechanisms underlying neural reserve and compensation. fNIRS was shown to be appropriate for studying the age-related neurofunctional reorganization of complex cognitive abilities.

Clinical Focus on Prosodic, Discursive and Pragmatic Treatment for Right Hemisphere Damaged Adults: What's Right?

Researchers and clinicians acknowledge today that the contribution of both cerebral hemispheres is necessary to a full and adequate verbal communication. Indeed, it is estimated that at least 50% of right brain damaged individuals display impairments of prosodic, discourse, pragmatics and/or lexical semantics dimensions of communication. Since the 1990's, researchers have focused on the description and the assessment of these impairments and it is only recently that authors have shown interest in planning specific intervention approaches. However, therapists in rehabilitation settings still have very few available tools. This review of recent literature demonstrates that, even though theoretical knowledge needs further methodological investigation, intervention guidelines can be identified to target right hemisphere damage communication impairments in clinical practice. These principles can be incorporated by speech and language pathologists, in a structured intervention framework, aiming at fully addressing prosodic, discursive and pragmatic components of communication.

Differences in participation according to specific cognitive deficits following a stroke.

This study compared participation following a stroke according to the presence of specific cognitive deficits. Participation is defined as the involvement of a person in daily activities and social roles. Three weeks after being discharged home, 197 older adults (aged 65 years and older) who had a stroke were evaluated using the Assessment of Life Habits, which includes 12 domains of daily activities and social roles. The presence of a cognitive deficit was determined by the scores obtained on tests assessing memory, visual perception, language, unilateral attention, and the inhibition component of executive functions. After adjusting for depressive symptoms, time since stroke, and comorbidities, five of the domains of participation are significantly more restricted by some cognitive deficits. Memory deficits affect the communication (p = .006) and leisure (p = .032) domains. In the presence of visual perception deficits, the nutrition (p = .019), communication (p = .004), and responsibilities (p < .0005) domains are more limited. Language deficits have an impact on several domains of participation, namely communication (p < .0005), responsibilities (p < .0005), community life (p = .001), and leisure (p = .021). Unilateral neglect and deficits in the inhibition component of executive functions are not found to restrict participation. Overall, participation after stroke is related to cognitive function. Looking carefully at individual domains of activities and roles provides essential information in guiding rehabilitation interventions aimed at enhancing participation after discharge.

Participation after a stroke: changes over time as a function of cognitive deficits.

Participation refers to the engagement of a person in daily activities and social roles. The goal of this study was to compare changes in older adults' participation over time following a stroke as a function of the presence of deficits in memory, visual perception, executive functions, visual attention or language. A total of 197 persons with stroke were assessed 3 weeks, 3 months and 6 months after discharge from an acute care hospital, rehabilitation unit or geriatric day hospital. The Assessment of Life Habits (ALH) was used to measure participation. Neuropsychological measures were used to assess the presence of a cognitive deficit in the domains of memory, visual perception, executive functions (inhibition), visual attention and language. Overall, results indicate that participation after a stroke improves over time after hospital discharge in spite of cognitive deficits. Changes in participation over time differed between unimpaired and impaired participants only for language and executive deficits in three domains: interpersonal relationships, community life and responsibilities. These results indicate that when returning to the community after a stroke, positive changes in participation over time are possible even with cognitive deficits.

Episodic memory, concentrated attention and processing speed in aging: a comparative study of Brazilian age groups / Memória episódica, atenção concentrada e velocidade de processamento no envelhecimento: um estudo comparativo de grupos etários brasileiros

Neuropsychological studies on the processing of some specific cognitive functions throughout aging are essential for the understanding of human cognitive development from ages 19 to 89. Objectives: This study aimed to verify the occurrence of differences in the processing of episodic memory, concentrated attention and speed of attentional processing among four age groups of adults. Methods: A total of 136 neurologically healthy adults, aged 19-89, with 9 or more years of schooling, took part in the study. Participants were divided according to four age groups: young, middle-aged, elderly and oldest old adults. Subtests of the Brief Neuropsychological Evaluation Instrument (NEUPSILIN) were applied for the cognitive assessment. Mean score of corrected answers and of response times were compared between groups by means of a one-way ANOVA test with post-hoc Scheffe procedures and ANCOVA including the co-variables of years of schooling and socio-economical scores. Results: In general, differences in performance were observed from 60 years old on. Only the episodic memory task of delayed recall reflected differences from the age of around 40 onwards and processing speed from around the age of 70 onwards. Thus, differences were found between the age groups regarding their cognitive performance, particularly between young adults and elderly adults, and young adults and oldest old adults. Conclusions: Our research indicates that the middle-aged group should be better analyzed and that comparative cross-sectional studies including only extreme groups such as young and elderly adults are not sufficient.

Os estudos neuropsicológicos sobre o processamento de algumas funções cognitivas específicas no envelhecimento são essenciais para a compreensão do desenvolvimento humano na idade de 19 a 89 anos. Objetivos: Esse estudo teve como objetivo verificar a ocorrência de diferenças no processamento da memória episódica, atenção concentrada e velocidade de processamento entre quatro grupos etários. Métodos: Participaram desse estudo 136 adultos neurologicamente saudáveis de 19 a 89 anos, com 9 anos ou mais de escolaridade, divididos em quatro grupos etários: jovens, de idade intermediária, idosos e longevos. Subtestes do Instrumento de Avaliação Neuropsicológica Breve -NEUPSILIN foram utilizados para a avaliação cognitiva. A média dos escores e o tempo de resposta foram comparados entre os grupos através do teste one-way ANOVA, com o procedimento post-hoc Scheffe e uma ANCOVA com as co-variáveis anos de escolaridade e escore sócio-econômico. Resultados: De maneira geral, foram encontradas diferenças entre os grupos a partir dos 60 anos. Somente na tarefa de memória episódica tardia foram encontradas diferenças aproximadamente a partir dos 40 anos, e na velocidade de processamento, a partir dos 70 anos de idade. Dessa forma, houve diferenças entre os grupos no seu desempenho cognitivo, principalmente entre o grupo de adultos jovens e adultos idosos e adultos jovens e adultos longevos. Conclusões: Os resultados demonstraram, ainda, que o grupo de adultos de idade intermediária deve ser mais bem investigado e, a partir disso, que estudos comparativos incluindo grupos de faixas etárias extremas não são suficientes.

Episodic memory, concentrated attention and processing speed in aging: A comparative study of Brazilian age groups.

Neuropsychological studies on the processing of some specific cognitive functions throughout aging are essential for the understanding of human cognitive development from ages 19 to 89. OBJECTIVES: This study aimed to verify the occurrence of differences in the processing of episodic memory, concentrated attention and speed of attentional processing among four age groups of adults. METHODS: A total of 136 neurologically healthy adults, aged 19-89, with 9 or more years of schooling, took part in the study. Participants were divided according to four age groups: young, middle-aged, elderly and oldest old adults. Subtests of the Brief Neuropsychological Evaluation Instrument (NEUPSILIN) were applied for the cognitive assessment. Mean score of corrected answers and of response times were compared between groups by means of a one-way ANOVA test with post-hoc Scheffe procedures and ANCOVA including the co-variables of years of schooling and socio-economical scores. RESULTS: In general, differences in performance were observed from 60 years old on. Only the episodic memory task of delayed recall reflected differences from the age of around 40 onwards and processing speed from around the age of 70 onwards. Thus, differences were found between the age groups regarding their cognitive performance, particularly between young adults and elderly adults, and young adults and oldest old adults. CONCLUSIONS: Our research indicates that the middle-aged group should be better analyzed and that comparative cross-sectional studies including only extreme groups such as young and elderly adults are not sufficient.

Os estudos neuropsicológicos sobre o processamento de algumas funções cognitivas específicas no envelhecimento são essenciais para a compreensão do desenvolvimento humano na idade de 19 a 89 anos. OBJETIVOS: Esse estudo teve como objetivo verificar a ocorrência de diferenças no processamento da memória episódica, atenção concentrada e velocidade de processamento entre quatro grupos etários. MÉTODOS: Participaram desse estudo 136 adultos neurologicamente saudáveis de 19 a 89 anos, com 9 anos ou mais de escolaridade, divididos em quatro grupos etários: jovens, de idade intermediária, idosos e longevos. Subtestes do Instrumento de Avaliação Neuropsicológica Breve ­ NEUPSILIN foram utilizados para a avaliação cognitiva. A média dos escores e o tempo de resposta foram comparados entre os grupos através do teste one-way ANOVA, com o procedimento post-hoc Scheffe e uma ANCOVA com as co-variáveis anos de escolaridade e escore sócio-econômico. RESULTADOS: De maneira geral, foram encontradas diferenças entre os grupos a partir dos 60 anos. Somente na tarefa de memória episódica tardia foram encontradas diferenças aproximadamente a partir dos 40 anos, e na velocidade de processamento, a partir dos 70 anos de idade. Dessa forma, houve diferenças entre os grupos no seu desempenho cognitivo, principalmente entre o grupo de adultos jovens e adultos idosos e adultos jovens e adultos longevos. CONCLUSÕES: Os resultados demonstraram, ainda, que o grupo de adultos de idade intermediária deve ser mais bem investigado e, a partir disso, que estudos comparativos incluindo grupos de faixas etárias extremas não são suficientes.

Theoretical, behavioral and neuroimage evidence on discourse processing aging

A growing interest in cognition in aging has been observed because of both the epidemiologic factor of an increase in the lifespan of the world's population and the cognitive changes behaviorally and biologically detectable in this population. The most complex of language components and fundamental in social interaction, discourse production and comprehension are among the most scarcely explored cognitive functions in this context. This review presents and discusses discourse processing in healthy aging with regard to theoretical, behavioral, and neuroimaging evidence. Cognitive and neurobiological models are reviewed, such as the Hemispheric Asymmetry Reduction in Older Adults (HAROLD) model and the Posterior-Anterior Shift in Aging (PASA) model. Among the neuropsycholinguistic research developed to characterize discourse processing in aging individuals, which has contributed to the prevention and treatment of language impairment and the maintenance of communicative competence in aging, studies on the relationship between discourse and working memory, attention, and some executive components are discussed. Regarding neuroimaging data, very few studies that have included cognitive tasks and discourse stimuli were found. Such studies suggest that discourse processing requires not only the participation of both brain hemispheres, but also a more prominent activation of frontal regions. Considering the great complexity and usefulness of discourse in elderly adults' daily communication and the emergence of cognitive deficits related to aging in complex information processing, the necessity of further behavioral and neuroimaging studies, including discourse processing tasks, comparing tasks involving executive, attentional, and mnemonic demands becomes evident.(AU)

Theoretical, behavioral and neuroimage evidence on discourse processing aging

A growing interest in cognition in aging has been observed because of both the epidemiologic factor of an increase in the lifespan of the world's population and the cognitive changes behaviorally and biologically detectable in this population. The most complex of language components and fundamental in social interaction, discourse production and comprehension are among the most scarcely explored cognitive functions in this context. This review presents and discusses discourse processing in healthy aging with regard to theoretical, behavioral, and neuroimaging evidence. Cognitive and neurobiological models are reviewed, such as the Hemispheric Asymmetry Reduction in Older Adults (HAROLD) model and the Posterior-Anterior Shift in Aging (PASA) model. Among the neuropsycholinguistic research developed to characterize discourse processing in aging individuals, which has contributed to the prevention and treatment of language impairment and the maintenance of communicative competence in aging, studies on the relationship between discourse and working memory, attention, and some executive components are discussed. Regarding neuroimaging data, very few studies that have included cognitive tasks and discourse stimuli were found. Such studies suggest that discourse processing requires not only the participation of both brain hemispheres, but also a more prominent activation of frontal regions. Considering the great complexity and usefulness of discourse in elderly adults' daily communication and the emergence of cognitive deficits related to aging in complex information processing, the necessity of further behavioral and neuroimaging studies, including discourse processing tasks, comparing tasks involving executive, attentional, and mnemonic demands becomes evident.

Executive functions in frontotemporal dementia and Lewy body dementia.

Diagnosis of different types of dementia is often based on clinical symptomatology rather than underlying pathology; therefore, accurate diagnosis depends on a thorough description of cognitive functioning in different dementias. Furthermore, direct comparison of cognitive functions between different types of dementia is necessary for differential diagnosis. Executive dysfunction is common in several types of dementia, including frontotemporal dementia (FTD) and Lewy body dementia (LBD); however, FTD and LBD patients have never been directly compared on measures of executive functioning. The authors compared the performance of 17 FTD and 15 LBD patients on 6 measures of executive functioning in terms of statistical group differences, mean severity of clinical impairment in comparison to normal controls, and frequency of impairment. Results indicated a remarkably similar pattern of performance across all areas examined in terms of mean performance, as well as degree and frequency of impairment. Only the Stroop test produced results that could potentially differentiate the patient groups. These findings suggest that both FTD and LBD should be considered disorders involving executive dysfunction.