Apathy and actions- another consideration when theorizing about embodied nature of language in Parkinson's disease.

Objectives Individuals with Parkinson's disease (PD) have difficulty processing actions or verbs relative to nouns. Verb difficulties are thought to represent the coupling of language and motor networks. However, those with PD also frequently experience apathy. The overlap between apathy and action language difficulties is to date unexplored. Furthermore, whether verb/action fluency difficulty represents verb degradation (semantic/conceptual) or a selective lexical retrieval difficulty has not been determined. Methods In the current study, 20 individuals with PD without dementia completed cued action (verb) and animal (noun) fluency tasks in addition to assessments of apathy, cognition, and motor functioning. Results Individuals who exhibited impairments on action and animal fluency improved around 50% with the provision of cueing. The degree to which action fluency improved with cueing was correlated with behavioral/initiation apathy (rs=.56) as well as motor dysfunction (rs=-.57), while no similar relationship was found between those factors and nouns. Conclusions These findings suggest that impaired retrieval of actions and nouns are present in PD, but may have different underlying neuropsychological underpinnings. This provides preliminary support for grounded cognition models, which suggest the brain organizes information around motor, perceptual, and other networks. MESH terms Parkinson Disease, Neurocognitive Disorders, Apathy, Language Disorders, Neuropsychological Tests, Cognition.

Everyday Language Difficulties in Parkinson's Disease: Caregiver Description and Relationship With Cognition, Activities of Daily Living, and Motor Disability.

Purpose Parkinson's disease (PD) impacts language in multiple ways, though important questions remain. The current article explores 2 main issues: what type of everyday language difficulties (ELDs) are noted by care partners and how do ELDs relate to cognition, daily activities, and motor disability in PD. Method Care partner reports of ELD were collected in 42 community-dwelling individuals with PD. Descriptive information of ELD was tallied, and the relationship of cognitive decline, activities of daily living (ADLs), and motor disability with ELD was evaluated. Results Forty-two percent of patients were described by care partners as having at least 1 consistent ELD, and the frequency of ELD increased in the presence of dementia, χ2(2) = 14.37, p = .0008. The most commonly described ELDs by caregivers were related to comprehension of instructions and deriving the point of conversations. ELD was correlated with worse cognition ( r s = -.524, p < .001), increased difficulty with daily activities ( r s = .634, p < .001), and increased motor dysfunction ( r s = .554, p < .001). Mild ADL decline (Functional Assessment Questionnaire score of 4); an area under the curve of .81 ( SE = .07) was highly specific to the presence of ELD (95.4%). Conclusions Care partners note a variety of ELDs in patients with PD, most commonly comprehension difficulties. These difficulties increase with overall cognitive decline but are described in 30%-40% of those without significant cognitive deficits. ADL difficulties correlate with functional, motoric, and cognitive status, with even mild functional declines predictive of the presence of ELD. Implications for research and practice in this population are discussed.

Supporting Safety in the Older Adult Driver: A Public Health Nursing Opportunity.

The effective operation of a motor vehicle encompasses a wide range of cognitive processes that can decline due to age-related changes in neuroanatomical structures and cognitive functionality. The increasing number of older adult drivers in our rapidly aging population heightens the public safety concern of unsafe driving associated with these changes. Nurses caring for older adults in public health settings are well positioned to make a difference in the management of older patients who may be at risk of endangering themselves or others on the roadways. In this article, information is provided for increasing nurses' awareness of the cognitive factors inhibiting effective driving, recognizing older adults who may be at risk for unsafe driving, and facilitating a patient/family to seek a driving evaluation.