Cognitive-Communication Disorders of Dementia : Definition, Diagnosis, and Treatment,

282 Pages·2018·3.768 MB·English

by  Kathryn Bayles, Kimberly McCullough, Cheryl Tomoeda

Cognitive-Communication
Disorders of
MCI and Dementia
Definition, Assessment,
and Clinical Management
Third Edition

Cognitive-Communication
Disorders of
MCI and Dementia
Definition, Assessment,
and Clinical Management
Third Edition
Kathryn Bayles, PhD, CCC-SLP
Kimberly McCullough, PhD, CCC-SLP
Cheryl Tomoeda, MS, CCC-SLP
5521 Ruffin Road
San Diego, CA 92123
e-mail: [email protected]
Web site: http://www.pluralpublishing.com
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Library of Congress Cataloging-in-Publication Data:
Names: Bayles, Kathryn A., 1942- author. | McCullough, Kimberly (Speech-language
pathologist), author. | Tomoeda, Cheryl K., author.
Title: Cognitive-communication disorders of MCI and dementia : definition, assessment,
and clinical management / Kathryn Bayles, Kimberly McCullough, Cheryl Tomoeda.
Other titles: Cognitive-communication disorders of dementia
Description: Third edition. | San Diego, CA : Plural Publishing, [2020] | Preceded by
Cognitive-communication disorders of dementia / Kathryn A. Bayles and
Cheryl K. Tomoeda. Second edition. 2014. | Includes bibliographical references and index.
Identifiers: LCCN 2018028636| ISBN 9781635500608 (alk. paper) | ISBN 1635500605
(alk. paper)
Subjects: | MESH: Cognitive Dysfunction—diagnosis | Dementia—diagnosis | Communication
Disorders—etiology | Dementia—complications |Communication Disorders—diagnosis |
Communication Disorders—therapy
Classification: LCC RC521 | NLM WM 220 | DDC 616.8/3—dc23
LC record available at https://lccn.loc.gov/2018028636
Contents
Preface xiii
Acknowledgments xv
1 Speech-Language Pathology, Mild Cognitive Impairment,
and Dementia 1
Introduction 1
Communication Defined 2
Rationale for Therapy 2
Neuroplasticity 3
Memory Systems and Their Selective Vulnerability to Disease 3
Cognitive Reserve 5
Summary of Important Points 6
References 7
2 Cognition, Memory, and Communication 11
Cognition and Memory 11
The “Company of Cognition” 11
Memory Defined 12
Sensory Memory 12
Working Memory 13
Long-Term Memory 14
Relation of Cognition and Memory to Communication 19
Production of Linguistic Information 19
Comprehension of Linguistic Information 20
Summary of Important Points 20
References 21
3 MCI: Mild Cognitive Impairment a.k.a. Mild
Neurocognitive Disorder 25
Introduction 25
Prevalence of MCI 25
Diagnostic Criteria for MCI 26
Risk and Protective Factors 26
Causes and Clinical Presentations of MCI 27
Neuropsychological Deficits Associated with MCI 27
Language Performance Deficits 28
Conversion to Dementia 32
Conclusion 33
Summary of Important Points 33
References 33
v
vi COGNITIVE-COMMUNICATION DISORDERS OF MCI AND DEMENTIA
4 Alzheimer’s Dementia 39
Alzheimer’s Disease (AD) Introduction 39
Diagnostic Criteria for AD 39
Risk Factors for AD 42
Age 42
Family History of AD 42
Education 44
History of Head Trauma 45
Loneliness 45
Gender 45
Maternal Age 45
Apolipoprotein E4 Allele 46
Chronic Lack of Sleep 46
Mild Cognitive Impairment 46
Predictors of Disease Progression 46
Protective Factors 46
Effects of AD on Cognitive and Communicative Functions 46
Early Stage 47
Middle Stage 50
Late Stage 52
Summary of Important Points 53
References 54
5 Dementia and Down Syndrome 61
Introduction 61
Common Features of People with DS 61
Risk of Developing Alzheimer’s Disease 61
Prevalence of Dementia in DS 62
Diagnosing Dementia in Individuals with DS 63
A Study of the Cognitive-Communication Profiles of DS Adults
with and without Dementia 64
Language and Communication Skills in Adults with DS 64
Premorbid Language 64
Language Change in Dementia 65
Cognitive and Behavioral Measures Appropriate for
Individuals with DS 65
Summary of Important Points 67
References 67
6 Vascular Dementia 71
Introduction 71
Neuropathology 71
Diagnostic Criteria 73
Diagnosing Vascular Cognitive Impairment 73
CONTENTS vii
Risk Factors for VaD 73
Aging 73
Hypertension 73
Family History 74
Ethnicity and Gender 74
Diabetes Mellitus (Type 2) 74
Lifestyle 74
Vascular Pathology May Be a Trigger for Alzheimer’s Dementia 75
Comparison of Effects of Cortical and Subcortical Pathologies on
Cognition and Communicative Function 75
Cortical Pathologies 75
Subcortical Pathologies 76
VCI Compared with AD 76
Observations from Course-of-Disease Studies 76
Summary: Effects of VCI on Cognitive and Communicative Functioning 77
Conclusion 77
Summary of Important Points 77
References 78
7 Parkinson’s Disease and Dementia 83
Parkinsonism and Parkinson’s Disease (PD) 83
Incidence and Prevalence 83
Symptoms of PD: Motor, Affective, Cognitive 83
Neuropathology of PD 85
Risk Factors 85
Diagnostic Criteria for PD 86
Cognition: Continuum from Normal to Dementia 86
Diagnostic Criteria PD-MCI 86
Diagnostic Criteria for Parkinson’s Disease with Dementia (PDD) 87
Prevalence of PDD 87
Nature of Cognitive Impairment 87
Attention/Executive Function 87
Memory 88
Visuoperceptual/Visuospatial Function Deficits 89
Communicative Function of PD Patients without and with Dementia 89
A Study of Communicative Function in Demented PD Patients 90
Individuals with PD and Dementia Compared with Individuals
with AD on the ABCD 91
Discourse Sample of PD Patient with Dementia 91
Relation of PDD, Dementia with Lewy Bodies, and AD 92
Summary of Important Points 92
References 93
viii COGNITIVE-COMMUNICATION DISORDERS OF MCI AND DEMENTIA
8 Dementia and Lewy Body Disease 99
Lewy Body Disease 99
Diagnostic Criteria and Symptomatology 100
Consortium Consensus Criteria for Diagnosis of Dementia 102
Caregiver Report of Early Symptoms 102
LBD Risk Factors 102
Effects of LBD on Cognition 103
Executive Function and Attention 103
Visuoperceptual and Spatial Functions 103
Memory 104
Language and Communicative Function 104
A Case of Pure LBD 105
Summary of Changes in Communicative Functioning 106
Cognitive Profile of LBD Compared with AD 106
Cognitive Profile of LBD Compared with PDD 106
Summary of Important Points 107
References 107
9 Dementia and Huntington’s Disease 113
Overview and Genetics of Huntington’s Disease 113
Neuropathology of HD 114
Symptomatology 114
Affect and Motor Symptoms 114
Effects of HD on Speech 114
Effects on Cognition 115
Language 116
Dysphagia Is Also a Concern 118
Cognition and Communication 118
Summary of Important Points 119
References 119
10 Frontotemporal Dementia 123
Introduction 123
Diagnosis of Frontotemporal Dementia (FTD) 124
Behavioral Presentation 124
Behavioral Variant Frontotemporal Dementia (bvFTD) 124
Language Presentation of FTD: Primary Progressive Aphasia 127
Variants of PPA 127
Differentiating the Behavioral Variant of FTD from the Primary
Progressive Aphasia Variants 131
Amyotrophic Lateral Sclerosis and FTD 131
Effects of ALS-FTD on Language 132
Summary of Important Points 132
References 133
CONTENTS ix
Clinical Management Guide: Assessments and Interventions
for Cognitive-Communication Disorders of Dementia
I Assessment 141
Introduction 141
Assessment Procedures that Produce Valid and Reliable Data 141
Prior to Testing 141
Be Alert to Depression 143
Be Alert to Drug Effects on Performance 143
Know the Criteria for Diagnosing MCI and Dementia 144
Severity of Cognitive Impairment Affects Test Selection 145
Tests for Diagnosing MCI and Dementia 146
Arizona Battery for Communication Disorders of Dementia (ABCD-1)
aka Arizona Battery for Cognitive-Communicative Disorders
(ABCD-2) 146
ABCD-2 Subtests Most Sensitive to Mild AD 153
Functional Linguistic Communication Inventory (FLCI) for
Moderately and Severely Demented Individuals 153
Many Other Tests Are Available for Diagnosing MCI and Dementia 154
Broad-Based Assessments 155
Short Screening Tests 157
What About Aphasia Test Batteries? 157
ADAS-COG: Widely Used in Drug Trials 158
Differentiating the Types of Dementia 158
Differentiating MCI and Mild Dementia from Delirium and Depression 158
Differentiating Frontotemporal Dementias (FTD) 159
Differentiating Primary Progressive Aphasia (PPA) and Mild AD 161
An Assessment for Differentiating Semantic Dementia:
The Cambridge Semantic Memory Test 162
Differentiating AD from Vascular Dementia 163
Differentiating Mild AD from Dementia with Lewy Bodies (DLB)
and Parkinson’s Disease with Dementia (PDD) 165
Summary of Important Points 166
II Cognitive Intervention 169
A Treatment Model for Successful Clinical Intervention 169
Cognitive Intervention for Mild Cognitive Impairment (MCI) 169
Cognitive Reserve is “Neuroprotective” 170
Cognitive Intervention Strengthens Cognitive Reserve 170
Make Treatment Person Centered 171
Suggestions for How To Make Therapy Person Centered 172
Target Skills and Behaviors that Have the Potential to Improve 172
Provide Individual and Group Therapy 172
Provide Training of Strategies that Can Improve Function 173