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At least 793 records · Page 44Linked to original sources
PubMed2002

Does caffeine intake protect from Alzheimer's disease?

Caffeine is the most widely consumed behaviourally active substance in the western world. Neuroprotective effects of caffeine in low doses, chronically administered, have been shown in different experimental models. If caffeine intake could protect against neurodegeneration in Alzheimer's disease (AD), then higher levels of caffeine consumption in normal subjects as compared with AD patients should be detectable in the presumably long period before diagnosis when insidious pathogenic changes are taking place. A case-control study was used: cases were 54 patients with probable AD fulfilling the National Institute of Neurologic and Communicative Disorders and Stroke and the AD and Related Disorders Association criteria, in a Dementia Clinics setting. Controls were 54 accompanying persons, cognitively normal, matched for age (+/-3 years) and sex. Patients with AD had an average daily caffeine intake of 73.9 +/- 97.9 mg during the 20 years that preceded diagnosis of AD, whereas the controls had an average daily caffeine intake of 198.7 +/- 135.7 mg during the corresponding 20 years of their lifetimes (P < 0.001, Wilcoxon signed ranks test). Using a logistic regression model, caffeine exposure during this period was found to be significantly inversely associated with AD (odds ratio=0.40, 95% confidence interval=0.25-0.67), whereas hypertension, diabetes, stroke, head trauma, smoking habits, alcohol consumption, non-steroid anti-inflammatory drugs, vitamin E, gastric disorders, heart disease, education and family history of dementia were not statistically significantly associated with AD. Caffeine intake was associated with a significantly lower risk for AD, independently of other possible confounding variables. These results, if confirmed with future prospective studies, may have a major impact on the prevention of AD.

Aged↗
PubMed2001

The validation of a mailed health survey for screening of dementia of the Alzheimer's type.

OBJECTIVE: To test the efficacy of a mailed health survey, which included the Clock Completion Test (CCT), to screen previously undiagnosed older adults for dementia of the Alzheimer's type (DAT) in a community-dwelling population, and to determine whether the addition of selected risk factors for Alzheimer's disease (AD) would enhance the screening instrument's operating characteristics. DESIGN: Comparison of the results of a self-administered screen for DAT with the diagnosis of DAT by clinician evaluation or telephone interviews. SETTING: A geriatric assessment clinic. PARTICIPANTS: Three hundred and five women age 65 and older from St. Louis, Missouri. MEASUREMENTS: The sensitivity and specificity of the CCT and the CCT plus risk factors for AD were evaluated using two standards: The Short Blessed Test (SBT) and the physician diagnosis of probable AD using National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria. RESULTS: Sensitivity and specificity for the CCT by SBT criteria were 63% and 79%, respectively. Using the physician's assessment as a criterion, the CCT had better sensitivity (67%) but poorer specificity (69%). Adding two or more risk factors for AD improved sensitivity and specificity to 71% and 89% and, in the physician assessment subgroup, to 75% and 87%, primarily by halving the false-positive rate. CONCLUSION: The combination of the simple, self-administered CCT and two or more AD risk factors is a more effective screening instrument for DAT and potentially preclinical DAT than the CCT alone. However, the instrument may be better suited for use in an office setting because of a poor response rate by subjects with dementia.

Aged↗
PubMed2002

Central auditory dysfunction may precede the onset of clinical dementia in people with probable Alzheimer's disease.

OBJECTIVES: To document the prognostic significance of a central auditory speech-processing deficit for the subsequent onset of probable Alzheimer's disease. DESIGN: Prospective cohort study. SETTING: Framingham Heart Study. PARTICIPANTS: Seven hundred forty dementia-free volunteers from the Framingham Heart Study cohort with symmetric hearing thresholds at biennial examination 15 (1983-1985). MEASUREMENTS: The diagnosis of probable Alzheimer's disease was made prospectively using the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease Related Disorder Association criteria. A central auditory speech-processing deficit was defined as a score of 50% of less correct on the Synthetic Sentence Identification with Ipsilateral Competing Message test in at least one ear with normal word recognition ability in both ears. Cox proportional hazards regression assessed the relationship between a central auditory speech-processing deficit and the age at diagnosis of probable Alzheimer's disease. RESULTS: Forty subjects (5.4%) received a diagnosis of probable Alzheimer's disease during an average of 8.4 years (range 3-12) of follow-up; seven (17.5%) of these had a central auditory speech-processing deficit. The presence of a central auditory speech-processing deficit had an age-adjusted risk ratio for probable Alzheimer's disease of 10.8 (95% CI = 4.6-25.2), and the estimated risk ratio adjusted for age, gender, education level, apolipoprotein allele E4 presence, and hearing level was 23.3 (95% CI =6.6-82.7). A central auditory speech-processing deficit had a positive predictive value for subsequent probable Alzheimer's disease of 47% but the sensitivity was only 17.5%. CONCLUSION: Central auditory speech-processing deficits may be an early manifestation of probable Alzheimer's disease and may precede the onset of dementia diagnosis by many years.

Aged↗
PubMed2000

All children are ready to learn: an emergent versus readiness perspective in early literacy assessment.

Assessment of emergent literacy is relatively new to the field of communication disorders. Traditional approaches to reading assessment evaluated mastery of reading readiness skills. By contrast, emergent literacy assessment evaluates the increased awareness and understanding of print that begin early in development. One of the most influential figures in emergent literacy assessment has been Marie M. Clay. She has defined critical components of emergent literacy and, in so doing, has played an integral role in the paradigm shift from a reading readiness to an emergent literacy perspective. This article is intended to distinguish emergent literacy from reading readiness, explicate Marie Clay's contribution to our current understanding of effective emergent literacy assessment, and provide some guidance in using her assessment techniques with children with significant disabilities.

Age Factors↗
PubMed2000

Language development and assessment in children with human immunodeficiency virus: 3 to 6 years.

Young children infected or exposed, or both to the human immunodeficiency virus (HIV) present with a variety of speech, language, and communication problems. The purpose of this article is to provide an overview of the impact that HIV has on young children from 3 to 6 years of age. Issues concerning medically related problems are discussed, along with assessment criteria and descriptions of communication disorders among HIV-infected and -exposed children.

Child↗
PubMed2003

Clinical ethics in the context of language and cognitive impairment: rights and protections.

Ethical dilemmas are particularly complex when a patient has a communication disorder. Questionable decision-making capacity can affect an individual's ability to participate in the informed consent process. When other cognitive impairments as well as language deficits are present, the risk of losing one's right to autonomy is greatly increased. Alternatively, the protection afforded those who are clearly incompetent may be limited if a person appears to have decision-making capacity but is unable to adequately process information. These challenges are illustrated in this article by use of clinical case descriptions. They also serve to demonstrate ways in which speech-language pathologists can provide the expertise needed to assist patients and medical teams in addressing these particular issues and ensuring patient autonomy.

Advance Directives↗
PubMed2004

The challenge of language assessment for african american english-speaking children: a historical perspective.

The diagnostic problem of how validly to assess the language of children who speak dialects different from Mainstream American English (MAE) has challenged the field of communication disorders for several decades. The key to its solution is to recognize differences due to dialect or development and remove them from the initial diagnosis of a disorder. A new approach to the puzzle, implemented jointly by University of Massachusetts scholars and the Psychological Corporation (TPC), takes two directions: (1) it provides new normative data on African American English (AAE) development, and (2) it proposes a level of analysis deeper than dialect for the discovery of alternate markers of a disorder. We present three objectives for a language assessment instrument designed to solve this longstanding problem: (1) to answer the problem/no problem question for a given child; (2) to provide explanatory data about the nature of the problem; and (3) to achieve objectives 1 and 2 in a way that is culturally and linguistically fair to both speakers of MAE and speakers of other dialects of English such as AAE.

Black or African American↗
PubMed2004

Verbal perseveration in individuals with Alzheimer's disease.

Perseveration has been described as a reliable indicator of disturbed brain function and is a common characteristic of neurological conditions such as Alzheimer's disease (AD). This article will begin with a review of recent theories that account for the phenomenon of perseveration, and data from a National Institute on Deafness and Other Communication Disorders (NIDCD)--supported study further delineate the nature of perseveration among individuals with AD. The study investigated the frequency of verbal perseveration in individuals with AD in relation to task type, mental status, and performance on attention and memory tests. Thirty Alzheimer's patients and 40 healthy elders were given a confrontation naming, generative naming, and picture description test. Perseveration was defined as a proportion of total number of responses. Data analysis revealed that individuals with AD perseverated more than normal elders did, but variability was high. Generative naming elicited more perseveration than either confrontation naming or picture description did. When overall frequency of perseveration was correlated with mental status and performance on attention and memory tests, seemingly paradoxical results were obtained, probably because the unique cognitive demands of each language test affected the probability of perseveration differently. Nonparadoxical, strong positive correlations were obtained, however, between language test scores and performance on tests of attention, memory and mental status.

Aged↗
PubMed2005

Instructional techniques in cognitive rehabilitation: a preliminary report.

Instruction is an essential component of effective cognitive rehabilitation, which requires teaching or reteaching a variety of skills and concepts to people with compromised learning. Currently, the field lacks a cohesive set of principles to guide clinicians' instructional behaviors. A review of the literature in related fields, in conjunction with findings in neuropsychology, reveals evidence-based principles that lead to effective instructional design and implementation. This article summarizes this work and attempts to provide clinicians with principles to guide their treatment planning when training or teaching clients with cognitive-communication disorders.

Amnesia↗
PubMed1994

Prevalence of prematurity, low birthweight, and asphyxia as perinatal risk factors in a current population of children with cerebral palsy.

To test the hypothesis that increasing survival of infants at highest risk for long-term neurological sequelae has strengthened the associations between perinatal events and subsequent cerebral palsy (CP), we compared the prevalence rates for prematurity, low birthweight, congenital malformations, and perinatal asphyxia from a current population of children with CP with those reported nearly 30 years ago by the National Collaborative Perinatal Project (NCPP, 1959-1966) of the National Institute of Neurologic and Communicative Disorders and Stroke. Although we saw no differences in the proportion of children who were born prematurely, we did find a significant shift in the birthweight and gestational age distribution, with a nearly threefold greater prevalence of births less than 1501 g in our population (31.1% and 95% confidence interval [CI] of 20.6 to 41.7% vs 9.1% and 95% CI of 5.0 to 13.2%). Nearly half (43.5%) of these very low birthweight infants had evidence of brain injury (intraventricular hemorrhage), a diagnosis not commonly recognized in the NCPP. On the other hand, birth asphyxia and congenital malformations occurred no more frequently in our population than that reported earlier. Furthermore, the majority (60%) of full-term infants who develop CP continue to be the products of normal pregnancies and have no perinatal events that may have caused their neurological impairment. The increasing prevalence of births less than 1501 g among children with CP may well reflect the improving survival of very small infants over the last 30 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Asphyxia Neonatorum↗
PubMed1996

[Early indications for surgical vocal cord medial relocation in unilateral recurrent nerve paralysis in advanced age].

BACKGROUND: Unilateral vocal cord paralysis is usually treated conservatively. Phonosurgery is not indicated before 1 year after the onset of the palsy as during this period spontaneous recovery can be expected. In the elderly patient conservative voice rehabilitation is often limited by a restricted general condition. In these cases a severe communication disorder may result unless vocal cord function recovers spontaneously. PATIENTS AND METHODS: In 4 patients aged 68 to 79 years who had suffered from latrogenic unilateral vocal cord paralysis for 6 to 9 months, surgical medialisation of the paralysed vocal cord was carried out in local anaesthesia as an Isshiki-Type-I-operation after unsuccessful conservative treatment prior to surgery. RESULTS: In all cases a definite amelioration of voice function could be reached. There were no local or general complications. No spontaneous recovery of nerve function could be detected by electromyography between 6 to 9 months after the operation. Voice function remained stable during this period. CONCLUSIONS: We conclude that in elderly patients with unilateral vocal cord paralysis with no signs of spontaneous recovery and unsuccessful conservative treatment, surgical voice rehabilitation may be indicated before 1 year after the onset of the palsy.

Aged↗
PubMed1990

[Bilateral congenital profound hearing loss and hypospadias--a new syndrome?].

Five children with hypospadia and profound hearing loss were presented to the Clinic for Speech and Communication Disorders of the University of Mainz. Anamnestic and laboratory investigations strongly suggest, that the malformations are interrelated and may represent a new syndrome. Therefore it appears to be helpful to carry out a routine hearing check in children, who are hospitalized for the first surgical treatment of hypospadias.

Audiometry, Pure-Tone↗
PubMed1997

Discourse behaviors in older adults.

An overview of the changes in older adults' comprehension of language and discourse is provided before changes in production are discussed in some detail. Age-related changes in discourse production have been studied in terms of semantic skills, syntactic complexity, verbal fragmentation, information load, cohesion, macrostructural elements, and conversation. In spite of the heterogeneity in older adults' discourse behaviors, they have a tendency to use shorter, less complex sentences and more indefinite, ambiguous references. Nevertheless, the basic conversational skills of the normally aging elderly are usually well preserved.

Adult↗
PubMed2004

Cerebral anoxia and disability.

OBJECTIVES: To describe the sequelae of cerebral anoxia following out-of-hospital cardiac arrest, to study the functional outcome and to seek a link between the acute stage and the disability. METHOD: A retrospective study was performed. The initial findings and the neurological and neuropsychological status are recorded of 12 patients admitted to the rehabilitation unit for after-effects of cerebral anoxia following out-of-hospital cardiac arrest. RESULTS: After clinical and neuropsychological assessment, all patients displayed cognitive impairment. Two groups of patients appeared: seven patients were severely disabled with a dysexecutive and behavioural frontal lobe syndrome and memory deficit; five out of the seven also presented an extra-pyramidal syndrome; the other five patients presented behavioural dysfunction related to frontal lobe disorder but were independent in daily life activities. No correlation was found between the acute stage data and the outcome. CONCLUSION: Neurological and neuropsychological impairment after cerebral anoxia may be severe but seems difficult to predict. A dysexecutive syndrome was noted in all 12 patients.

Activities of Daily Living↗
PubMed1998

Child and adolescent traumatic brain injury: correlates of disruptive behaviour disorders.

A record review focused on children and adolescents, with a history of traumatic brain injury (TBI), who were consecutively admitted to a brain injury clinic in which all new patients are psychiatrically evaluated. Correlates of post-injury oppositional defiant disorder/conduct disorder (ODD/CD) and post-injury attention deficit hyperactivity disorder (AHD) were investigated. Subjects who developed ODD/CD following TBI, when compared to subjects without a lifetime history of the disorder, had significantly more impaired family functioning, showed a trend toward a greater family history of alcohol dependence/abuse and suffered a milder TBI. In contrast, there were no variables which discriminated between subjects who developed ADHD following injury and those with no lifetime history of ADHD. It is difficult to determine whether ODD, CD and ADHD occurring after TBI in the patient is related to the TBI, directly or indirectly. Appropriate clinical assessment requires consideration of the important mediating role of family functioning, severity of injury and family psychiatric history.

Adolescent↗
PubMedDate not supplied

Organizing language intervention relative to the client's personal experience: a clinical case study.

An analysis is presented of two different therapeutic activities designed for a profoundly deaf adult with cerebral palsy, DP. The study draws on techniques of qualitative methodology to identify elements that contribute to effective intervention practices for DP. Results indicate that therapeutic materials and activities must first of all be relevant to the client's needs, interest, and personal experience to be maximally effective. The results are consistent with recent research on language and language development, particularly the cognitive linguistic view that our linguistic knowledge is rooted in our experience with the world (Kecskes). These results are also consistent with a "socially valid and consumer focused method of tracking outcome" (Simmons-Mackie and Damico) in that language intervention must typically capture the personal experience of communicatively disordered individuals. Specific recommendations are made for optimizing language intervention.

Adult↗
PubMed2005

Acute cognitive and neurobehavioural intervention for individuals with acquired brain injury: preliminary outcome data.

The present study provides a rationale for and detailed description of a structured curriculum for a cognitive and neurobehavioural group intervention for patients in an acute inpatient brain injury rehabilitation setting. Preliminary outcome data are provided for 29 patients with acquired brain injuries who attended the group during inpatient rehabilitation. The group was held during three 30-minute sessions per week. Prior to discharge, patients completed a Learning Assessment, which assessed their level of knowledge about the material covered during the course. Patients received a mean score of 85.54 on the Learning Assessment. High scores on the Learning Assessment correlated significantly with discharge Disability Rating Scale total and Social Interaction FIM scores. Age, level of education, race, sex, and length of stay did not significantly impact these results. Results suggest that patients with acquired brain injuries benefit from acute cognitive and neurobehavioural intervention and are capable of learning compensatory strategies, even in the acute stages of recovery. This learning may help improve functional status, especially skills needed for psychosocial adjustment.

Acute Disease↗