Speech pauses in speakers with and without aphasia: A usage-based approach.

Pauses in speech are indicators of cognitive effort during language production and have been examined to inform theories of lexical, grammatical and discourse processing in healthy speakers and individuals with aphasia (IWA). Studies of pauses have commonly focused on their location and duration in relation to grammatical properties such as word class or phrase complexity. However, recent studies of speech output in aphasia have revealed that utterances of IWA are characterised by stronger collocations, i.e., combinations of words that are often used together. We investigated the effects of collocation strength and lexical frequency on pause duration in comic strip narrations of IWA and non-brain-damaged (NBD) individuals with part of speech (PoS; content and function words) as covariate. Both groups showed a decrease in pause duration within more strongly collocated bigrams and before more frequent content words, with stronger effects in IWA. These results are consistent with frameworks which propose that strong collocations are more likely to be processed as holistic, perhaps even word-like, units. Usage-based approaches prove valuable in explaining patterns of preservation and impairment in aphasic language production.

The efficacy of the picture version of the free and cued selective reminding test to detect significant neurocognitive deficits in a Chilean population.

The picture version of the Free and cued selective reminding test with immediate recall is a test adept at measuring the memory encoding and the effect of semantic cues. Furthermore, it is sensitive to detect early dementia stages. This study aimed to obtain psychometric properties of visual Buschke and Grober The Free and Cued Selective Reminding Test (FCSRT) in healthy older adults, mild neurocognitive disorders, and major neurocognitive subjects on a Chilean population. METHOD: 226 participants were included, 113 healthy older adults (HOA), 65 mild neurocognitive disorder (NCD) subjects, and 48 major NCD. Each individual was assessed with the same protocol. RESULTS: The observed area under the curve (AUC) was higher than .90 in all the FCSRT measures in the major cognitive disorders and healthy older people. CONCLUSION: according to the AUCs, it was shown that Free Recall, Sensitivity to Cueing Index, and Delay Recall of the FCSRT are suitable to detect major neurocognitive disorders.

[Development of Normative Data for the Mini Mental State Examination (MMSE) in the Elderly Population of Chile: A Multi-City Study]. / Nuevos datos normativos para el Mini Mental State Examination (MMSE) en la población de personas mayores en Chile.

BACKGROUND: The Mini-Mental State Examination (MMSE) is one of the most widely used tests to assess the global cognitive deterioration of older adults. There are many versions of this Test in Spanish. A validation study was previously conducted in Chile, but to date, no standards computed from a large population sample are available. AIM: to develop normative scores according to age and educational level for older people living in Chile. METHOD: Data were collected from a sample of 1199 subjects between 50 and 91 years of age from various research centers. RESULTS: We present the normative scores in percentiles calculated according to age (50-64, 65-74, 75-91 years of age) and educational level (1-12 years and more than 13 years of formal schooling). CONCLUSION: This article provides normative scores for the MMSE that should be useful in clinical practice as they may help better interpret the performances of Chilean older adults who seek consultation for cognitive impairment.

Effects of a Structured Multicomponent Physical Exercise Intervention on Quality of Life and Biopsychosocial Health among Chilean Older Adults from the Community with Controlled Multimorbidity: A Pre-Post Design.

Structured multicomponent physical exercise (PE) for older adults, with a combination of strength, aerobic, flexibility, and balance exercises, has been shown to have benefits for physical, cognitive, social, and metabolic functioning, as well as counteracting chronic pathologies and geriatric syndromes. However, little is known about the effect of these interventions in Chilean older adults. Our objective was to determine the effect of a structured multicomponent PE intervention on the quality of life (QoL) and biopsychosocial factors of community-living older adults. We conducted a pre-post intervention without control group, with a face-to-face structured multicomponent PE intervention (cardiovascular, strength/power, flexibility, static and dynamic balance, other psychomotor components, and education), based on FITT-VP principles (frequency, intensity, type, time, volume, and progression of exercise), at moderate intensity, 60 min per session, three times per week, and 12 weeks in duration, among 45 persons with an average age of 70.74 years. Participants were evaluated at the beginning and end of the intervention with different instruments of comprehensive gerontological assessment (CGA). Post intervention, participants (83.70% average attendance) significantly improved scores in QoL, biological and biopsychosocial frailty, sarcopenia, functionality in basic, instrumental, and advanced activities of daily living, dynamic balance, cognitive status and mood, systolic and diastolic blood pressure, weight, body mass index, strength and flexibility clinical tests of lower and upper extremity, aerobic capacity, agility, and tandem balance. The indication and prescription of structured multicomponent PE based on FITT-VP principles, as evaluated with the CGA, improved the QoL and biopsychosocial health of older adults. This intervention could serve as a pilot for RCTs or to improve PE programs or services for older adults under the auspices of existing public policy.

Cognitive impairment with Type 2 Diabetes Mellitus among community-dwelling older adults in Chile: Prevalence, risk factors and cognitive characteristics.

Introduction: The aim of this study is to determine prevalence and risk factors of Cognitive Impairment (CI) and its association with Type 2 Diabetes Mellitus (T2DM) in subjects aged 65 years and above. Additionally, we attempt to provide a cognitive profile for T2DM group. Methodology: A cross-sectional analytical study to assess CI was carried out. We evaluated a sample of community-dwelling residents from Chile. All participants underwent a general interview, lifestyle questionnaires and a comprehensive neuropsychological battery. Regression analyses were performed to evaluate risk of CI with T2DM and influencing factors. Results between groups in the different domains of the neuropsychological assessment were compared by Student's t-tests and MANOVA. Results: Among all 358 subjects, overall T2DM prevalence were 17.3%. The prevalence of CI was higher in T2DM group compared to the healthy participants (30.7%, p < 0.001). The risk of CI was 2.8 times higher in older people with T2DM compared to older people without the diagnosis. Multiple regression analysis, adjusted for age and gender, demonstrated that age, education, presence of dyslipidemia, and T2DM duration were the predictor variables significantly associated with CI. T2DM group performed worse on global cognitive performance, attention, language, verbal memory, visual memory, visual constructional ability, and executive function. After adjusting for significant covariates from multiple regression analysis, a relationship between "cognition" and T2DM is still observed. Amnesic multi-domain impairment was the specific cognitive identified pattern for T2DM group. Conclusion: The present study confirms the high prevalence of CI with T2DM among Chilean older adults in a community-based population. T2DM is significantly associated with a higher risk of CI, and age, education, presence of dyslipidemia, and duration of T2DM are risk factors. T2DM patients with CI are impaired in multiple cognitive domains, even after adjusting covariables, resulting in an amnesic multi-domain cognitive profile.

Efecto de una intervención no farmacológica multidimensional en un grupo de personas con deterioro cognitivo leve / Effects of a multidimensional intervention in older adults with mild cognitive impairment

BACKGROUND: Mild Cognitive Impairment (MCI) is defined as the intermediate stage between the cognitive changes associated with normal aging and dementia. People with MCI can benefit from the implementation of multidimensional non-pharmacological interventions. Aim: To determine the effect of a Multidimensional Intervention based on cognitive, physical, and social training (IMCFS) on the cognitive performance of a group of people with MCI. MATERIALS AND METHODS: Pre and post intervention measurements of cognitive and physical parameters were performed in 10 adults aged 76 ± 4 years with MCI, who participated in the IMCFS lasting three months. Results: A significant improvement was observed in global cognitive performance, anterograde memory, visuospatial memory and in associative learning after IMCFS implementation. No significant effects of the IMCFS on attention, executive functions, language, and viso-constructive skills were observed. CONCLUSIONS: Older adults with MCI benefit from the implementation of a multidimensional intervention, such as IMCFS, which is feasible to implement and integrate into the programs offered by the Chilean healthcare network.

[Effects of a multidimensional intervention in older adults with mild cognitive impairment]. / Efecto de una intervención no farmacológica multidimensional en un grupo de personas con deterioro cognitivo leve.

BACKGROUND: Mild Cognitive Impairment (MCI) is defined as the intermediate stage between the cognitive changes associated with normal aging and dementia. People with MCI can benefit from the implementation of multidimensional non-pharmacological interventions. AIM: To determine the effect of a Multidimensional Intervention based on cognitive, physical, and social training (IMCFS) on the cognitive performance of a group of people with MCI. MATERIALS AND METHODS: Pre and post intervention measurements of cognitive and physical parameters were performed in 10 adults aged 76 ± 4 years with MCI, who participated in the IMCFS lasting three months. RESULTS: A significant improvement was observed in global cognitive performance, anterograde memory, visuospatial memory and in associative learning after IMCFS implementation. No significant effects of the IMCFS on attention, executive functions, language, and viso-constructive skills were observed. CONCLUSIONS: Older adults with MCI benefit from the implementation of a multidimensional intervention, such as IMCFS, which is feasible to implement and integrate into the programs offered by the Chilean healthcare network.

Montreal Cognitive Assessment as Screening Measure for Mild and Major Neurocognitive Disorder in a Chilean Population.

BACKGROUND: The Montreal Cognitive Assessment (MoCA) is a sensitive screening instrument for mild neurocognitive disorder (mild NCD). However, cut-off scores and accuracy indices should be established using representative samples of the population. In this context, the aim of this study was to update the normative values, and diagnostic efficiency statistics of the MoCA to detect mild NCD in the Chilean population. METHODS: This study included 226 participants from the north, center, and south of the country, classified into 3 groups: healthy elderly (HE; n = 113), mild NCD (n = 65), and major neurocognitive disorder (major NCD; n = 48). RESULTS: The optimal cut-off score to discriminate mild NCD from HE participants was 20 points with a sensitivity of 82.8% and a specificity of 84.1%. The observed balance between sensitivity and specificity shows a good test performance either to confirm or discard a diagnosis. The cut-off between mild NCD and major NCD from HE participants was 19 points with 85.6% of sensitivity and 90.3% of specificity. CONCLUSION: Overall diagnostic accuracy can be considered as outstanding (AUC ≥0.904) when discriminating HE from both mild NCD and major NCD. These results showed that the MoCA is a suitable tool to identify mild NCD and major NCD.