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Sentence Comprehension Deficits as a Critical Linguistic Marker to Differentiate Mild Cognitive Impairment from Normal Aging

Jee Eun Sung1*, Bora Eom1, Chaewon Park1, Seung He Paik1, Hanjae Lee1, Jee Hyang Jeong2 and Geonha Kim3
  • 1 Ewha Womans University, Dept. of Communication Disorders, Republic of Korea
  • 2 Ewha Womans University School of Medicine, Dept. of Neurology, Republic of Korea
  • 3 Ewha Womans University Brain Institute, Republic of Korea

Introduction Individuals with mild cognitive impairment (MCI) presented several clinical symptoms including cognitive and linguistic impairments, but with intact functional abilities associated with activities of daily living unlike dementia of the Alzheimer’s type DAT (Petersen, 2004). The concept of MCI received considerable attention in the past decades as a diagnostic entity to identify individuals at risk for dementia. Early focus on behavioral symptoms of MCI was memory impairment as an incipient dementia stage (Collie et al., 2002; Petersen et al, 1999). However, more recent studies suggested that the syntactic comprehension abilities in MCI seemed to be affected, and these syntactic deficits emerged more clearly as a function of the task complexity (e.g., Tsantali, Economidis, & Tsolaki, 2013). The current study investigated whether individuals with MCI presented differential deficits in sentence comprehension abilities compared to normal elderly adults when the demands on sentence processing increased. Methods Fifteen individuals with amnestic-MCI and 15 age- and education-matched normal elderly adults (NEA) participated in the study. Persons with MCI met Petersen’s most recent criteria (Petersen, 2004) diagnosed by trained neurologists. Their Clinical Dementia Rating (Hughes et al., 1982) score was 0.5. The NEA group showed normal range of performance on Seoul Neuropsychological Screening Battery (SNSB) (Kang & Na, 2003) and K-MMSE (Kang, Na, & Hahn, 1997). Both groups presented normal range of Geriatric Depression Scale (GDS) (Jung et al., 1997) and Seoul-Instrumental Activities of Daily Living (S-IADL) (Ku et al., 2004). Both groups were administered two subsets of active and passive conditions from the sentence comprehension task (SCT) (Sung, 2015). The SCT employed a sentence-picture paradigm with semantically reversible sentence stimuli in which linguistic constituents such as agents and patients were depicted using a humanized pictogram to minimize the influence of top-down semantic processing on syntactic comprehension. Digit-forward and digit-backward span tasks were used as a composite measure of working memory (WM) (Yeom, Park, Oh, Kim, & Lee, 1992). The Seoul Verbal Learning Test (SVLT)-immediate and SVLT-delayed (Kang & Na, 2003) were administered. Results A two-way mixed ANOVAs (Group: MCI vs. NEA x Sentence type: Active vs. Passive) revealed a significant main effect for the group, F(1, 28) = 7.804, p < .01, η2partial = .218, with MCI group presenting significantly lower accuracy than the NEA group. A significant main effect for the sentence type emerged, F(1, 28) = 18.401, p < .0001,η2partial = .397, indicating that passive sentences elicited significantly worse performance than active sentences. The two-way interaction between the sentence type and group (Figure 1) was not significant, F(1, 28) = 1.818, p = .188, η2partial = .061. A stepwise discriminant analysis determined the best predictors that contribute most to differentiate the MCI group from normal elderly group. Predictor variables included overall accuracy on the SCT, accuracy on each sentence type (active and passive), WM, SVLT-immediate, SVLT-delayed, education, and K-MMSE scores. The overall accuracy on the SCT was entered into the analysis as a significant predictor in the discriminant function, Wilk’s Lamda = .782, chi-square = 6.761, p < .01. Sixty percent of participants with MCI were successfully classified as an MCI group, and 73.3% of normal elderly adults were entered into the normal group. Discussion Individuals with MCI clearly presented sentence comprehension deficits in a controlled sentence comprehension test. In general, both groups demonstrated greater difficulties in processing passive than active sentences. Results from the discriminant analysis suggested that overall accuracy on the sentence comprehension task is the critical factor to differentiate MCI from the normal aging group, indicating that syntactic comprehension deficits emerged from the early stage of DAT and may serve as a critical linguistic marker among other factors to make differential diagnosis for MCI.

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References

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Keywords: Mild Cognitive Impairment, Sentence comprehension deficits, linguistic marker, Active sentence, passive sentence

Conference: 54th Annual Academy of Aphasia Meeting, Llandudno, United Kingdom, 16 Oct - 18 Oct, 2016.

Presentation Type: Poster Sessions

Topic: Academy of Aphasia

Citation: Sung J, Eom B, Park C, Paik S, Lee H, Jeong J and Kim G (2016). Sentence Comprehension Deficits as a Critical Linguistic Marker to Differentiate Mild Cognitive Impairment from Normal Aging. Front. Psychol. Conference Abstract: 54th Annual Academy of Aphasia Meeting. doi: 10.3389/conf.fpsyg.2016.68.00132

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Received: 01 May 2016; Published Online: 15 Aug 2016.

* Correspondence: PhD. Jee Eun Sung, Ewha Womans University, Dept. of Communication Disorders, Seoul, Republic of Korea, jeesung@ewha.ac.kr