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Front. Aging Neurosci. | doi: 10.3389/fnagi.2019.00221

Discourse Measures to Differentiate Between Mild Cognitive Impairment and Healthy Aging

 Bo Seon Kim1, Yong Bum Kim2 and  HyangHee Kim1, 3*
  • 1Yonsei University, South Korea
  • 2Kangbuk Samsung Hospital, South Korea
  • 3College of Medicine, Yonsei University, South Korea

Although subtle discourse declines in people with mild cognitive impairment (MCI) have been reported, heterogeneous measures and tasks among the MCI discourse studies have yielded widely varying outcomes. The present study aimed to first, identify discourse measures that aid the differentiation among people with amnestic MCI (aMCI), people with non-amnestic MCI (naMCI), and cognitively healthy control (HC) participants, and second, delineate the cognitive functions related to such discourse measures. Three discourse tasks (an episodic narrative, a planning task, and a picture description) were performed by 30 aMCI, 22 naMCI, and 21 HC participants. Samples were analyzed using six categories of 15 measures, namely coherence, cohesion, proposition, grammaticality, lexicality, and fluency. The statistical analyses included 1) a multivariate analysis of variance for group comparison; 2) binary simple logistic regression and receiver operating characteristic curve analysis for differentiation between two groups; 3) binary multiple logistic regression for being diagnosed with naMCI or aMCI with the minimum number of predictors; and 4) Pearson correlation analysis for identifying the cognitive functions associated with the discourse measures. The proportion of cohesive words and propositional density in aMCI participants were worse than those in naMCI participants. Global coherence, the proportion of cohesive words, and the proportion of dysfluencies and pauses in naMCI participants were lower than those in the HC participants. Global and local coherence and the proportion of cohesive words, cohesive ties per utterances, propositional density, and dysfluencies and pauses in aMCI participants were worse than those in the HC participants. The aforementioned measures were demonstrated to be effective predictors for classifying groups by receiver operating characteristic curve analysis. In addition, the proportions of cohesive words and pauses were common discourse measures for differentiation between naMCI and HC participants or between aMCI and HC participants using binary multiple logistic regression. According to the correlation analysis, memory and executive functions are needed for coherent, cohesive, and efficient discourse productions in MCI. The detailed description of discourse performances in this study will aid the characterization of the declined language abilities of MCI participants and also the understanding of the cognitive functions involved in discourse performance in MCI.

Keywords: Mild Cognitive Impairment, discourse, Measures, Cognition, Language impairment

Received: 28 Jul 2018; Accepted: 05 Aug 2019.

Edited by:

Aurel Popa-Wagner, Department of Neurology, University Hospital Essen, Germany

Reviewed by:

Andrea Marini, University of Udine, Italy
Peter S. Pressman, University of Colorado Denver, United States  

Copyright: © 2019 Kim, Kim and Kim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: PhD. HyangHee Kim, Yonsei University, Seoul, South Korea, h.kim@yonsei.ac.kr