p3-160: syntactic complexity in patients with alzheimer's disease

1
white race, high education, younger age, and absence of diabetes protect against a decline. P3-160 SYNTACTIC COMPLEXITY IN PATIENTS WITH ALZHEIMER’S DISEASE Thaı ´s Soares Cianciarullo Minett, Juliana Onofre Lira, Aline Carvalho Campanha, Karin Zazo Ortiz, Paulo Henrique Ferreira Bertolucci, Federal University of Sa ˜o Paulo, Sa ˜o Paulo, Brazil. Contact e-mail: [email protected] Background: Alzheimer’s disease (AD) is a degenerative illness char- acterized by the damage of memory and other cognitive functions, among them language. Discourse is a natural form of communication which involves all the linguistic abilities. There is a controversy if syntactic aspect of the discourse is preserved in AD. Syntactic com- plexity is considered a useful measure of syntactic aspect. Purpose: To analyze the syntactic complexity of narrative discourse in individuals with AD. Methods: Cross-sectional study in which we evaluated 121 participants above of 60 years, divided in 2 groups: 61 controls and 60 AD, with more than 4 years of education level. Mini Mental State Examination and Adas-Cog Scale were applied and the individuals had been requested to tell a story about seven pictures that we presented to them. It was made an analysis of syntactic index (SI). The SI provided a measure of the syntactic complexity of discourse production. It was obtained by dividing the number of complex clauses (subordinate, coordinate and reduced) by the total number of clauses (simple and complex). It was used descriptive analysis and linear regression. The linear regression model was used to observe the differences between the groups, controlled by age, sex and education. Results: The AD group have presented 26,4% in SI and control group have presented 43,5% (CI 11,8-22,5, p 0,001). In regression analysis, it was observed for group -0,47 (CI -0,22 to -0,10, p 0,001). Conclusions: The indi- viduals with DA have presented reduction in the syntactic complexity of narrative discourse. P3-161 IN-PERSON VERSUS TELEPHONE ADMINISTRATION OF A NEUROPSYCHOLOGICAL BATTERY FOR AN ELDERLY COHORT Effie M. Mitsis 1 , Diane Jacobs 1 , Xiaodong Luo 1 , Howard Andrews 2 , Karen Andrews 2 , Mary Sano 1 , 1 Mount Sinai School of Medicine, New York, NY, USA; 2 Columbia University College of Physicians and Surgeons, New York, NY, USA. Contact e-mail: effi[email protected] Background: Longitudinal assessment of cognitive performance in healthy elderly provides the opportunity to observe the earliest transition to cognitive impairment and dementia. However, retention of an aging cohort with in-person assessment can be challenging due to declining health or transportation difficulties. Several studies have proposed using telephone assessment, though few have systematically compared these methods.This study was designed to compare a telephone and in-person administered battery developed to assess cognitive loss in the elderly. Methods: Women, 65 years of age and older were recruited from senior centers and other community sources. Inclusion included self reported good health, the absence of major neurologic and psychiatric illnesses and willingness to be assessed twice: in-person and by telephone. Subjects were randomized to receive either telephone or in-person assessment first separated by a max- imum of 4 weeks. Tests consisted of Selective Reminding Test (SRT), Digit Span, Logical Memory, Letter and Animal fluency, and an oral Trail Making Test. All tests were administered identically. For these analyses, SRT comparisons were made between total score for the first 3 trials. Linear regression models, controlling for age, education and type of ad- ministration, were used to determine whether there were performance differences by method on the first test. We then examined the learning effect observed when in-person was followed by telephone administration. Results: Fifty-four women (age 797.7; education 15.43.3), were included. There were no differences in performance between telephone and in-person assessment on the first test. For those who received in-person assessment first, there was no difference between any of the tests subse- quently administered over the telephone. Conclusions: These pilot data support telephone administration of a neuropsychological battery that yields comparable performance to in-person assessment. P3-162 AGE AND EDUCATION ADJUSTMENT OF NEUROPSYCHOLOGICAL TESTS: EFFECTS ON ASSOCIATIONS WITH MRI MEASURES OF BRAIN STRUCTURE Dan Mungas 1 , Bruce R. Reed 2 , Sarah Tomaszewski Farias 1 , Charles DeCarli 1 , 1 University of California, Davis, Sacramento, CA, USA; 2 University of California, Davis, Martinez, CA, USA. Contact e- mail: [email protected] Background: There is controversy about whether age and education ad- justment of neuropsychological test scores in demographically diverse elders increases or decreases validity for identifying brain changes asso- ciated with dementing dieseases. This study examined how age and edu- cation influence the relationship between neuropsychological test scores and structural MRI in demographically diverse older people. Methods: A sample of 351 African Americans, 410 Hispanics, and 458 Caucasians received neuropsychological testing, and volumetric MRI measures of total brain, white matter hyperintensity, and hippocampus were available for a sub sample of 77 African Americans, 90 Hispanics, and 123 Caucasians. Latent variable modeling was used to examine independent effects of age, education, and MRI on test scores and to determine how much variance MRI variables explained in test scores adjusted for the effects of age and education and in unadjusted test scores. Results: Age adjustment consis- tently resulted in weaker relationships of test scores and MRI variables. Adjustment for ethnicity yielded stronger relationships. Education adjust- ment increased relationships with MRI in the combined sample and in Hispanics, made no difference in Caucasians, but decreased associations in African Americans. The negative effect of education adjustment in African Americans appeared to be due to a confounding relationship of age and education in African Americans that was not present in Caucasians and Hispanic. Conclusions: Results suggest that adjustment for demographic characteristics is beneficial when demographic variables are strongly re- lated to test scores independent of measures of brain structure, but adjust- ment has negative consequences when effects of demographic character- istics are mediated through brain structure. P3-163 COMPARISON OF COMMUNICATION ABILITIES IN LATE-ONSET DEPRESSION AND ALZHEIMER’S DISEASE Tania M. S. Novaretti, Marcia Radanovic, Ricardo Nitrini, Department of Neurology University of Sao Paulo School of Medicine, Sao Paulo, Brazil. Contact e-mail: [email protected] Background: The elderly segment of population in whom dementia and depression diseases are very prevalent. An inherent component of AD is impairment in linguistic communication. Language impairment can also be found in depressed patients. The Arizona Battery for Communication Disor- ders of Dementia (ABCD) is a clinical instrument designed to identify and quantify the functional linguistic communication deficits and provides infor- mation about cognition, orientation memory, and the ability to recall informa- tion as well as functional communication. The aim of this study is to verify the performance of healthy elderly, depressed and mild AD patients and to com- pare the profiles of communication abilities in these groups. Methods: We studied 12 patients with late onset depression (mean age 74 (6.4); schooling: 9.7 (6.3)) and 10 patients with mild (CDR1) AD (mean age 79.4 (6.3); schooling: 11 (6.2)) using the ABCD. The performance of both groups was also compared to a control group of 18 healthy subjects (mean age 75.3 (3.3); schooling: 8 (3.8)). Results: Mild AD patients differed from controls in the T567 Poster Presentations P3:

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white race, high education, younger age, and absence of diabetes protectagainst a decline.

P3-160 SYNTACTIC COMPLEXITY IN PATIENTS WITHALZHEIMER’S DISEASE

Thaıs Soares Cianciarullo Minett, Juliana Onofre Lira,Aline Carvalho Campanha, Karin Zazo Ortiz,Paulo Henrique Ferreira Bertolucci, Federal University of Sao Paulo,Sao Paulo, Brazil. Contact e-mail: [email protected]

Background: Alzheimer’s disease (AD) is a degenerative illness char-acterized by the damage of memory and other cognitive functions,among them language. Discourse is a natural form of communicationwhich involves all the linguistic abilities. There is a controversy ifsyntactic aspect of the discourse is preserved in AD. Syntactic com-plexity is considered a useful measure of syntactic aspect. Purpose: Toanalyze the syntactic complexity of narrative discourse in individualswith AD. Methods: Cross-sectional study in which we evaluated 121participants above of 60 years, divided in 2 groups: 61 controls and 60AD, with more than 4 years of education level. Mini Mental StateExamination and Adas-Cog Scale were applied and the individuals hadbeen requested to tell a story about seven pictures that we presented tothem. It was made an analysis of syntactic index (SI). The SI provideda measure of the syntactic complexity of discourse production. It wasobtained by dividing the number of complex clauses (subordinate,coordinate and reduced) by the total number of clauses (simple andcomplex). It was used descriptive analysis and linear regression. Thelinear regression model was used to observe the differences between thegroups, controlled by age, sex and education. Results: The AD grouphave presented 26,4% in SI and control group have presented 43,5%(CI� 11,8-22,5, p� 0,001). In regression analysis, it was observed forgroup �� -0,47 (CI� -0,22 to -0,10, p� 0,001). Conclusions: The indi-viduals with DA have presented reduction in the syntactic complexityof narrative discourse.

P3-161 IN-PERSON VERSUS TELEPHONEADMINISTRATION OF ANEUROPSYCHOLOGICAL BATTERY FOR ANELDERLY COHORT

Effie M. Mitsis1, Diane Jacobs1, Xiaodong Luo1, Howard Andrews2,Karen Andrews2, Mary Sano1, 1Mount Sinai School of Medicine, NewYork, NY, USA; 2Columbia University College of Physicians andSurgeons, New York, NY, USA. Contact e-mail: [email protected]

Background: Longitudinal assessment of cognitive performance inhealthy elderly provides the opportunity to observe the earliest transition tocognitive impairment and dementia. However, retention of an aging cohortwith in-person assessment can be challenging due to declining health ortransportation difficulties. Several studies have proposed using telephoneassessment, though few have systematically compared these methods.Thisstudy was designed to compare a telephone and in-person administeredbattery developed to assess cognitive loss in the elderly. Methods:Women, 65 years of age and older were recruited from senior centers andother community sources. Inclusion included self reported good health, theabsence of major neurologic and psychiatric illnesses and willingness to beassessed twice: in-person and by telephone. Subjects were randomized toreceive either telephone or in-person assessment first separated by a max-imum of 4 weeks. Tests consisted of Selective Reminding Test (SRT),Digit Span, Logical Memory, Letter and Animal fluency, and an oral TrailMaking Test. All tests were administered identically. For these analyses,SRT comparisons were made between total score for the first 3 trials.Linear regression models, controlling for age, education and type of ad-ministration, were used to determine whether there were performancedifferences by method on the first test. We then examined the learningeffect observed when in-person was followed by telephone administration.

Results: Fifty-four women (age�79�7.7; education�15.4�3.3), wereincluded. There were no differences in performance between telephone andin-person assessment on the first test. For those who received in-personassessment first, there was no difference between any of the tests subse-quently administered over the telephone. Conclusions: These pilot datasupport telephone administration of a neuropsychological battery thatyields comparable performance to in-person assessment.

P3-162 AGE AND EDUCATION ADJUSTMENT OFNEUROPSYCHOLOGICAL TESTS: EFFECTS ONASSOCIATIONS WITH MRI MEASURES OFBRAIN STRUCTURE

Dan Mungas1, Bruce R. Reed2, Sarah Tomaszewski Farias1,Charles DeCarli1, 1University of California, Davis, Sacramento, CA,USA; 2University of California, Davis, Martinez, CA, USA. Contact e-mail: [email protected]

Background: There is controversy about whether age and education ad-justment of neuropsychological test scores in demographically diverseelders increases or decreases validity for identifying brain changes asso-ciated with dementing dieseases. This study examined how age and edu-cation influence the relationship between neuropsychological test scoresand structural MRI in demographically diverse older people. Methods: Asample of 351 African Americans, 410 Hispanics, and 458 Caucasiansreceived neuropsychological testing, and volumetric MRI measures of totalbrain, white matter hyperintensity, and hippocampus were available for asub sample of 77 African Americans, 90 Hispanics, and 123 Caucasians.Latent variable modeling was used to examine independent effects of age,education, and MRI on test scores and to determine how much varianceMRI variables explained in test scores adjusted for the effects of age andeducation and in unadjusted test scores. Results: Age adjustment consis-tently resulted in weaker relationships of test scores and MRI variables.Adjustment for ethnicity yielded stronger relationships. Education adjust-ment increased relationships with MRI in the combined sample and inHispanics, made no difference in Caucasians, but decreased associations inAfrican Americans. The negative effect of education adjustment in AfricanAmericans appeared to be due to a confounding relationship of age andeducation in African Americans that was not present in Caucasians andHispanic. Conclusions: Results suggest that adjustment for demographiccharacteristics is beneficial when demographic variables are strongly re-lated to test scores independent of measures of brain structure, but adjust-ment has negative consequences when effects of demographic character-istics are mediated through brain structure.

P3-163 COMPARISON OF COMMUNICATION ABILITIESIN LATE-ONSET DEPRESSION ANDALZHEIMER’S DISEASE

Tania M. S. Novaretti, Marcia Radanovic, Ricardo Nitrini, Departmentof Neurology University of Sao Paulo School of Medicine, Sao Paulo,Brazil. Contact e-mail: [email protected]

Background: The elderly segment of population in whom dementia anddepression diseases are very prevalent. An inherent component of AD isimpairment in linguistic communication. Language impairment can also befound in depressed patients. The Arizona Battery for Communication Disor-ders of Dementia (ABCD) is a clinical instrument designed to identify andquantify the functional linguistic communication deficits and provides infor-mation about cognition, orientation memory, and the ability to recall informa-tion as well as functional communication. The aim of this study is to verify theperformance of healthy elderly, depressed and mild AD patients and to com-pare the profiles of communication abilities in these groups. Methods: Westudied 12 patients with late onset depression (mean age 74 (6.4); schooling:9.7 (6.3)) and 10 patients with mild (CDR�1) AD (mean age 79.4 (6.3);schooling: 11 (6.2)) using the ABCD. The performance of both groups wasalso compared to a control group of 18 healthy subjects (mean age 75.3 (3.3);schooling: 8 (3.8)). Results: Mild AD patients differed from controls in the

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