Cognitive-Communication Disorders of Dementia : Definition, Diagnosis, and Treatment,

Description

Preface Acknowledgments 1. Speech-Language Pathology, Mild Cognitive Impairment, and Dementia Introduction Communication Defined Rationale for Therapy Neuroplasticity Memory Systems and Their Selective Vulnerability to Disease Cognitive Reserve Summary of Important Points References 2. Cognition, Memory, and Communication Cognition and Memory The “Company of Cognition” Memory Defined Sensory Memory Working Memory Long-Term Memory Relation of Cognition and Memory to Communication Production of Linguistic Information Comprehension of Linguistic Information Summary of Important Points References 3. MCI: Mild Cognitive Impairment a.k.a. Mild Neurocognitive Disorder Introduction Prevalence of MCI Diagnostic Criteria for MCI Risk and Protective Factors Causes and Clinical Presentations of MCI Neuropsychological Deficits Associated with MCI Language Performance Deficits Conversion to Dementia Conclusion Summary of Important Points References 4. Alzheimer’s Dementia Alzheimer’s Disease (AD) Introduction Diagnostic Criteria for AD Risk Factors for AD Age Family History of AD Education History of Head Trauma Loneliness Gender Maternal Age Apolipoprotein E4 Allele Chronic Lack of Sleep Mild Cognitive Impairment Predictors of Disease Progression Protective Factors Effects of AD on Cognitive and Communicative Functions Early Stage Middle Stage Late Stage Summary of Important Points References 5. Dementia and Down Syndrome Introduction Common Features of People with DS Risk of Developing Alzheimer’s Disease Prevalence of Dementia in DS Diagnosing Dementia in Individuals with DS A Study of the Cognitive-Communication Profiles of DS Adults with and without Dementia Language and Communication Skills in Adults with DS Premorbid Language Language Change in Dementia Cognitive and Behavioral Measures Appropriate for Individuals with DS Summary of Important Points References 6. Vascular Dementia Introduction Neuropathology Diagnostic Criteria Diagnosing Vascular Cognitive Impairment Risk Factors for VaD Aging Hypertension Family History Ethnicity and Gender Diabetes Mellitus (Type 2) Lifestyle Vascular Pathology May Be a Trigger for Alzheimer’s Dementia Comparison of Effects of Cortical and Subcortical Pathologies on Cognition and Communicative Function Cortical Pathologies Subcortical Pathologies VCI Compared with AD Observations from Course-of-Disease Studies Summary: Effects of VCI on Cognitive and Communicative Functioning Conclusion Summary of Important Points References 7. Parkinson’s Disease and Dementia Parkinsonism and Parkinson’s Disease (PD) Incidence and Prevalence Symptoms of PD: Motor, Affective, Cognitive Neuropathology of PD Risk Factors Diagnostic Criteria for PD Cognition: Continuum from Normal to Dementia Diagnostic Criteria PD-MCI Diagnostic Criteria for Parkinson’s Disease with Dementia (PDD) Prevalence of PDD Nature of Cognitive Impairment Attention/Executive Function Memory Visuoperceptual/Visuospatial Function Deficits Communicative Function of PD Patients without and with Dementia A Study of Communicative Function in Demented PD Patients Individuals with PD and Dementia Compared with Individuals with AD on the ABCD Discourse Sample of PD Patient with Dementia Relation of PDD, Dementia with Lewy Bodies, and AD Summary of Important Points References 8. Dementia and Lewy Body Disease Lewy Body Disease Diagnostic Criteria and Symptomatology Consortium Consensus Criteria for Diagnosis of Dementia Caregiver Report of Early Symptoms LBD Risk Factors Effects of LBD on Cognition Executive Function and Attention Visuoperceptual and Spatial Functions Memory Language and Communicative Function A Case of Pure LBD Summary of Changes in Communicative Functioning Cognitive Profile of LBD Compared with AD Cognitive Profile of LBD Compared with PDD Summary of Important Points References 9. Dementia and Huntington’s Disease Overview and Genetics of Huntington’s Disease Neuropathology of HD Symptomatology Affect and Motor Symptoms Effects of HD on Speech Effects on Cognition Language Dysphagia Is Also a Concern Cognition and Communication Summary of Important Points References 10. Frontotemporal Dementia Introduction Diagnosis of Frontotemporal Dementia (FTD) Behavioral Presentation Behavioral Variant Frontotemporal Dementia (bvFTD) Language Presentation of FTD: Primary Progressive Aphasia Variants of PPA Differentiating the Behavioral Variant of FTD from the Primary Progressive Aphasia Variants Amyotrophic Lateral Sclerosis and FTD Effects of ALS-FTD on Language Summary of Important Points References Clinical Management Guide: Assessments and Interventions for Cognitive-Communication Disorders of Dementia I. Assessment Introduction Assessment Procedures that Produce Valid and Reliable Data Prior to Testing Be Alert to Depression Be Alert to Drug Effects on Performance Know the Criteria for Diagnosing MCI and Dementia Severity of Cognitive Impairment Affects Test Selection Tests for Diagnosing MCI and Dementia Arizona Battery for Communication Disorders of Dementia (ABCD-1) aka Arizona Battery for Cognitive-Communicative Disorders (ABCD-2) ABCD-2 Subtests Most Sensitive to Mild AD Functional Linguistic Communication Inventory (FLCI) for Moderately and Severely Demented Individuals Many Other Tests Are Available for Diagnosing MCI and Dementia Broad-Based Assessments Short Screening Tests What About Aphasia Test Batteries? ADAS-COG: Widely Used in Drug Trials Differentiating the Types of Dementia Differentiating MCI and Mild Dementia from Delirium and Depression Differentiating Frontotemporal Dementias (FTD) Differentiating Primary Progressive Aphasia (PPA) and Mild AD An Assessment for Differentiating Semantic Dementia: The Cambridge Semantic Memory Test Differentiating AD from Vascular Dementia Differentiating Mild AD from Dementia with Lewy Bodies (DLB) and Parkinson’s Disease with Dementia (PDD) Summary of Important Points II. Cognitive Intervention A Treatment Model for Successful Clinical Intervention Cognitive Intervention for Mild Cognitive Impairment (MCI) Cognitive Reserve is “Neuroprotective” Cognitive Intervention Strengthens Cognitive Reserve Make Treatment Person Centered Suggestions for How To Make Therapy Person Centered Target Skills and Behaviors that Have the Potential to Improve Provide Individual and Group Therapy Provide Training of Strategies that Can Improve Function Use Repetition and Repeated Retrieval to Create and Strengthen New Learning Computer-Based Training Include Neuro-Proactive Education for Clients About Physical, Mental, and Social Health Provide Opportunities to Support Communicative Engagement and Socialization Ensure that Duration of Treatment Is Sufficient to Strengthen Skills and Create Learning Use Objective and Subjective Measures of Skill Strength and Learning Looking Forward III. Treatment: Direct Interventions for Individuals with Mild Cognitive Impairment and Dementia Introduction Clinical Strategies Supported by Neuroscience Strategy: Provide Stimulation Related to Client’s Needs Strategy: Personalize Tasks by Giving Clients Choices Strategy: Involve Multiple Modalities Strategy: Avoid Having Clients Multitask Strategy: Engage Clients through Self-Generation Strategy: Control Task Complexity Strategy: Work within Schemas to Increase Knowledge and Facilitate Retrieval Strategy: Use Stimuli that Evoke Positive Emotion Strategy: Use Reminiscence to Stimulate Recall, Engage Attention, and Elicit Emotion Strategy: Design Stimulation to Reduce Errors Strategy: Use Repetition to Produce Durable Memory Repeated Retrieval: A Potent Form of Repetition that Profoundly Affects Learning Spaced Retrieval: Retrieval of Information or Actions Over Increasingly Longer Intervals Strategy: Elaborated Encoding Produces Stronger Memory Strategy: Use Priming to Facilitate Memory and Increase Knowledge Strategy: Use Reward to Sustain Attention, Increase Frequency of Desired Response, and Elicit Positive Emotion Strategy: Provide Education About How Sleep, Diet, and Exercise Support Neuroplasticity and Cognition Summary: Science and Clinical Practice IV. Indirect Interventions for Individuals with Dementia Overview Linguistic Modifications Improving Language Comprehension Improving Language Production Environmental Modifications Facilitate Perception of Stimuli Vision and Aging Managing Problems with Vision to Facilitate Learning Color and Vision Hearing and Aging Facilitating Mood and Behavior Provide Something to Nurture Reduce Verbal Perseveration and Disruptions The Environment Should Promote Safety Technologies to Support Cognition and Communication Technologies to Support Memory Technologies to Support Engagement Technologies to Support Safety and Independence Support of Feeding Caregiver Education and Support Health Risks of Caregiving Gender and Caregiving Family Strife and Violence Factors that Influence Caregiver Burden and Stress Ethnic Minority Groups and Caregiver Burden Family Counseling Culture Matters in Counseling Emphasize What the Patient Can Do Caregiver Education and Training V. Reimbursement and Care Planning for Persons with Dementia Introduction Federal Law Mandates Care Medicare’s Comprehensive Assessment Minimum Data Set Care Area Assessment (CAA) Process Centers for Medicare and Medicaid Services Role of the SLP A Relevant Question Can SLPs Be Reimbursed for Cognitive Therapy? Medicare Review Threshold for Therapy Claims Using Test Performance to Develop Treatment Plans Planning Intervention A Case-Based Example of a Restorative Care Plan A Case-Based Example of a Maintenance Program Documentation Is Critical Evaluation and Plan of Care Progress Notes Treatment Encounter Notes Documentation Pitfalls Synopsis References for Clinical Guide Index