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Assessment of Disorders of Language and Communication > Dementia > Flashcards

Dementia Flashcards

1
Q

who diagnoses dementia

A
  • GP
  • consult geriatrician, nuerologist, psychiatrist
  • memory clinics
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2
Q

how is dementia diagnosed

A
  • subjective reports
  • brain imaging
  • blood tests (biomarkers)
  • cognitive screening
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3
Q

clinical consensus meeting

A
  • working diagnostic formulation between MDT
  • referrals likely (OT, SLT, neuropsychology)
  • CSF biomarkers for AD
  • further neuroimaging
  • cases are rediscussed once neuroimaging results are available
  • medical review is booked
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4
Q

role of SLT in communication assessment

A
  • assess body functions and structures that contribute to communication disorders
  • informal and formal assessment of communication to develop of a profile of skills and difficulties (may include psychological and social)
  • contribute to MDT
  • engage in assessment of the capacity for decision-making when there are language difficulties
  • functional assessment (ICF)
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5
Q

MDT

A
  • client and family
  • geriatrician, neurologist, psychiatrist, GP
  • nurse, nurse specialist, ANP
  • OT, PT
  • dietician
  • neuropsychologist
  • medical social worker
  • pharmacist
  • radiologist
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6
Q

pre-diagnostic assessment considerations

A
  • ask their view on cognition
  • co-occurring conditions
  • predisposition
  • emotions around a possible diagnosis
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7
Q

post-diagnostic assessment considerations

A
  • coping ability
  • supports available
  • fear for the future
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8
Q

assessment considerations

A
  • environment, time of day, hearing aids/glass, family present, dentures
  • sight and hearing
  • fatigue
  • medication
  • education
  • first language
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9
Q

modifiable risk factor (promotes brain health)

A

hearing loss

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10
Q

hearing enables ?

A
  • cognition
  • facilitates social interaction
  • enhances communication
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11
Q

different purposes of assessment

A
  • communication screening
  • functional communication assessment
  • comprehensive cognitive communication assessment
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12
Q

assessment components

A
  • case history
  • conversational skills
  • collateral (e.g. “can’t get the words out, lose concentration when watching tv, going off topic”)
  • language assessment
  • assessment of cognitive domains
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13
Q

case history includes ?

A
  • medical history
  • social history
  • communication history
  • environmental evaluation
  • hearing/vision
  • progression of language vs. memory difficulties
  • fatigue
  • first language
  • education
  • life and work experience
  • physical activity
  • medications and interventions
  • coping with diagnosis
  • support systems
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14
Q

formal vs. informal assessment

A
  • both valid
  • consider if the person with dementia can engage with formal testing
  • use many different tools to elicit a complete picture
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15
Q

cognitive linguistic domains

A
  • language
  • memory
  • executive function
  • visuospatial skills
  • attention
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16
Q

receptive language skills to assess

A
  • auditory comprehension (single word, sentence, paragraph)
  • follow commands (level of breakdown)
  • yes/no questions
  • semantic knowledge
  • reading and writing
17
Q

expressive language skills to assess

A
  • confrontational naming
  • generative naming (verbal fluency)
  • repetition (single word, sentence, complex sentence) and level of breakdown
  • picture description
  • narrative discourse
18
Q

conversation analysis

A
  • focuses on interactions between 2 people
  • areas of conversation breakdown and repair, turn taking, and topic maintenance
  • video conversation analyzed by SLT for successes, breakdowns, barriers
19
Q

conversational skills

A
  • turn taking
  • greeting/closing
  • topic maintenance
  • conversation breakdown/repair
  • tangential speech
  • social skills
20
Q

assessment considerations in acute care

A
  • limited time
  • medically unwell
  • informal screens with family, general conversations usually most appropriate
  • be aware of onward referral
  • ensure person with dementia stays connected
21
Q

assessment in PPA

A
  • assess cognitive-linguistic ability (formal and informal methods, aphasia battery)
  • motor speech assessment
  • develop a profile of linguistic abilities and difficulties
22
Q

specific PPA assessments

A
  • sydney language battery (SYDBAT)
  • repeat and point test
  • progressive aphasia severity scale (PASS)
23
Q

how to assess single word, sentence, and paragraph comprehension

A
  • word/sentence to picture matching
  • word-to-definition matching
  • synonym matching
  • answering personally relevant questions
  • answering yes/no questions (simple and abstract), answering questions to a read paragraph
  • familiarity, frequency, grammatical complexity, word length
  • object knowledge
24
Q

assessing semantics

A
  • word meanings and concepts
  • extensive network of associations and concepts form our knowledge (when one is activated, related concepts, events, words are activated)
  • attach meaning onto word form, making it able to be spoken
25
Q

assessing naming

A
  • confrontational naming
  • single word-retrieval in response to pictures and objects
  • error rates and types
  • delay in naming
  • factors that affect naming (familiar vs unfamiliar, nouns vs verbs, semantic category)
26
Q

assessing picture description

A
  • spontaneous speech
  • fluency
  • articulation
  • word-finding, naming difficulties
  • effortfulness
  • hesitations
  • grammatical structure
  • accuracy of content
  • melody, prosody
  • specific error types
  • mean length of utterance
  • speech rate
27
Q

assessing verbal fluency

A
  • generative naming
  • prominent role in neuropsychology testing
  • not just assessing whether can retrieve a word or not, tap into cognitive-linguistic skill (verbal functioning)
28
Q

semantic fluency

A
  • resembles everyday production taks
  • exploit existing links between related concepts to retrieve responses
29
Q

phonemic fluency

A
  • rarely done in everyday speech production
  • more cognitively demanding than semantic fluency
  • suppress the activation of semantically related or associated words
30
Q

how to assess repetition

A
  • single words
  • multisyllabic words
  • phrases
  • sentences
  • non words

Assessment of Disorders of Language and Communication (11 decks)

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