Effects of language stimulation on cognition of institutionalized aged people: a preliminary case series study

Cunha, Ruttienya Dias Braga da; Pacheco, Tayane Frez; Barreto, Simone dos Santos

doi:10.1590/1980-57642021dn15-010015

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Dementia & Neuropsychologia

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Original Article • Dement Neuropsychol 15 (1) • Jan-Mar 2021 • https://doi.org/10.1590/1980-57642021dn15-010015 copy

Effects of language stimulation on cognition of institutionalized aged people: a preliminary case series study

EFEITOS DA ESTIMULAÇÃO DA LINGUAGEM NA COGNIÇÃO DE IDOSOS INSTITUCIONALIZADOS: ESTUDO DE SÉRIE DE CASOS PRELIMINAR

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT.

Cognitive stimulation programs for institutionalized elderly people show positive results, however few studies have investigated the effectiveness of language stimulation programs for the health of this population.

Objectives:

To characterize the cognitive-linguistic profile of institutionalized elderly and to compare their performance before and after a language stimulation program (LSP).

Methods:

An exploratory case series study was conducted with nine residents of a Home for the Aged. Elderly people aged 60 or over, of both sexes, without neurological or neuropsychiatric diseases, communication disorders, intellectual impairment or severe visual or hearing impairment were included. The participants were submitted to an initial assessment through the Montreal Cognitive Assessment (MoCA) and Montreal Toulouse Battery Language Assessment – Brazil to characterize the cognitive-linguistic profile of the studied group. Five elderly were selected to participate in the LSP, of wich only two participated effectively in the program, but all were reassessed after the program was completed.

Results:

on the initial assessment, of the nine participants, only one had adequate cognitive performance and all presented changes in macro and/or microlinguistics aspects of oral discourse, with oral comprehension preserved. On the reassessment carried out with five participants, only two participants who adhered effectively to the program obtained improvements in MoCa scores. In regarding language, three participants performed better in the oral emission measures. The performance of the participants in oral comprehension remained or declined.

Conclusion:

The speech-language therapy intervention through a LSP contributes to improving the cognitive-linguistic performance of institutionalized elderly.

Keywords:
language; cognition; homes for the aged; language therapy; treatment outcome

Tests		Scores of participant
Tests		P1	P2	P3⁺ + elderly people aged 80 years or older;	P4⁺ + elderly people aged 80 years or older;	P5	P6^§ § scores vary due to applied version.	P7	P8	P9
MoCa
	Executive functions (1/5)	0	0	0	0	0	4	0	0	0
	Naming (4/3)	3	4	3	4	2	3	3	2	4
	Memory/ delayed recall (5/5)	1	0	0	0	0	3	2	1	0
	Attention (3/3)	0	3	1	0	0	3	1	1	0
	Language/ fluency (2/3)	0	1	1	1	1	2	1	0	1
	Abstraction (3/2)	2	2	1	1	1	2	1	2	1
	Orientation (6/6)	4	6	6	6	4	6	5	4	4
	Calculation (3/3)	1	3	3	2	1	3	0	0	3
	Visual perception (3/0)	0	3	3	1	0	---	0	0	2
	Extra point (schooling)	1	1	1	1	1	1	1	1	1
	Total score (30)	12	23	19	16	10	27^* * Performance above the cut-off score;	14	11	16
MTL-Oral narrative
	Number of words	17^* * Performance above the cut-off score;	93^* * Performance above the cut-off score;	100^* * Performance above the cut-off score;	37^* * Performance above the cut-off score;	53^* * Performance above the cut-off score;	144^* * Performance above the cut-off score;	21^* * Performance above the cut-off score;	7	55^* * Performance above the cut-off score;
	Information units (10)	1	6^* * Performance above the cut-off score;	4^* * Performance above the cut-off score;	1	1	8^* * Performance above the cut-off score;	2	0	2
	Scenes (3)	0	2^* * Performance above the cut-off score;	2^* * Performance above the cut-off score;	0	0	3^* * Performance above the cut-off score;	0	0	0
	Cohesion (1)	1	1	1	1	0	1	0	0	0
	Coherence (1)	0	1	1	0	0	1	1	0	0
MTL-Oral text comprehension
	Total (9)	7^* * Performance above the cut-off score;	5^* * Performance above the cut-off score;	7^* * Performance above the cut-off score;	6^* * Performance above the cut-off score;	2	8^* * Performance above the cut-off score;	5^* * Performance above the cut-off score;	3	2

MoCa tasks	Performance
	P1			P7			P3⁺ + elderly people aged 80 years;			P6^§ § sores vary due to applied version;			P2
	As^\|\| \|\| assessment;	Re^¶ ¶ reassessment,	Dif^ difference.	As	Re	Dif	As	Re	Dif	As	Re	Dif	As	Re	Dif
Executive functions (1/5)	0	0	0	0	0	0	0	0	0	4	4	0	0	0	0
Naming (4/3)	3	4	-1	3	3	0	3	4	-1	3	3	0	4	4	0
Memory/delayed recall (5/5)	1	0	1	2	2	0	0	0	0	3	2	1	0	1	-1
Attention (3/3)	0	0	0	1	3	-2	1	0	1	3	3	0	3	2	1
Language/fluency (2/3)	0	0	0	1	1	0	1	0	1	2	1	1	1	1	0
Abstraction (3/2)	2	2	0	1	2	-1	1	1	0	2	0	2	2	1	1
Orientation (6/6)	4	5	-1	5	4	1	6	4	2	6	5	1	6	6	0
Calculation (3/3)	1	2	-1	0	1	-1	3	3	0	3	1	2	3	3	0
Visual perception (3/0)	0	0	0	0	2	-2	3	2	1	---	---	0	3	3	0
Total	12	14	-2	14	19	-5	19	15	4	27^* * Performance above the cut-off score;	20	7	23	22	1

MTL-Brazil subtests		Performance
		P1			P7			P3			P6			P2
		As⁺ + assessment;	Re^§ § reassessment;	Dif^\|\| \|\| difference.	As	Re	Dif	As	Re	Dif	As	Re	Dif	As	Re	Dif
Oral narrative
	Number of words	17^* * Performance above the cut-off score;	45^* * Performance above the cut-off score;	-28	21^* * Performance above the cut-off score;	37^* * Performance above the cut-off score;	-16	100^* * Performance above the cut-off score;	102^* * Performance above the cut-off score;	-2	144^* * Performance above the cut-off score;	47^* * Performance above the cut-off score;	-97	93^* * Performance above the cut-off score;	99^* * Performance above the cut-off score;	-6
	Information units	1	2	-1	2	4^* * Performance above the cut-off score;	-2	4^* * Performance above the cut-off score;	5^* * Performance above the cut-off score;	-1	8^* * Performance above the cut-off score;	6^* * Performance above the cut-off score;	2	6^* * Performance above the cut-off score;	5^* * Performance above the cut-off score;	1
	Scenes	0	0	0	0	1^* * Performance above the cut-off score;	-1	2^* * Performance above the cut-off score;	1^* * Performance above the cut-off score;	1	3^* * Performance above the cut-off score;	1^* * Performance above the cut-off score;	1	2^* * Performance above the cut-off score;	2^* * Performance above the cut-off score;	0
	Cohesion	1	1	0	0	0	0	1	1	0	1	1	0	1	1	0
	Coherence	0	0	0	1	1	0	1	1	0	1	1	0	1	1	0
Oral text comprehension
	Total	7^* * Performance above the cut-off score;	7^* * Performance above the cut-off score;	0	5^* * Performance above the cut-off score;	4^* * Performance above the cut-off score;	1	7^* * Performance above the cut-off score;	3	4	8^* * Performance above the cut-off score;	7^* * Performance above the cut-off score;	1	5^* * Performance above the cut-off score;	5^* * Performance above the cut-off score;	0

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Simone dos Santos Barreto. Rua Dr Silvio Henrique Braune, 22 – Centro – 28625-650 Nova Friburgo RJ – Brazil. E-mail: simonebarreto@id.uff.br