Journal List > Dement Neurocogn Disord > v.13(3) > 1120729

Dement Neurocogn Disord. 2014 Sep;13(3):51-62. Korean.
Published online Sep 30, 2014.  https://doi.org/10.12779/dnd.2014.13.3.51
© 2014 Korean Dementia Association
Characteristics of Language Comprehension in Normal Elderly and the Mild Cognitive Impaired
Soo Jung Lee, M.S.,* Seung Jin Lee, M.S.,*, Ji Yeon Song, M.S.,* and HyangHee Kim, Ph.D.*,
*Graduate Program in Speech and Language Pathology, Yonsei University, Seoul, Korea.
Department of Speech and Language Habilitation, Daelim University College, Anyang, Korea.
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.

Address for correspondence: HyangHee Kim, Ph.D. Graduate Program in Speech and Language Pathology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 250-752, Korea. Tel: +82-2-2228-3900, Fax: +82-2-2227-7984, Email: h.kim@yonsei.ac.kr
Received May 30, 2014; Revised Aug 24, 2014; Accepted Aug 24, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Background

Healthy aging is characterized by declines in language function and it is important to differentiate language comprehension difficulties due to pathological aging (i.e., mild cognitive impairment) from those due to normal aging. The purposes of this study were to review the literature on characteristics of language comprehension in normal elderly and the mild cognitive impaired, and to compare their performances on different language domains.

Methods

A comprehensive literature search identified numerous studies on language comprehension in both groups, and we analyzed them according to each language domain.

Results

The results indicated that the normal elderly show more difficulties in the comprehension of grammatically or lexically complex sentences and in text/discourse comprehension than words or simple sentences. Compared to normal elderly, MCI shows significantly lower performance on text/discourse comprehension and other tasks demanding higher cognitive function. In both groups, there are many different factors affecting language comprehension, such as hearing sensitivity, speech rate, literacy, and cognition.

Conclusions

The results may provide insight into useful language comprehension tasks for differential diagnosis between normal aging and MCI. Further research on various compensatory strategies in daily life to facilitate language comprehension for both groups is warranted.

Keywords: Normal elderly; Mild cognitive impairment; Language comprehension

Figures


Fig. 1
Bottom-up and top-down processing of auditory input (adapted from Edwards, 2007).
Click for larger image

Appendix 1

References
1. Walhovd KB, Fjell AM, Espeseth T. Cognitive decline and brain pathology in aging - need for a dimensional, lifespan and systems vulnerability view. Scand J Psychol.
in press.
2. Lee MS, Kim H. Characteristics of expressive language in normal aging, mild cognitive impairment, and Alzheimer's disease. Dement Neurocogn Disord 2011;10:69–79.
3. Burda AN. In: Communication and swallowing changes in healthy aging adults. Burlington: Jones & Barlett Learning, LLC; 2011. pp. 41-57.
4. Haynes WO, Pindzola RH. In: Diagnosis and evaluation in speech pathology. Needham Heights: Allyn & Bacon; 1998. pp. 134-171.
5. Raphael LJ, Borden GJ, Harris KS. In: Speech science primer: physiology, acoustics, and perception of speech. Philadelphia: Lippincott Williams & Wilkins; 2011. pp. 2-15.
6. DeDe G, Caplan D, Kemtes K, Waters G. The relationship between age, verbal working memory, and language comprehension. Psychol Aging 2004;19:601–616.
7. Waters G, Caplan D. The relationship between age, processing speed, working memory capacity, and language comprehension. Memory 2005;13:403–413.
8. Adlam AL, Bozeat S, Arnold R, Watson P, Hodges JR. Semantic knowledge in mild cognitive impairment and mild Alzheimer's disease. Cortex 2006;42:675–684.
9. De Jager CA, Hogervorst E, Combrinck M, Budge MM. Sensitivity and specificity of neuropsychological tests for mild cognitive impairment, vascular cognitive impairment and Alzheimer's disease. Psychol Med 2003;33:1039–1050.
10. Vandenbulcke M, Peeters R, Dupont P, Van Hecke P, Vandenberghe R. Word reading and posterior temporal dysfunction in amnestic mild cognitive impairment. Cereb Cortex 2007;17:542–551.
11. Lambon Ralph MA, Patterson K, Graham N, Dawson K, Hodges JR. Homogeneity and heterogeneity in mild cognitive impairment and Alzheimer's disease: a cross-sectional and longitudinal study of 55 cases. Brain 2003;126:2350–2362.
12. Nordlund A, Rolstad S, Hellstrom P, Sjogren M, Hansen S, Wallin A. The Goteborg MCI study: mild cognitive impairment is a heterogeneous condition. J Neurol Neurosurg Psychiatry 2005;76:1485–1490.
13. Schmitter-Edgecombe M, Creamer S. Assessment of strategic processing during narrative comprehension in individuals with mild cognitive impairment. J Int Neuropsychol Soc 2010;16:661–671.
14. Tsantali E, Economidis D, Tsolaki M. Could language deficits really differentiate Mild Cognitive Impairment (MCI) from mild Alzheimer's disease? Arch Gerontol Geriatr 2013;57:263–270.
15. Chapman SB, Zientz J, Weiner M, Rosenberg R, Frawley W, Burns MH. Discourse changes in early Alzheimer disease, mild cognitive impairment, and normal aging. Alzheimer Dis Assoc Disord 2002;16:177–186.
16. Taler V, Klepousniotou E, Phillips NA. Comprehension of lexical ambiguity in healthy aging, mild cognitive impairment, and mild Alzheimer's disease. Neuropsychologia 2009;47:1332–1343.
17. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256:183–194.
18. Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, et al. Current concepts in mild cognitive impairment. Arch Neurol 2001;58:1985–1992.
19. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303–308.
20. Shuai L, Gong T. Temporal relation between top-down and bottom-up processing in lexical tone perception. Front Behav Neurosci 2014;8:97.
21. Edwards B. The future of hearing aid technology. Trends Amplif 2007;11:31–45.
22. Gulya J. Structural and physiological changes of the auditory and vestibular mechanisms with aging. In: Ripich D, editor. Handbook of geriatric communication disorders. Austin, TX: Pro-Ed.; 1991. pp. 39-54.
23. Tun PA, Williams VA, Small BJ, Hafter ER. The effects of aging on auditory processing and cognition. Am J Audiol 2012;21:344–350.
24. Bellis TJ, Ferre JM. Multidimensional approach to the differential diagnosis of central auditory processing disorders in children. J Am Acad Audiol 1999;10:319–328.
25. Gordon-Salant S, Yeni-Komshian G, Fitzgibbons P. The role of temporal cues in word identification by younger and older adults: effects of sentence context. J Acoust Soc Am 2008;124:3249–3260.
26. Shin J. In: The sounds of Korean. Seoul: The Knowledge and Culture Press; 2011. pp. 97-116.
27. Clinard CG, Tremblay KL, Krishnan AR. Aging alters the perception and physiological representation of frequency: evidence from human frequency-following response recordings. Hear Res 2010;264:48–55.
28. Pichora-Fuller K, MacDonald E. Auditory temporal processing deficits in older listeners: a review and overview. In: Dau T, Buchholz J, Harte J, Christiansen T, editors. Auditory signal processing in hearing-impaired listeners. 1st international symposium on auditory and audiological research (ISAAR 2007). Copenhagen: Centertryk A/S; 2008. pp. 297-306.
29. Snyder JS, Alain C. Age-related changes in neural activity associated with concurrent vowel segregation. Brain Res Cogn Brain Res 2005;24:492–499.
30. Fogerty D, Humes LE, Kewley-Port D. Auditory temporal-order processing of vowel sequences by young and elderly listeners. J Acoust Soc Am 2010;127:2509–2520.
31. Schneider BA, Daneman M, Pichora-Fuller MK. Listening in aging adults: from discourse comprehension to psychoacoustics. Can J Exp Psychol 2002;56:139–152.
32. Gosselin PA, Gagne JP. Older adults expend more listening effort than young adults recognizing audiovisual speech in noise. Int J Audiol 2011;50:786–792.
33. Belmore SM. Age-related changes in processing explicit and implicit language. J Gerontol 1981;36:316–322.
34. Cohen G. Language comprehension in old age. Cogn Psychol 1979;11:412–429.
35. Whitbourne SK. In: Adult development and aging: biopsychosocial perspectives. New York: John Wiley & Sons; 2005. pp. 206-240.
36. Borella E, Ghisletta P, de Ribaupierre A. Age differences in text processing: the role of working memory, inhibition, and processing speed. J Gerontol B Psychol Sci Soc Sci 2011;66:311–320.
37. Faustmann A, Murdoch BE, Finnigan SP, Copland DA. Effects of advancing age on the processing of semantic anomalies in adults: evidence from event-related brain potentials. Exp Aging Res 2007;33:439–460.
38. Federmeier KD, Kutas M. Aging in context: age-related changes in context use during language comprehension. Psychophysiology 2005;42:133–141.
39. Giaquinto S, Ranghi F, Butler S. Stability of word comprehension with age. An electrophysiological study. Mech Ageing Dev 2007;128:628–636.
40. Federmeier KD, Van Petten C, Schwartz TJ, Kutas M. Sounds, words, sentences: age-related changes across levels of language processing. Psychol Aging 2003;18:858–872.
41. Kim SK, Lee HY. The semantic priming effects of young and older adults in Korean word recognitio. Korean J Biol Physiol Psychol 2007;19:279–297.
42. Howard DV, Shaw RJ, Heisey JG. Aging and the time course of semantic activation. J Gerontol 1986;41:195–203.
43. Tun PA, Benichov J, Wingfield A. Response latencies in auditory sentence comprehension: effects of linguistic versus perceptual challenge. Psychol Aging 2010;25:730–735.
44. Pena-Casanova J, Quinones-Ubeda S, Gramunt-Fombuena N, Aguilar M, Casas L, Molinuevo JL, et al. Spanish Multicenter Normative Studies (NEURONORMA Project): norms for Boston naming test and token test. Arch Clin Neuropsychol 2009;24:343–354.
45. Sakellaridou E, Wersching H, Reinholz J, Lohmann H, Knecht S. Comprehension of complex instructions deteriorates with age and vascular morbidity. Age (Dordr) 2011;33:101–106.
46. Feier CD, Gerstman LJ. Sentence comprehension abilities throughout the adult life span. J Gerontol 1980;35:722–728.
47. Vuorinen E, Laine M, Rinne J. Common pattern of language impairment in vascular dementia and in Alzheimer disease. Alzheimer Dis Assoc Disord 2000;14:81–86.
48. Waters GS, Caplan D. Age, working memory, and on-line syntactic processing in sentence comprehension. Psychol Aging 2001;16:128–144.
49. Wingfield A, McCoy SL, Peelle JE, Tun PA, Cox LC. Effects of adult aging and hearing loss on comprehension of rapid speech varying in syntactic complexity. J Am Acad Audiol 2006;17:487–497.
50. Small JA, Kemper S, Lyons K. Sentence comprehension in Alzheimer's disease: effects of grammatical complexity, speech rate, and repetition. Psychol Aging 1997;12:3–11.
51. Kim H, Sung JE, Kim J, Park EJ, Yoon JH, Yoo HJ, et al. Response time measurements in the iOS app-based Token Test, the Brief Token Test in the elderly. Geriatr Gerontol Int.
in press.
52. Ribeiro F, de Mendonca A, Guerreiro M. Mild cognitive impairment: deficits in cognitive domains other than memory. Dement Geriatr Cogn Disord 2006;21:284–290.
53. Griffith HR, Netson KL, Harrell LE, Zamrini EY, Brockington JC, Marson DC. Amnestic mild cognitive impairment: diagnostic outcomes and clinical prediction over a two-year time period. J Int Neuropsychol Soc 2006;12:166–175.
54. Haense C, Kalbe E, Herholz K, Hohmann C, Neumaier B, Krais R, et al. Cholinergic system function and cognition in mild cognitive impairment. Neurobiol Aging 2012;33:867–877.
55. Caplan D, Dede G, Waters G, Michaud J, Tripodis Y. Effects of age, speed of processing, and working memory on comprehension of sentences with relative clauses. Psychol Aging 2011;26:439–450.
56. DeDe G. Reading and listening in people with aphasia: effects of syntactic complexity. Am J Speech Lang Pathol 2013;22:579–590.
57. Saxton JA, Ratcliff G, Dodge H, Pandav R, Baddeley A, Ganguli M. Speed and capacity of language processing test: normative data from an older American community-dwelling sample. Appl Neuropsychol 2001;8:193–203.
58. Stine-Morrow EA, Ryan S, Leonard JS. Age differences in on-line syntactic processing. Exp Aging Res 2000;26:315–322.
59. Brebion G, Ehrlich MF, Tardieu H. Working memory in older subjects: dealing with ongoing and stored information in language comprehension. Psychol Res 1995;58:225–232.
60. Kemmer L, Coulson S, De Ochoa E, Kutas M. Syntactic processing with aging: an event-related potential study. Psychophysiology 2004;41:372–384.
61. Grossman M, Cooke A, DeVita C, Alsop D, Detre J, Chen W, et al. Age-related changes in working memory during sentence comprehension: an fMRI study. Neuroimage 2002;15:302–317.
62. Dijkstra K, Yaxley RH, Madden CJ, Zwaan RA. The role of age and perceptual symbols in language comprehension. Psychol Aging 2004;19:352–356.
63. Taler V, Jarema G. Processing of mass/count information in Alzheimer's disease and mild cognitive impairment. Brain Lang 2004;90:262–275.
64. Price JM, Sanford AJ. Reading in healthy ageing: the influence of information structuring in sentences. Psychol Aging 2012;27:529–540.
65. Qualls CD, Harris JL. Age, working memory, figurative language type, and reading ability: influencing factors in African American adults' comprehension of figurative language. Am J Speech Lang Pathol 2003;12:92–102.
66. Maki Y, Yamaguchi T, Koeda T, Yamaguchi H. Communicative competence in Alzheimer's disease: metaphor and sarcasm comprehension. Am J Alzheimers Dis Other Demen 2013;28:69–74.
67. Duchan J. Approaches to the study of discourse in the social sciences. In: Bloom RL, Obler LK, DeSanti S, Ehrlich JS, editors. Discourse analysis and applications: studies in adult clinical populations. Hillsdale: Lawrence Erlbaum Associates, inc.; 1994. pp. 1-14.
68. Gordon MS, Daneman M, Schneider BA. Comprehension of speeded discourse by younger and older listeners. Exp Aging Res 2009;35:277–296.
69. Getzmann S, Falkenstein M. Understanding of spoken language under challenging listening conditions in younger and older listeners: a combined behavioral and electrophysiological study. Brain Res 2011;1415:8–22.
70. Sommers MS, Hale S, Myerson J, Rose N, Tye-Murray N, Spehar B. Listening comprehension across the adult lifespan. Ear Hear 2011;32:775–781.
71. Wright HH, Capilouto GJ, Srinivasan C, Fergadiotis G. Story processing ability in cognitively healthy younger and older adults. J Speech Lang Hear Res 2011;54:900–917.
72. Bielak AA, Hultsch DF, Kadlec H, Strauss E. Was that part of the story or did I just think so? Age and cognitive status differences in inference and story recognition. Exp Aging Res 2007;33:295–322.
73. Ulatowska HK, Hayashi MM, Cannito MP, Fleming SG. Disruption of reference in aging. Brain Lang 1986;28:24–41.
74. Bennett DA, Wilson RS, Schneider JA, Evans DA, Beckett LA, Aggarwal NT, et al. Natural history of mild cognitive impairment in older persons. Neurology 2002;59:198–205.
75. Tabert MH, Manly JJ, Liu X, Pelton GH, Rosenblum S, Jacobs M, et al. Neuropsychological prediction of conversion to Alzheimer disease in patients with mild cognitive impairment. Arch Gen Psychiatry 2006;63:916–924.
76. Schneider BA, Daneman M, Murphy DR, See SK. Listening to discourse in distracting settings: the effects of aging. Psychol Aging 2000;15:110–125.
77. Tye-Murray N, Sommers M, Spehar B, Myerson J, Hale S, Rose NS. Auditory-visual discourse comprehension by older and young adults in favorable and unfavorable conditions. Int J Audiol 2008;47 Suppl 2:S31–S37.
78. Schmitt JF, Carroll MR. Older listeners' ability to comprehend speaker-generated rate alteration of passages. J Speech Hear Res 1985;28:309–312.
79. Schmitt JF. The effects of time compression and time expansion on passage comprehension by elderly listeners. J Speech Hear Res 1983;26:373–377.
80. De Beni R, Borella E, Carretti B. Reading comprehension in aging: the role of working memory and metacomprehension. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2007;14:189–212.
81. Ehrlich MF, Brebion J, Tardieu H. Working-memory capacity and reading comprehension in young and older adults. Psychol Res 1994;56:110–115.
82. Harris JL, Rogers WA, Qualls CD. Written language comprehension in younger and older adults. J Speech Lang Hear Res 1998;41:603–617.
83. Rozek E, Kemper S, McDowd J. Learning to ignore distracters. Psychol Aging 2012;27:61–66.
84. Stine-Morrow EA, Morrow DG, Leno R 3rd. Aging and the representation of spatial situations in narrative understanding. J Gerontol B Psychol Sci Soc Sci 2002;57:P291–P297.
85. de Oliveira MO, Nitrini R, Brucki SM. The S-TOFHLA as a Measure of Functional Literacy in Patients with Mild Alzheimer's Disease or Mild Cognitive Impairment. Arch Clin Neuropsychol 2014;29:269–277.
86. Hannon B, Daneman M. Age-related changes in reading comprehension: an individual-differences perspective. Exp Aging Res 2009;35:432–456.
87. Tallberg IM, Stormoen S, Almkvist O, Eriksdotter M, Sundstrom E. Investigating medical decision-making capacity in patients with cognitive impairment using a protocol based on linguistic features. Scand J Psychol 2013;54:386–392.
88. Shammi P, Stuss DT. The effects of normal aging on humor appreciation. J Int Neuropsychol Soc 2003;9:855–863.
89. Uekermann J, Thoma P, Daum I. Proverb interpretation changes in aging. Brain Cogn 2008;67:51–57.
90. Dywan J, Murphy WE. Aging and inhibitory control in text comprehension. Psychol Aging 1996;11:199–206.
91. Liu CJ, Kemper S, McDowd J. The use of illustration to improve older adults' comprehension of health-related information: is it helpful? Patient Educ Couns 2009;76:283–288.
92. Maury P, Besse F, Martin S. Age differences in outdated information processing during news reports reading. Exp Aging Res 2010;36:371–392.
93. Brebion G. Working memory, language comprehension, and aging: four experiments to understand the deficit. Exp Aging Res 2003;29:269–301.
94. Miller P, Wingfield A. Distinct effects of perceptual quality on auditory word recognition, memory formation and recall in a neural model of sequential memory. Front Syst Neurosci 2010;4:14.
95. Stewart R, Wingfield A. Hearing loss and cognitive effort in older adults' report accuracy for verbal materials. J Am Acad Audiol 2009;20:147–154.
96. Peelle JE, Troiani V, Grossman M, Wingfield A. Hearing loss in older adults affects neural systems supporting speech comprehension. J Neurosci 2011;31:12638–12643.
97. Peelle JE, Troiani V, Wingfield A, Grossman M. Neural processing during older adults' comprehension of spoken sentences: age differences in resource allocation and connectivity. Cereb Cortex 2010;20:773–782.
98. Kim J, Yoon JH, Kim SR, Kim H. Effect of literacy level on cognitive and language tests in Korean illiterate older adults. Geriatr Gerontol Int.
in press.
99. Kwon OD, Cho SS, Seo SW, Na DL. Effect of illiteracy on neuropsychological tests and glucose metabolism of brain in later life. J Neuroimaging 2012;22:292–298.
100. Prencipe M, Casini AR, Ferretti C, Lattanzio MT, Fiorelli M, Culasso F. Prevalence of dementia in an elderly rural population: effects of age, sex, and education. J Neurol Neurosurg Psychiatry 1996;60:628–633.
101. Stern Y, Gurland B, Tatemichi TK, Tang MX, Wilder D, Mayeux R. Influence of education and occupation on the incidence of Alzheimer's disease. Jama 1994;271:1004–1010.