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.
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 Neurocognitive Disord. 2011; 10:69–79.
3. Burda AN. Communication and swallowing changes in healthy aging adults. Burlington: Jones & Barlett Learning, LLC;2011. p. 41–57.
4. Haynes WO, Pindzola RH. Diagnosis and evaluation in speech pathology. Needham Heights: Allyn & Bacon;1998. p. 134–171.
5. Raphael LJ, Borden GJ, Harris KS. Speech science primer: physiology, acoustics, and perception of speech. Philadelphia: Lippincott Williams & Wilkins;2011. p. 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.
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.
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. p. 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. The sounds of Korean. Seoul: The Knowledge and Culture Press;2011. p. 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. p. 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.
35. Whitbourne SK. Adult development and aging: biopsychosocial perspectives. New York: John Wiley & Sons;2005. p. 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. p. 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.
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.