title: Deficits in narrative discourse elicited by visual stimuli are already present in patients with mild cognitive impairment.
abstract: Language batteries used to assess the skills of elderly individuals, such as naming and semantic verbal fluency, present some limitations in differentiating healthy controls from patients with amnestic mild cognitive impairment (a-MCI). Deficits in narrative discourse occur early in dementia caused by Alzheimer's disease (AD), and the narrative discourse abilities of a-MCI patients are poorly documented. The present study sought to propose and evaluate parameters for investigating narrative discourse in these populations. After a pilot study of 30 healthy subjects who served as a preliminary investigation of macro- and micro-linguistic aspects, 77 individuals (patients with AD and a-MCI and a control group) were evaluated. The experimental task required the participants to narrate a story based on a sequence of actions visually presented. The Control and AD groups differed in all parameters except narrative time and the total number of words recalled. The a-MCI group displayed mild discursive difficulties that were characterized as an intermediate stage between the Control and AD groups' performances. The a-MCI and Control groups differed from the AD group with respect to global coherence, discourse type and referential cohesion. The a-MCI and AD groups were similar to one another but differed from the Control group with respect to the type of words recalled, the repetition of words in the same sentence, the narrative structure and the inclusion of irrelevant propositions in the narrative. The narrative parameter that best distinguished the three groups was the speech effectiveness index. The proposed task was able to reveal differences between healthy controls and groups with cognitive decline. According to our findings, patients with a-MCI already present narrative deficits that are characterized by mild discursive difficulties that are less severe than those found in patients with AD.
authors.affiliation: D'Or Institute for Research and Education (IDOR) Rio de Janeiro, Brazil ; Institute of Biomedical Sciences - Morphological Sciences Program, Federal University of Rio de Janeiro Rio de Janeiro, Brazil ; Department of Speech and Hearing Pathology, Federal University of Rio de Janeiro Rio de Janeiro, Brazil.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Drummond
authors.affiliation: D'Or Institute for Research and Education (IDOR) Rio de Janeiro, Brazil ; Institute of Biomedical Sciences - Morphological Sciences Program, Federal University of Rio de Janeiro Rio de Janeiro, Brazil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Coutinho
authors.affiliation: Laboratory of Clinical and Experimental Neuropsychology, Department of Psychology, Pontificial Catholic University of Rio Grande do Sul Porto Alegre, Brazil.
authors.forename: Rochele Paz
authors.initials: RP
authors.lastname: Fonseca
authors.affiliation: D'Or Institute for Research and Education (IDOR) Rio de Janeiro, Brazil.
authors.forename: Naima
authors.initials: N
authors.lastname: Assunção
authors.affiliation: D'Or Institute for Research and Education (IDOR) Rio de Janeiro, Brazil.
authors.forename: Alina
authors.initials: A
authors.lastname: Teldeschi
authors.affiliation: D'Or Institute for Research and Education (IDOR) Rio de Janeiro, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: de Oliveira-Souza
authors.affiliation: D'Or Institute for Research and Education (IDOR) Rio de Janeiro, Brazil.
authors.forename: Jorge
authors.initials: J
authors.lastname: Moll
authors.affiliation: D'Or Institute for Research and Education (IDOR) Rio de Janeiro, Brazil ; Institute of Biomedical Sciences - Morphological Sciences Program, Federal University of Rio de Janeiro Rio de Janeiro, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Tovar-Moll
authors.affiliation: D'Or Institute for Research and Education (IDOR) Rio de Janeiro, Brazil ; Institute of Biomedical Sciences - Morphological Sciences Program, Federal University of Rio de Janeiro Rio de Janeiro, Brazil ; Department of Psychiatry and Forensic Medicine, Institute of Psychiatry, Federal University of Rio de Janeiro Rio de Janeiro, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Mattos
keywords: Alzheimer's disease; aging; language; mild cognitive impairment; narrative discourse