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      Naming ability in patients with mild to moderate Alzheimer's disease: what changes occur with the evolution of the disease?

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          Abstract

          OBJECTIVES:

          Naming deficit is a linguistic symptom that appears in the initial phase of Alzheimer's disease, but the types of naming errors and the ways in which this deficit changes over the course of the disease are unclear. We analyzed the performance of patients with Alzheimer's disease on naming tasks during the mild and moderate phases and verified how this linguistic skill deteriorates over the course of the disease.

          METHODS:

          A reduced version of the Boston Naming Test was administered to 30 patients with mild Alzheimer's disease, 30 patients with moderate Alzheimer's disease and 30 healthy controls. Errors were classified as verbal semantic paraphasia, verbal phonemic paraphasia, no response (pure anomia), circumlocution, unrelated verbal paraphasia, visual errors or intrusion errors.

          RESULTS:

          The patients with moderate Alzheimer's disease had significantly fewer correct answers than did both the control group and the group with mild Alzheimer's disease. With regard to the pattern of errors, verbal semantic paraphasia errors were the most frequent errors in all three groups. Additionally, as the disease severity increased, there was an increase in the number of no-response errors (pure anomia). The group with moderate Alzheimer's disease demonstrated a greater incidence of visual errors and unrelated verbal paraphasias compared with the other two groups and presented a more variable pattern of errors.

          CONCLUSIONS:

          Performance on nominative tasks worsened as the disease progressed in terms of both the quantity and the type of errors encountered. This result reflects impairment at different levels of linguistic processing.

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          Most cited references42

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          Semantic memory impairment in Alzheimer's disease: failure of access or degraded knowledge?

          A battery of neuropsychological tests designed to assess semantic knowledge about the same items both within and across different modalities was administered to a group of 22 patients with dementia of the Alzheimer type (DAT) and 26 matched controls. The DAT patients were impaired on tests of category fluency, picture naming, spoken word-picture matching, picture sorting and generation of verbal definitions. A relative preservation of superordinate knowledge on the sorting and definition tests, as well as a disproportionate reduction in the generation of exemplars from lower order categories was noted. Analysis of the errors made by each patient across the different tests, revealed a significant correspondence between the individual items. These findings offer compelling evidence that the semantic breakdown in DAT is caused by storage degradation.
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            Development of a functional measure for persons with Alzheimer's disease: the disability assessment for dementia.

            This article describes the development of an assessment of functional disability for use with proxy-respondents of community-dwelling persons who have Alzheimer's disease as well as a study testing its reliability. Panels composed of health care professionals and caregivers of persons with Alzheimer's disease were used to develop the Disability Assessment for Dementia (DAD). Fifty-nine caregivers participated in the refinement of the content and the testing of reliability. The DAD includes 40 items: 17 related to basic self-care and 23 to instrumental activities of daily living. It demonstrated a high degree of internal consistency (Cronbach's alpha = .96) and excellent interrater (N = 31, ICC = .95) and test-retest (N = 45, ICC = .96) reliability. In addition, it was found not to have gender bias. This instrument may help clinicians and caregivers of the population with Alzheimer's disease make decisions regarding the choice of suitable interventions.
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              Sugestões para o uso do mini-exame do estado mental no Brasil

              Arquivos de Neuro-Psiquiatria, 61(3B), 777-781 Modificações no mini-exame do estado mental (MEM) foram sugeridas anteriormente em nosso meio. Neste artigo relatamos sugestões para aplicação uniforme deste instrumento. MÉTODO: Avaliamos 433 indivíduos saudáveis sem queixas de memória através do MEM tendo seu desempenho sido avaliado quanto às variáveis demográficas. As modificações propostas foram detalhadamente descritas. RESULTADOS: A escolaridade foi o principal fator que influenciou o desempenho dos indivíduos. Na análise de variância entre os grupos de escolaridade obtivemos F(4,425)=100,45, p<0,0001. Os escores medianos por escolaridade foram: para analfabetos, 20; para idade de 1 a 4 anos, 25; de 5 a 8 anos, 26,5; de 9 a 11 anos, 28; para indivíduos com escolaridade superior a 11 anos, 29. CONCLUSÃO: Sugerimos o uso desta versão para uniformização dos resultados em nosso meio. Sua aplicabilidade revelou-se boa para ambientes hospitalar, ambulatorial e para estudo populacionais. Mini-metal state examination (MMSE) is a screening test to detect cognitive impairment. The objectives of the present study are to describe some adaptations for use of MMSE in Brazil and to propose rules for its uniform application. METHOD: We evaluated 433 healthy subjects using the MMSE and verified the possible influence of demographic variables on total scores. RESULTS: Educational level was the main factor that influenced performance, demonstrated by ANOVA: F(4,425) = 100.45, p<0.0001. The median values for educational groups were: 20 for illiterates; 25 for 1 to 4 yrs; 26.5 for 5 to 8 yrs; 28 for 9 to 11 yrs and 29 for higher levels. CONCLUSION: The MMSE is an excellent screening instrument and definitive rules are necessary for comparison purposes.
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                Author and article information

                Journal
                Clinics (Sao Paulo)
                Clinics (Sao Paulo)
                Clinics
                Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
                1807-5932
                1980-5322
                June 2015
                June 2015
                : 70
                : 6
                : 423-428
                Affiliations
                [I ]Universidade Federal de São Paulo, Department of Speech Therapy, São Paulo/, SP, Brazil
                [II ]Universidade Federal de São Paulo, Department of Neurology and Neurosurgery, Sector of Behavior Neurology, São Paulo/, SP, Brazil
                Author notes

                Silagi ML collected, analyzed and interpreted the data and drafted the submitted material. Bertolucci PH performed critical revision of the paper. Ortiz KZ supervised the collection, analysis and interpretation of the data and performed critical revision of the paper.

                Karin Zazo OrtizCorresponding author: E-mail: karin_zazo@ 123456hotmail.com
                Article
                cln_70p423
                10.6061/clinics/2015(06)07
                4462568
                26106961
                eda29725-9631-48b8-95f2-b8365a926e0e
                Copyright © 2015 Hospital das Clínicas da FMUSP

                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.

                History
                : 20 October 2014
                : 8 January 2015
                : 19 March 2015
                Categories
                Clinical Science

                Medicine
                alzheimer's disease,language,anomia
                Medicine
                alzheimer's disease, language, anomia

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