| 1. |
- Thalén, Liv, et al.
(författare)
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Do adapted vignettes improve medical decision-making capacity forindividuals with Alzheimer's disease?
- 2017
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 58:6, s. 497-503
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Tidskriftsartikel (refereegranskat)abstract
- Medical decision-making capacity (MDC) is known to decline in individuals with Alzheimer's disease (AD). The vignette method uses hypothetical information as a prerequisite for measuring the capacity to make well-informed decisions to clinical trials. Our aim was to investigate if adapted vignettes can help individuals with mild AD to assimilate information, make decisions and express them in an understandable way, compared to corresponding decisions based on linguistically more demanding vignettes, as measured by the Swedish Linguistic Instrument for Medical Decision-making (LIMD). Two vignettes from LIMD were altered linguistically with the aim to facilitate understanding for individuals with AD. An experimental within-subject design was used to study the influence on MDC of readability (original/adapted vignettes) and content (two different clinical trials). We included 24 patients with mild AD in this prospective study, which read all four vignettes along with a few other tests. This allowed us to investigate the association between MDC and cognitive function. Adapted vignettes did not yield significant differences regarding MDC as compared with original vignettes using a two-way repeated measures analysis of variance. A difference was found between the two clinical trials where LIMD score was significantly higher for Kidney disease than hypertension vignettes. Our results indicate that adapted vignettes may not improve MDC for individuals with mild AD. MDC was affected by which clinical trial the vignettes regarded, which implies that other factors affecting MDC need to be investigated, like length of text and vocabulary used.
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| 2. |
- Aarne, Päivikki, et al.
(författare)
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Parent-rated socio-emotional development in children with language impairment in comparison with typically developed children
- 2014
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Ingår i: European Journal of Developmental Psychology. - : Informa UK Limited. - 1740-5629 .- 1740-5610. ; 11:3, s. 279-291
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Tidskriftsartikel (refereegranskat)abstract
- Children with language impairment (LI) and children with typical development (TD) were assessed by their respective parents using The MacArthur Communicative Development Inventories (Swedish version SECDI) and Greenspan Socio Emotional Growth Chart (GSEGC). The aim was to investigate socio-emotional and language development in children with LI and TD with respect to possible differential patterns and relations between the groups. The results highlight a clear association between language and socio-emotional development. Children with LI were rated similar to young language-matched children with TD, but significantly lower relative to age-matched TD children, particularly concerning symbolic stages of development: the use of linguistic symbols as well as related areas such as symbol play and symbolic mental ability. The results are discussed in light of presumable background factors and possible consequences for children or sub-groups of children with LI.
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| 3. |
- Lofkvist, Ulrika, et al.
(författare)
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Lexical and semantic ability in groups of children with cochlear implants, language impairment and autism spectrum disorder
- 2014
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 78:2, s. 253-263
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Lexical-semantic ability was investigated among children aged 6-9 years with cochlear implants (CI) and compared to clinical groups of children with language impairment (LI) and autism spectrum disorder (ASD) as well as to age-matched children with normal hearing (NH). In addition, the influence of age at implantation on lexical-semantic ability was investigated among children with Cl. Methods: 97 children divided into four groups participated, CI (n = 34), LI (n = 12), ASD (n = 12), and NH (n = 39). A battery of tests, including picture naming, receptive vocabulary and knowledge of semantic features, was used for assessment. A semantic response analysis of the erroneous responses on the picture-naming test was also performed. Results: The group of children with Cl exhibited a naming ability comparable to that of the age-matched children with NH, and they also possessed a relevant semantic knowledge of certain words that they were unable to name correctly. Children with CI had a significantly better understanding of words compared to the children with LI and ASD, but a worse understanding than those with NH. The significant differences between groups remained after controlling for age and non-verbal cognitive ability. Conclusions: The children with Cl demonstrated lexical-semantic abilities comparable to age-matched children with NH, while children with LI and ASD had a more atypical lexical-semantic profile and poorer sizes of expressive and receptive vocabularies. Dissimilar causes of neurodevelopmental processes seemingly affected lexical-semantic abilities in different ways in the clinical groups.
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| 4. |
- Stormoen, Sara, et al.
(författare)
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Cognitive predictors of medical decision-making capacity in mild cognitive impairment and Alzheimer's disease
- 2014
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 29:12, s. 1304-1311
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Impaired capacity to make decisions in everyday life and situations of medical treatment is an inevitable consequence of the cognitive decline in Alzheimer's disease (AD). The objective of this study was to identify the most powerful cognitive component(s) that best predicted medical decision-making capacity (MDMC) in patients with AD and mild cognitive impairment.Method: Three groups of subjects participated in the study: patients with AD (n = 20), mild cognitive impairment (n = 21), and healthy control subjects (n = 33). MDMC was assessed by the linguistic instrument for medical decision-making (LIMD) and related to demographics and 27 cognitive test measures.Results: The cognitive tests were found to aggregate into four components using a principle component analysis. The four components, which correspond to verbal knowledge, episodic memory, cognitive speed, and working memory, accounted for 73% of the variance in LIMD according to a stepwise regression analysis. Verbal knowledge was the most powerful predictor of LIMD (beta = 0.66) followed by episodic memory (beta = 0.43), cognitive speed (beta = 0.32), and working memory (beta = 0.23). The best single test as shown by the highest correlation with LIMD was Reading speed (R = 0.77).Conclusion: Multiple factors are involved in MDMC in subjects with cognitive impairment. The component of verbal knowledge was the best predictor of MDMC and Reading speed was the most important single cognitive test measurement, which assessed both rapid Reading and understanding of text.
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| 5. |
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| 6. |
- Löfkvist, Ulrika, et al.
(författare)
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Predictions of Grammatical Sentence Understanding in Children with CI(s)
- 2013
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Konferensbidrag (refereegranskat)abstract
- The aim of the study was to examine grammatical sentence understanding (TROG-2) in 6-9 year old children with cochlear implants (CI), and compare their performance to age-matched children with normal hearing (NH). Receptive vocabulary, picture naming, semantic feature knowledge, word fluency, non-word discrimination (phonology), word learning and non-verbal cognitive ability were examined as possible predicting factors for TROG-2. Age at implantation, hearing age, and speech recognition were also investigated in children with CI. For TROG-2, 6-7 year old children with CI performed similar to controls, and 50 % of them reached one year or more above the age-equivalent norm level. Speech recognition and age at 2nd implantation were associated with better results on TROG-2. Non-verbal cognitive ability and picture naming predicted grammatical sentence understanding in children with CI. Earlier age at implantation and a shorter period between 1st and 2nd implantation might also have a positive influence on TROG-2 for younger children with CI. The predicting factors of grammatical sentence understanding in the group of children with NH were related to non-word discrimination and breadth and depth in receptive vocabulary.
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| 7. |
- Tallberg, Ing-Mari, et al.
(författare)
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Investigating medical decision-making capacity in patients with cognitive impairment using a protocol based on linguistic features
- 2013
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 54:5, s. 386-392
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Tidskriftsartikel (refereegranskat)abstract
- A critical question is whether cognitively impaired patients have the competence for autonomous decisions regarding participation in clinical trials. The present study aimed to investigate medical decision-making capacity by use of a Swedish linguistic instrument for medical decision-making (LIMD) in hypothetical clinical trials in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Three comparable groups (age, education) participated in the study: AD (n=20; MMSE: 24.1 +/- 3.3) and MCI (n=22; MMSE: 26.7 +/- 2.4) patients and healthy controls (n=37; MMSE: 29.1 +/- 1.0). Medical decision-making capacity was operationalized as answers to questions regarding participation in three hypothetical clinical trials. Answers were scored regarding comprehension, evaluation and intelligibility of decisions, and a total LIMD score was used as the measure of medical decision-making ability. Groups differed significantly in LIMD with AD patients performing worst and MCI poorer than the control group. A strong association was found between all LIMD scores and diagnosis which supported the assertion that LIMD as it is designed is a one-dimensional instrument of medical decision-making capacity (MDMC). The results indicate that a fundamental communicative ability has an impact on the competence for autonomous decisions in cognitive impairment.
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