@article{448380ee06a241fdb6a0858c7ff16620,
title = "Predicting Cognitive Impairment in Cerebrovascular Disease Using Spoken Discourse Production",
abstract = "Purpose: Dementia due to cerebrovascular disease (CVD) is common. Detecting early cognitive decline in CVD is critical because addressing risk factors may slow or prevent dementia. This study used a multidomain discourse analysis approach to determine the spoken language signature of CVD-related cognitive impairment. Method: Spoken language and neuropsychological assessment data were collected prospectively from 157 participants with CVD as part of the Ontario Neurodegenerative Disease Research Initiative, a longitudinal, observational study of neurodegenerative disease. Participants were categorized as impaired (n = 92) or cognitively normal for age (n = 65) based on neuropsychology criteria. Spoken language samples were transcribed orthographically and annotated for 13 discourse features, across five domains. Discriminant function analyses were used to determine a minimum set of discourse variables, and their estimated weights, for maximizing diagnostic group separation. Results: The optimal discriminant function that included 10 of 13 discourse measures correctly classified 78.3% of original cases (69.4% cross-validated cases) with a sensitivity of 77.2% and specificity of 80.0%. Conclusion: Spoken discourse appears to be a sensitive measure for detecting cognitive impairment in CVD with measures of productivity, information content, and information efficiency heavily weighted in the final algorithm.",
keywords = "assessment, biomarker, cerebrovascular disease (CVD), cognition, dementia, multilevel discourse analysis, neurodegeneration, spoken discourse, spoken language, vascular cognitive impairment (VCI)",
author = "Angela Roberts and Katharine Aveni and Shalane Basque and Orange, {Joseph B.} and Paula McLaughlin and Joel Ramirez and Troyer, {Angela K.} and Stephanie Gutierrez and Angie Chen and Robert Bartha and Binns, {Malcolm A.} and Black, {Sandra E.} and Casaubon, {Leanne K.} and Dar Dowlatshahi and Ayman Hassan and Donna Kwan and Brian Levine and Jennifer Mandzia and Sahlas, {Demetrios J.} and Scott, {Christopher J.M.} and Stephen Strother and Sunderland, {Kelly M.} and Sean Symons and Richard Swartz",
note = "Funding Information: This research was conducted with the support of the Ontario Brain Institute, an independent nonprofit corporation, funded partially by the Ontario government. The opinions, results, and conclusions are those of the authors and no endorsement by the Ontario Brain Institute is intended or should be inferred. Matching funds were provided by participant hospital (recruitment sites) and research institute foundations, including the Baycrest Foundation, Bruyere Research Institute, Centre for Addiction and Mental Health Foundation, London Health Sciences Foundation, McMaster University Faculty of Health Sciences, Ottawa Brain and Mind Research Institute, Queen{\textquoteright}s University Faculty of Health Sciences, the Sunnybrook Foundation, the Thunder Bay Regional Health Sciences Centre, the University of Ottawa Faculty of Medicine, and the Windsor/Essex County ALS Association. The Temerty Family Foundation provided the major infrastructure matching funds. This work also was supported by research grants to the first author (A.R.) from the National Institutes of Deafness and Communication Disorders 1R21DC017255-01, the Canadian Institutes Publisher Copyright: {\textcopyright} 2021 Lippincott Williams and Wilkins. All rights reserved.",
year = "2021",
month = jan,
doi = "10.1097/TLD.0000000000000242",
language = "English (US)",
volume = "41",
pages = "73--98",
journal = "Topics in Language Disorders",
issn = "0271-8294",
publisher = "Lippincott Williams and Wilkins",
number = "1",
}