A feasibility study of speech recording using a contact microphone in patients with possible or probable Alzheimer's disease to detect and quantify repetitions in a natural setting (original) (raw)
Related papers
Verbal repetition in patients with Alzheimer's disease who receive donepezil
International Journal of Geriatric Psychiatry, 2006
Background Cunent outcdnc measur'es t_or Alzheirner's disease (AD) drugs have been criticized as insulficiently palieitcentred. One cornmonly unneasuled goal ot' patients and caregivers is verbal repetition. Objectives We examined how of{en reducing rcpetitioi (of questions, statements or sto es) was set as treatment goal. whcthcr and rvhcn it rcsponded, and how change in lepetition correlated with change in othcr domains. Methods This is a secondary analysis of Ihe open-labcl Atlantic Canada Alzheimer's l)isease lnvestigation of Expectatiolls study ofdonepezil ior mild moderate AD in 100 conmlrnity-dwelling people. Goal Attainmcnt Scaling, an individualizcd account of thc goals of trcaln]ent. was the ptinary outcome measurc-Results Reducing repetition was a treatment goal in ,16%, who were not systematically different fiom others-Of I 8 palients in whom repelition improvcd for 9 nronths, 83'/c (15) showed a response al 3 n]onths. Eerly (3-month) response conciated bcst with thc overall level of goal altainnent (r:0.7,1) and changcs in lcisure aclivilies (r:0.69) and social interactions (r":0.68) compared with changes in cognition (/:0-.14) or behaviour (r:0.11). Correlations with the ADAS-Cog and MMSE change scores renraincd only modest (at l2 morlhs 0.25 and 0.19, rcspcctivcly). Correlations with the CIBIC-Plus werc highcr (0.47 at 3 months and 0.43 at 12 months). Conclusion Diminution of repetition is common, and appeaN to rnifk response to cholinesterase inhibition in somc petients. Responde6 generally also show improvcd cognition and function, pelhaps as an aspecl of improvcd cxccutive funclion.
Verbal Repetition in People With Mild-to-Moderate Alzheimer Disease
Alzheimer Disease & Associated Disorders, 2009
Background: Verbal repetition is a common symptom and target for treatment in Alzheimer disease (AD), yet little is known of its manifestations in the daily lives of patients. Here we characterized the nature of verbal repetition and its correlates. Methods: This is a qualitative, secondary analysis of video-recorded interviews with 130 community dwelling mild-to-moderate patients with Alzheimer disease and their carers, enrolled in the Video Imaging Synthesis of Treating Alzheimer's disease clinical trial. Narratives about verbal repetition were characterized using a qualitative framework analysis approach. Results: Verbal repetition was reported in 100/130 patients, 57 of whom identified diminished repetition as a desired outcome of treatment. Most patients (76/100) repeated questions (usually about upcoming events); fewer (32/100) patients repeated statements/stories (usually about recent events). Most repetitions occurred within a 2-hour interval (65/100), and for 52/100 patients the problem was consistent (eg, occurred everyday). There were no differences for interval between repetitions by dementia severity, but most patients who repeated statements/stories were mild (27/32). Conclusions: Verbal repetition is a common problem, and seems especially to be provoked by upcoming events. More frequent repetitions (shorter intervals between each repetition) were associated with goal setting around this problem.
Archives of Gerontology and Geriatrics, 2004
The improvement in cognitive performances due to cholinesterase inhibitors (ChEls) is not homogeneous among Alzheimer's disease (AD) subjects. Aim of this study is to evaluate whether a specific pattern of change in mini mental state examination (MMSE) could be observed in AD subjects after 9-month treatment with ChEls. From September 2000 to September 2002, 99 subjects enrolled in the CRONOS project. They have never been previously treated with ChEls. All of them completed both the 3-and the 9-month follow-up. The multidimensional assessment included MMSE, activity of daily living (ADL), instrumental activity of daily living (IADL), somatic health status, according to design of the CRONOS project. The MMSE was analyzed both as a total score and disaggregated in 11 items. All subjects were divided in 2 groups according to the degree of change in MMSE total score from baseline to the 9th month. Subjects with a change ≤ -1 were defined as non-responders (NR), whereas those with a change >0 as responders (R). At start, no statistically significant differences were found between the 2 groups. MMSE score was significantly higher in the R group both at 3 (p < 0.0001) and 9 months (p < 0.0001), while functional status (ADL and IADL) was significantly lower in NR group at 9 months (p = 0.025; p = 0.018, respectively). In MMSE qualitative analysis of 3-month, NR significantly worsened in temporal (p ≤ 0.05) and spatial orientation (p ≤ 0.001), and in delayed recall items (p ≤ 0.0005) in comparison to their counterpart. At 9-month the differences between the 2 groups were observed also for registration (p < 0.001), attention (p ≤ 0.0005), obeying oral commands (p < 0.0005), reading and obeying commands (p ≤ 0.0005), writing a sentence (p ≤ 0.0005) and copying a design (p ≤ 0.05). In a multivariate regression model, after adjustment for demographic (age, education, gender) and clinical factors (duration of disease), only the change at 3 months in 5 MMSE items (temporal and spatial orientation, delayed recall, obeying an oral command and reading and obeying command) is associated with global cognitive change observed at 9 months. Data suggest that the change in cognitive performances of AD subjects treated with ChEls involves few and specific MMSE items at 3-month, while it tend to generalize to almost all the others at 9-month treatment.
Exploration of verbal repetition in people with dementia using an online symptom-tracking tool
International psychogeriatrics, 2017
Online tools can be used by people with dementia and their caregivers to self-identify and track troubling symptoms, such as verbal repetition. We aimed to explore verbal repetition behaviors in people with dementia. Participants were recruited via an online resource for people with dementia and their caregivers. Respondents were instructed to complete information about symptoms that are most important to them for tracking over time. In this cross-sectional study, we analyzed data pertaining to individuals with dementia who had at least three symptoms selected for tracking. Of the 3,573 participants who began a user profile, 1,707 fulfilled criteria for analysis. Verbal repetition was identified as a treatment target in 807 respondents (47.3%). Verbal repetition was more frequent in individuals with mild dementia compared to those with moderate and severe dementia (57.2% vs. 36.0% and 39.9%, p < 0.01) and in those with Alzheimer's disease versus other dementias (65.2% vs. 29....
Effect of galantamine on verbal repetition in AD: A secondary analysis of the VISTA trial
Neurology, 2007
Abstract-Objectives: To understand how commonly diminution of verbal repetition was a goal of treatment in patients with Alzheimer disease (AD), how commonly that goal was achieved, whether goal attainment might be attributable to galantamine treatment, and whether change in verbal repetition is a marker of the overall treatment response. Methods: This is a secondary analysis of the Video-Imaging Synthesis of Treating Alzheimer's Disease study, a 4-month, doubleblind, randomized, placebo-controlled trial of galantamine in 130 community-dwelling patients with mild to moderate AD. The primary outcome was Goal Attainment Scaling, in which individualized problems identified by patients/caregivers and treating physicians were assessed bimonthly. Results: Reduction of verbal repetition was set as a treatment goal in 44% (n ϭ 57) of randomized patients. More patients/caregivers (32%) set repetition goals than did physicians (18%). After 4 months, more galantamine-treated patients showed diminution of verbal repetition (58%) than did placebo-treated patients (24%; p Ͻ 0.01). Reduction of verbal repetition correlated with improvement in clinical measures, but not in standardized ones. Conclusions: Reduction of verbal repetition is a common goal of Alzheimer disease treatment. After 4 months, patients treated with galantamine were more likely to experience a reduction of verbal repetition than those treated with placebo. Diminution of verbal repetition was associated with other improvements, suggesting it might be a clinical marker of a positive treatment response.
Aging Clinical and Experimental Research, 2024
Current drugs for Alzheimer's Disease (AD), such as cholinesterase inhibitors (ChEIs), exert only symptomatic activity. Different psychometric tools are needed to assess cognitive and non-cognitive dimensions during pharmacological treatment. In this pilot study, we monitored 33 mild-AD patients treated with ChEIs. Specifically, we evaluated the effects of 6 months (Group 1 = 17 patients) and 9 months (Group 2 = 16 patients) of ChEIs administration on cognition with the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Frontal Assessment Battery (FAB), while depressive symptoms were measured with the Hamilton Depression Rating Scale (HDRS). After 6 months (Group 1), a significant decrease in MoCA performance was detected. After 9 months (Group 2), a significant decrease in MMSE, MoCA, and FAB performance was observed. ChEIs did not modify depressive symptoms. Overall, our data suggest MoCA is a potentially useful tool for evaluating the effectiveness of ChEIs.
Verbal Repetition in Primary Progressive Aphasia and Alzheimer's Disease
2014
Journal of Alzheimer's Disease xx (20xx) x-xx Abstract. We aimed to explore the nature of verbal repetition deficits and infer the cognitive systems involved in primary progressive aphasia (PPA) and Alzheimer's disease (AD). A total of 63 patients (13 semantic variant (sv-PPA), 17 nonfluent/agrammatic variant (nfv-PPA), 10 logopenic variant (lv-PPA), 23 AD) and 13 matched healthy controls completed a battery of tests that included naming, word comprehension, digit span, repetition of multisyllabic single words, monosyllabic word span presented under similar and dissimilar phonological conditions, and sentence repetition. All patient groups displayed some level of impairment, however, specific patterns emerged in each variant. Participants with sv-PPA were the least impaired, showing marginal difficulties exclusively for sentence repetition, whereas those with lv-PPA had the worst overall performance. Cases with nfv-PPA showed compromised repetition of multisyllabic and phonologically similar words. The deficit in cases with AD was confined to span tasks. These distinctive patterns of language impairments can assist in the differential diagnosis of PPA variants and point toward the vulnerability of specific cognitive systems in each syndrome. 10 11 12 13 14 15 16 17 18 19 edge is preserved, but motor aspects of speech and/or 33 grammaticality are compromised and the underlying 34 pathology is more likely to be FTLD-tau [4-6]. The 35 third, logopenic variant (lv-PPA), presents with word-36 finding difficulties, anomia, and striking impairment 37 in sentence repetition, but sparing of semantic knowl-38 edge and motor aspects of speech, and its pathology is 39 associated with Alzheimer's disease (AD) [1, 7, 8].
Persistence with Cholinesterase Inhibitor Therapy for Dementia
Drugs & Aging, 2009
Objective: To determine if choice of drug and ease of administration affect persistence of therapy with cholinesterase inhibitors (ChEIs) for treatment of dementia. Methods: An observational administrative health database study was conducted in 5622 patients aged ‡65 years who received a new prescription for donepezil (DON), rivastigmine (RIV) or galantamine (GAL) from February to May 2006. Patients were followed for 1 year from initiation of therapy to determine percentage persistence and days of therapy. Once-daily galantamine extended release (GAL-ER) was compared with twice-daily galantamine immediate release (GAL-IR) to determine if ease of administration affected persistence. Previous treatment with ChEIs was also documented. Results: One-year persistence rates were significantly different among the ChEIs: GAL-ER 54% (95% CI 51, 57), DON 46% (95% CI 43, 49) and RIV 40% (95% CI 37, 43). Average days of therapy were greater for GAL-ER (293) than for RIV (272), but there were no differences between DON (287) and GAL-ER or DON and RIV. One-year persistence was significantly greater for GAL-ER 54% (95% CI 48, 59) than for GAL-IR 44% (95% CI 39, 50), although there was no significant difference in days of therapy (293 vs 286, respectively). More patients currently treated with RIV (40.5%) or GAL-ER (32.3%) had received previous treatment with a different ChEI than with DON (21.9%). Conclusion: Among possible factors affecting persistence of ChEI therapy for dementia, choice of drug, ease of administration and previous treatment appear to be important.