Paper
Thursday, 20 July 2006
This presentation is part of : Caring for the Chronically Ill
Communication and Cognitive Stages in Individuals with Alzheimer's Disease
Susan J. Barnes, PhD, RN, Kramer School of Nursing, Oklahoma City University, Oklahoma City, OK, USA
Learning Objective #1: The learner will be able to better understand the significance of cognitive stages and the constructing appropriate nursing interventions for those with dementia.
Learning Objective #2: The learner will be able to articulate the relationship between communication abilities and cognitive functioning in those with dementia.
This research examined the relationship between cognitive staging, communication, and functional abilities in individuals with Alzheimer’s disease (AD). Effective interpersonal communication is the foundation upon which relationships are built and depends upon communication competency in both propositional and affective components of language.  Affective prosody signals the emotional and attitudinal state of the speaker through the use of intonation patterns, stress, timing, rhythm, differential pausing and voice quality.  Previous research has shown that AD causes early changes in interpersonal communication that impact comprehension of affective but not of propositional language.  In this study, determination of cognitive levels was accomplished using the Cognition Sensitive Approach to Dementia which delineates four stages of cognition:  Sensorimotor I (advanced dementia), Sensorimotor II (severe dementia), Preoperational (midrange dementia) and Concrete thinking (early dementia). Thirty individuals diagnosed with AD were included in the study.  Subjects were individuals cared for at home by family members and who were seen at the CANDO Clinic at the Oklahoma City Veteran’s Affairs Medical Center.  Ten subjects were included in each of three cognitive stages (those with advanced dementia were not included).  Testing was done to determine the subjects cognitive state using the Barnes’s Cognition Test and the Folstein Mini Mental State Exam.  Communication ability was tested using a modified Affective Prosody Battery and the abbreviated Boston Naming Test.  Results demonstrated that AD subjects maintained their ability to communicate affective prosody late into the disease states but that they lost the ability to interpret affective prosody or emotive communication early on.  Case studies on the subjects with Pick’s Disease demonstrate an opposite phenomena, with subjects losing the ability to communicate emotive vocalizations but retaining the ability to comprehend affective prosody.  Cognitive stage, communication abilities, and functional abilities correlated well (r=0.7).  These findings have significant indications for interactions between AD patients and caregivers. 

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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)