Preliminary assessment of connected speech and language as marker for cognitive change in late middle-aged Black/African American adults at risk for Alzheimer's disease.
Elizabeth Evans, Sheryl L Coley, Diane C Gooding and 4 others
PMID 36016839WHAT IT FOUND
Connected speech did not differ by sex, age, or APOE, and total words did not separate Black/African American and non-Hispanic White adults.
In a small follow-up, participants with subtle decline used more pronouns, less content per word, and faster speech.
Key findings
01Connected speech and language measures did not differ significantly by sex, age tertile, or APOE status in the Black/African American sample.
02In Black/African American participants with more than one speech sample, those classified as cognitively unimpaired-declining showed increasing pronoun use, decreasing content information unit density, and increasing words per minute over time.
03After adjusting for age, sex, and reading level, total words spoken in response to the Cookie Theft picture did not differ significantly between Black/African American and non-Hispanic White participants.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was small, and all participants came from one Milwaukee site. The participants were selected for family history of Alzheimer's disease, so they may not represent Black/African American adults in the United States. Cognitive status relied partly on standardized tests that may misrepresent the abilities of Black/African American adults, so some participants may have been labelled as declining. The study did not account for examiner race, dialect differences, or social determinants beyond reading level. The longitudinal analysis included only participants with more than one speech sample. The Cookie Theft picture may be culturally dated and may not elicit representative speech for all patients.
The easy way to misread this
Do not conclude that connected speech is a validated screening test for Alzheimer's disease in Black/African American adults. This was a preliminary analysis with a small sample from one site, and the comparison between stable and declining participants did not show a clear overall difference.