Cognitive-Communication Disorders of Dementia : Definition, Diagnosis, and Treatment,

Preface
Acknowledgments
1. Speech-Language Pathology, Mild Cognitive Impairment, and Dementia
	Introduction
	Communication Defined
	Rationale for Therapy
		Neuroplasticity
		Memory Systems and Their Selective Vulnerability to Disease
		Cognitive Reserve
	Summary of Important Points
	References
2. Cognition, Memory, and Communication
	Cognition and Memory
	The “Company of Cognition”
	Memory Defined
		Sensory Memory
		Working Memory
		Long-Term Memory
	Relation of Cognition and Memory to Communication
		Production of Linguistic Information
		Comprehension of Linguistic Information
	Summary of Important Points
	References
3. MCI: Mild Cognitive Impairment a.k.a. Mild Neurocognitive Disorder
	Introduction
	Prevalence of MCI
	Diagnostic Criteria for MCI
	Risk and Protective Factors
	Causes and Clinical Presentations of MCI
		Neuropsychological Deficits Associated with MCI
		Language Performance Deficits
	Conversion to Dementia
	Conclusion
	Summary of Important Points
	References
4. Alzheimer’s Dementia
	Alzheimer’s Disease (AD) Introduction
	Diagnostic Criteria for AD
	Risk Factors for AD
		Age
		Family History of AD
		Education
		History of Head Trauma
		Loneliness
		Gender
		Maternal Age
		Apolipoprotein E4 Allele
		Chronic Lack of Sleep
		Mild Cognitive Impairment
	Predictors of Disease Progression
	Protective Factors
	Effects of AD on Cognitive and Communicative Functions
		Early Stage
		Middle Stage
		Late Stage
	Summary of Important Points
	References
5. Dementia and Down Syndrome
	Introduction
	Common Features of People with DS
	Risk of Developing Alzheimer’s Disease
	Prevalence of Dementia in DS
	Diagnosing Dementia in Individuals with DS
		A Study of the Cognitive-Communication Profiles of DS Adults with and without Dementia
	Language and Communication Skills in Adults with DS
		Premorbid Language
		Language Change in Dementia
		Cognitive and Behavioral Measures Appropriate for Individuals with DS
	Summary of Important Points
	References
6. Vascular Dementia
	Introduction
	Neuropathology
	Diagnostic Criteria
		Diagnosing Vascular Cognitive Impairment
	Risk Factors for VaD
		Aging
		Hypertension
		Family History
		Ethnicity and Gender
		Diabetes Mellitus (Type 2)
		Lifestyle
	Vascular Pathology May Be a Trigger for Alzheimer’s Dementia
	Comparison of Effects of Cortical and Subcortical Pathologies on Cognition and Communicative Function
		Cortical Pathologies
		Subcortical Pathologies
		VCI Compared with AD
	Observations from Course-of-Disease Studies
	Summary: Effects of VCI on Cognitive and Communicative Functioning
	Conclusion
	Summary of Important Points
	References
7. Parkinson’s Disease and Dementia
	Parkinsonism and Parkinson’s Disease (PD)
	Incidence and Prevalence
	Symptoms of PD: Motor, Affective, Cognitive
	Neuropathology of PD
	Risk Factors
	Diagnostic Criteria for PD
	Cognition: Continuum from Normal to Dementia
		Diagnostic Criteria PD-MCI
		Diagnostic Criteria for Parkinson’s Disease with Dementia (PDD)
	Prevalence of PDD
	Nature of Cognitive Impairment
		Attention/Executive Function
		Memory
		Visuoperceptual/Visuospatial Function Deficits
	Communicative Function of PD Patients without and with Dementia
		A Study of Communicative Function in Demented PD Patients
		Individuals with PD and Dementia Compared with Individuals with AD on the ABCD
		Discourse Sample of PD Patient with Dementia
	Relation of PDD, Dementia with Lewy Bodies, and AD
	Summary of Important Points
	References
8. Dementia and Lewy Body Disease
	Lewy Body Disease
		Diagnostic Criteria and Symptomatology
	Consortium Consensus Criteria for Diagnosis of Dementia
	Caregiver Report of Early Symptoms
	LBD Risk Factors
	Effects of LBD on Cognition
		Executive Function and Attention
		Visuoperceptual and Spatial Functions
		Memory
	Language and Communicative Function
	A Case of Pure LBD
		Summary of Changes in Communicative Functioning
	Cognitive Profile of LBD Compared with AD
	Cognitive Profile of LBD Compared with PDD
	Summary of Important Points
	References
9. Dementia and Huntington’s Disease
	Overview and Genetics of Huntington’s Disease
	Neuropathology of HD
	Symptomatology
		Affect and Motor Symptoms
		Effects of HD on Speech
		Effects on Cognition
		Language
		Dysphagia Is Also a Concern
		Cognition and Communication
	Summary of Important Points
	References
10. Frontotemporal Dementia
	Introduction
	Diagnosis of Frontotemporal Dementia (FTD)
	Behavioral Presentation
		Behavioral Variant Frontotemporal Dementia (bvFTD)
	Language Presentation of FTD: Primary Progressive Aphasia
		Variants of PPA
	Differentiating the Behavioral Variant of FTD from the Primary Progressive Aphasia Variants
	Amyotrophic Lateral Sclerosis and FTD
		Effects of ALS-FTD on Language
	Summary of Important Points
	References
Clinical Management Guide: Assessments and Interventions for Cognitive-Communication Disorders of Dementia
	I. Assessment
		Introduction
		Assessment Procedures that Produce Valid and Reliable Data
			Prior to Testing
			Be Alert to Depression
			Be Alert to Drug Effects on Performance
		Know the Criteria for Diagnosing MCI and Dementia
			Severity of Cognitive Impairment Affects Test Selection
		Tests for Diagnosing MCI and Dementia
			Arizona Battery for Communication Disorders of Dementia (ABCD-1) aka Arizona Battery for Cognitive-Communicative Disorders (ABCD-2)
			ABCD-2 Subtests Most Sensitive to Mild AD
			Functional Linguistic Communication Inventory (FLCI) for Moderately and Severely Demented Individuals
			Many Other Tests Are Available for Diagnosing MCI and Dementia
			Broad-Based Assessments
			Short Screening Tests
			What About Aphasia Test Batteries?
			ADAS-COG: Widely Used in Drug Trials
		Differentiating the Types of Dementia
			Differentiating MCI and Mild Dementia from Delirium and Depression
			Differentiating Frontotemporal Dementias (FTD)
			Differentiating Primary Progressive Aphasia (PPA) and Mild AD
			An Assessment for Differentiating Semantic Dementia: The Cambridge Semantic Memory Test
			Differentiating AD from Vascular Dementia
			Differentiating Mild AD from Dementia with Lewy Bodies (DLB) and Parkinson’s Disease with Dementia (PDD)
		Summary of Important Points
	II. Cognitive Intervention
		A Treatment Model for Successful Clinical Intervention
		Cognitive Intervention for Mild Cognitive Impairment (MCI)
			Cognitive Reserve is “Neuroprotective”
			Cognitive Intervention Strengthens Cognitive Reserve
		Make Treatment Person Centered
			Suggestions for How To Make Therapy Person Centered
		Target Skills and Behaviors that Have the Potential to Improve
		Provide Individual and Group Therapy
		Provide Training of Strategies that Can Improve Function
		Use Repetition and Repeated Retrieval to Create and Strengthen New Learning
			Computer-Based Training
		Include Neuro-Proactive Education for Clients About Physical, Mental, and Social Health
		Provide Opportunities to Support Communicative Engagement and Socialization
		Ensure that Duration of Treatment Is Sufficient to Strengthen Skills and Create Learning
		Use Objective and Subjective Measures of Skill Strength and Learning
		Looking Forward
	III. Treatment: Direct Interventions for Individuals with Mild Cognitive Impairment and Dementia
		Introduction
		Clinical Strategies Supported by Neuroscience
			Strategy: Provide Stimulation Related to Client’s Needs
			Strategy: Personalize Tasks by Giving Clients Choices
			Strategy: Involve Multiple Modalities
			Strategy: Avoid Having Clients Multitask
			Strategy: Engage Clients through Self-Generation
			Strategy: Control Task Complexity
			Strategy: Work within Schemas to Increase Knowledge and Facilitate Retrieval
			Strategy: Use Stimuli that Evoke Positive Emotion
			Strategy: Use Reminiscence to Stimulate Recall, Engage Attention, and Elicit Emotion
			Strategy: Design Stimulation to Reduce Errors
			Strategy: Use Repetition to Produce Durable Memory
			Repeated Retrieval: A Potent Form of Repetition that Profoundly Affects Learning
			Spaced Retrieval: Retrieval of Information or Actions Over Increasingly Longer Intervals
			Strategy: Elaborated Encoding Produces Stronger Memory
			Strategy: Use Priming to Facilitate Memory and Increase Knowledge
			Strategy: Use Reward to Sustain Attention, Increase Frequency of Desired Response, and Elicit Positive Emotion
			Strategy: Provide Education About How Sleep, Diet, and Exercise Support Neuroplasticity and Cognition
		Summary: Science and Clinical Practice
	IV. Indirect Interventions for Individuals with Dementia
		Overview
		Linguistic Modifications
			Improving Language Comprehension
			Improving Language Production
		Environmental Modifications
		Facilitate Perception of Stimuli
			Vision and Aging
			Managing Problems with Vision to Facilitate Learning
			Color and Vision
			Hearing and Aging
		Facilitating Mood and Behavior
			Provide Something to Nurture
		Reduce Verbal Perseveration and Disruptions
		The Environment Should Promote Safety
		Technologies to Support Cognition and Communication
			Technologies to Support Memory
			Technologies to Support Engagement
			Technologies to Support Safety and Independence
		Support of Feeding
		Caregiver Education and Support
			Health Risks of Caregiving
			Gender and Caregiving
			Family Strife and Violence
			Factors that Influence Caregiver Burden and Stress
			Ethnic Minority Groups and Caregiver Burden
		Family Counseling
			Culture Matters in Counseling
			Emphasize What the Patient Can Do
		Caregiver Education and Training
	V. Reimbursement and Care Planning for Persons with Dementia
		Introduction
		Federal Law Mandates Care
		Medicare’s Comprehensive Assessment
			Minimum Data Set
			Care Area Assessment (CAA) Process
		Centers for Medicare and Medicaid Services
		Role of the SLP
			A Relevant Question
			Can SLPs Be Reimbursed for Cognitive Therapy?
		Medicare Review Threshold for Therapy Claims
		Using Test Performance to Develop Treatment Plans
		Planning Intervention
			A Case-Based Example of a Restorative Care Plan
			A Case-Based Example of a Maintenance Program
		Documentation Is Critical
			Evaluation and Plan of Care
			Progress Notes
			Treatment Encounter Notes
			Documentation Pitfalls
		Synopsis
References for Clinical Guide
Index