Comparison between oral and written spelling in Alzheimer's disease

Written and oral spelling were compared in 33 patients with Alzheimer's disease (AD) and 25 control subjects. AD patients had poorer spelling results which were influenced by orthographic difficulty and word frequency, but not by grammatical word class. Lexical spelling was also more deteriorated than phonological spelling. Moreover, oral spelling was more impaired than written spelling in AD patients, whereas no difference was present between oral and written spelling of controls. Analysis of spelling errors showed that, for controls, errors were predominantly phonologically accurate in both spelling tasks. Significantly, AD patients produced more phonologically accurate than inaccurate errors in written spelling, whereas these errors did not differ in oral spelling. In contrast to controls who produced more constant than variable responses in oral and written spelling, AD patients made more variable responses (words correctly spelled in one task but incorrectly in the other) and they showed many instances of variable errors (different misspellings from one spelling task to the other). Two stepwise regression procedures showed that written misspellings were specifically correlated with language impairment, whereas oral spelling errors were correlated with attentional and language disorders. These results suggest that AD increases the attentional demands of oral spelling process as compared to written spelling. This dissociation argues, either for a unique Graphemic Buffer in which oral spelling requires more attentional resources than written spelling or for the hypothesis of separate buffers for oral and written spelling.     

Verbal and nonverbal fluency in patients with probable Alzheimer's disease.

Verbal fluency (semantic category naming and letter fluency) and nonverbal fluency (semantic category drawing and design fluency) were measured in mildly and moderately demented patients with probable dementia of the Alzheimer type (pDAT), and related to age at onset, disease duration, and disease severity. Group and individual patient analyses revealed impairments within verbal and nonverbal modalities that were most severe on semantic category fluency tasks. Detailed assessments of errors emphasized the role of compromised semantic memory in pDAT patients' impaired fluency, regardless of the modality of response. Fluency performance was related to dementia severity but not to age of onset or disease duration. It is concluded that deficits on measures of fluency in pDAT are due in large part to semantic memory impairments and that fluency may be useful for following disease progression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early first-language reading and spelling skills predict later second-language reading and spelling skills.

This prospective study examined early first-language (L1) predictors of later second-language (L2) reading (word decoding, comprehension) and spelling skills by conducting a series of multiple regressions. Measures of L1 word decoding, spelling, reading comprehension, phonological awareness, receptive vocabulary, and listening comprehension administered in the 1st through 5th grades were used as predictors of L2 reading (word decoding, comprehension) and spelling skills in high school. The best predictor of L2 decoding skill was a measure of L1 decoding, and the best predictors of L2 spelling were L1 spelling and L1 phonological awareness. The best predictor of L2 reading comprehension was a measure of L1 reading comprehension. When L2 word decoding skill replaced L1 word decoding as a predictor variable for L2 reading comprehension, results showed that L2 word decoding was an important predictor of L2 reading comprehension. The findings suggest that even several years after students learn to read and spell their L1, word decoding, spelling, and reading comprehension skills transfer from L1 to L2. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From reading to spelling and spelling to reading: Transfer goes both ways.

This study compares the effects of practice spelling and reading specific words on the orthographic representations in memory involved in reading both practiced words and new, unfamiliar words. Typically developing readers in Grade 2 (mean age = 7 years, 7 months) participated in a training study examining whether transfer can occur between reading and spelling following a series of reading and spelling practice sessions. Practice consisted of either repeated reading or repeated spelling of words with shared orthographic rime patterns. A series of mixed analyses of variance was used to examine generalization within skill and transfer across skill. Following practice, word-specific transfer across skill was found. Specifically, children were better able to spell words they had practiced reading and to read words they had practiced spelling. In addition, generalization to new words with practiced rime units was found both within a skill and across skills. However, transfer from spelling to reading was greater than transfer from reading to spelling. Results indicate that the orthographic representations established through practice can be used for both reading and spelling. Subsequently, reading and spelling curricula should be coordinated to benefit children maximally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reading lexically without semantics: evidence from patients with probable Alzheimer's disease

Recent modifications of the lexical model of oral reading make the prediction that under conditions where sublexical reading processes alone cannot achieve the target pronunciation (i.e., when words have exceptional spellings or when sublexical processes are impaired), patients with severe semantic impairment should have more difficulty reading aloud semantically impaired words than semantically retained words. In a battery of lexical-semantic and reading tasks, two neurologically normal control subjects and two subjects with probable Alzheimer's disease (AD) and only moderate semantic impairment read aloud all words accurately. One AD subject with severe semantic impairment was impaired in word reading but demonstrated no difference in reading words with regular and exceptional spellings. Another AD subject with severe semantic impairment read aloud without error virtually all regular and exception words. Neither severely impaired AD subject demonstrated any relationship between oral reading accuracy and semantic knowledge of exception words. These findings support a model of word reading incorporating lexical, nonsemantic processes by which lexical orthographic input representations directly activate lexical phonological output representations without the necessity of semantic mediation.     

Risk of left ventricular dysfunction in patients with probable Alzheimer's disease with APOE*4 allele

OBJECTIVE: To examine the association between the APOE genotype and cardiovascular disease in Alzheimer's disease (AD) patients. DESIGN: Case register study of 100 consecutive referrals to a Memory Clinic where type of dementia and cardiovascular comorbidity were diagnosed and APOE genotype was determined. SETTING: The Memory Clinic, University Hospital Rotterdam Dijkzigt. PARTICIPANTS: One hundred Memory Clinic patients, 59 to 91 years of age, who attended the Memory Clinic in the period between January 1994 and March 1996. MEASUREMENTS: Relative risk of cardiovascular morbidity in probable AD, based on clinical and ECG findings. RESULTS: The diagnosis of probable AD was more frequent in APOE*4 allele-carrying AD patients. When comparing homozygotes for APOE*4 with homozygotes for APOE*3, a nine-fold increase in prevalence of cardiac ischemia on ECG was found in the former. When grouping parameters of left ventricular dysfunction, the prevalence was 7.2 (95% confidence interval 1.2-42.6) times greater in probable Alzheimer patients with APOE4/4. CONCLUSIONS: In patients with probable AD, APOE*4 is associated with cardiac disease indicative of left ventricular dysfunction.     

Early probable Alzheimer's disease and awareness context theory

The purpose of this research was to explore the explanatory value of Awareness Context Theory for social interactional issues in early probable Alzheimer's Disease (AD). Glaser and Strauss's Awareness Context Theory [Glaser and Strauss (1965) Awareness of Dying, Aldine, New York] served as the framework for the analysis of interview data from 14 early probable AD clients and 14 family caregivers, a written autobiographical account, a fictionalized account, observations of a family care-giver focus group, and excerpts that focused on early AD from field notes recorded during two years of participant observation at a specialized AD daycare center and a family caregiver support group. Initial open-ended study questions focused on the experience of early AD from the diverse perspectives represented in the data. After preliminary analysis of data suggesting emergent fit with Awareness Context Theory, questions were refocused to address awareness contexts. Data were coded and analyzed for fit with the theory. Awareness Context Theory provided a useful heuristic for thinking about the nuances and complexities of social interaction in early AD. Attention to awareness contexts should enable health care providers to suggest interventions to improve caregiver-client interactions.     

Contribution of spelling instruction to the spelling, writing, and reading of poor spellers.

The contribution of supplemental spelling instruction to spelling, writing, and reading was examined. Second-grade children experiencing difficulties learning to spell participated in 48 20-min sessions designed to improve their spelling skills. In comparison with peers in a contact control condition receiving mathematics instruction, students in the spelling condition made greater improvements on norm-referenced spelling measures, a writing-fluency test, and a reading word-attack measure following instruction. Six months later, students in the spelling treatment maintained their advantage in spelling but not on the writing-fluency and reading word-attack measures. However, spelling instruction had a positive effect at maintenance on the reading word-recognition skills of children who scored lowest on this measure at pretest. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of reading and spelling abilities in first- and second-language learners.

This study examined the basic literacy skills and related processes of 1st- through 4th-grade children speaking English as a 1st language (L1) and English as a 2nd language (ESL). The performances of the L1 and ESL children on phonological awareness, word and pseudoword reading, and word and pseudoword spelling tasks were highly similar. The ESL children were at an advantage with regard to lexical access but performed more poorly on verbal working memory and syntactic awareness tasks. The results suggest that the main processes underlying L1 children's basic reading ability in Grades 1 and 2, namely phonological awareness and lexical access, are of equal importance for ESL children. Phonological awareness remained the strongest predictor of word reading ability for L1 and ESL children in Grades 3 and 4. However, the processes involved in L1 and ESL word reading and spelling appeared to vary at other points. Verbal working memory and syntactic awareness were found to be of importance for the word reading and spelling abilities of L1 children but not for ESL children. Lexical access was found to be of more importance for ESL children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inference of beliefs and emotions in patients with Alzheimer's disease.

The present study compared 20 patients with mild to moderate Alzheimer's disease with 20 older controls (ages 69-94 years) on their ability to make inferences about emotions and beliefs in others. Six tasks tested their ability to make 1st-order and 2nd-order inferences as well as to offer explanations and moral evaluations of human action by appeal to emotions and beliefs. Results showed that the ability to infer emotions and beliefs in 1st-order tasks remains largely intact in patients with mild to moderate Alzheimer's. Patients were able to use mental states in the prediction, explanation, and moral evaluation of behavior. Impairment on 2nd-order tasks involving inference of mental states was equivalent to impairment on control tasks, suggesting that patients' difficulty is secondary to their cognitive impairments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Semantic space in Alzheimer's disease patients.

A within-category sorting task was used to investigate conceptual relations from 2 semantic categories (animals and occupations) in mild and moderately impaired Alzheimer's disease (AD) patients. A multidimensional scaling analysis was applied to the data. The resulting 2-dimensional solutions indicated that mildly affected AD patients sorted within-category terms in a manner largely consistent with controls' performance but were less consistent in their application of domain knowledge. Moderate AD patients' solutions were less similar to controls' solutions. Mild AD patients' explanations of their sorting schemes were similar to those given by controls but less focused. Together these findings suggest that attribute knowledge may remain largely accessible in mild AD; however a deficiency in recruiting reflective processes in the service of task-related goals may limit the selective application of this information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mere exposure effect in patients with Alzheimer's disease.

The mere exposure effect was examined in patients with mild to moderate Alzheimer's disease (AD). Twenty patients and 20 elderly controls judged the physical characteristics of faces. Implicit memory was tested later by presenting pairs of faces (old and new) and asking participants which faces they liked better. Patients and controls exhibited above chance preference for previously exposed faces. Experiment 2 evaluated whether the preserved implicit memory of patients was mediated by explicit memory. Patients and controls again judged faces but then later chose which faces they had seen before. Patients exhibited impaired recognition memory compared to controls. These findings suggest that a mere exposure affect for unfamiliar faces is present in mild to moderate AD. The results are discussed in terms of perceptual and conceptual priming and relatively spared occipital lobe functioning in early AD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intact text-specific implicit memory in patients with Alzheimer's disease.

The ability of patients with Alzheimer's disease (AD) to acquire and retain text-specific knowledge was investigated in a rereading study. Ten AD patients (aged 59–84 yrs) and 10 normal control Ss read 2 passages 3 times, each as quickly as possible, and answered recognition memory questions after the 3rd reading of each passage. The AD patients had poor explicit memory as evidenced by impaired recognition memory for the passages. In contrast, normal decreases in the times required for successive readings of each passage for AD patients indicated intact implicit memory for the passages. The absence of facilitation across passages indicated that the rereading effect was text specific, suggesting that AD patients may retain the ability to form certain kinds of implicit new associations. Alternative accounts of the mechanism underlying text-specific priming, and of the nature of intact and impaired implicit memory in AD, are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric correlates of MR deep white matter lesions in probable Alzheimer's disease

The authors examined the relationship between psychiatric symptoms and the presence of of MR deep white matter lesions (DWMLs) in 28 probable Alzheimer's disease (AD) patients with mild to moderate dementia. The difference in frequency of psychiatric symptoms between patients with and without DWMLs was not statistically significant. However, MR global scores of severity correlated with the presence of ideational disturbances (such as low self-esteem and suicidal ideation). Analysis of specific cerebral regions indicated that the highest correlation occurred in the frontal white matter. Thus, DWMLs are correlated with specific symptoms of depression in AD. Whether DWMLs are etiologically related to these symptoms remains to be determined.     

Comparison of age-extended norms for the Wechsler Adult Intelligence Scale—Revised in patients with Alzheimer's disease.

Recent studies by R. J. Ivnik et al (see record 1993-04116-001), J. F. Malec et al (see record 1993-04120-001), and J. J. Ryan et al (see record 1991-08835-001) have provided age-extended norms for the Wechsler Adult Intelligence Scale—Revised (WAIS—R). The current study compared IQ scores based on these newer age-extended norms in 216 elderly Alzheimer's disease (AD) patients. Results showed that when the norms from Ryan et al were used, IQ scores were consistently the same as or higher than when WAIS—R manual norms were used. When the norms provided by Ivnik et al and Malec et al were used, IQ scores tended to be lower than WAIS—R manual norms for younger patients with more intellectual impairment. Results illustrate the importance of reporting the normative sample upon which IQ test scores for older adults are based and provide guidelines for selecting which set of age-extended WAIS—R norms to use with cognitively impaired elderly Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of semantic context by patients with Alzheimer's disease.

Used semantic-priming procedures to examine limitations in the use of semantic context by 18 patients (mean age 68.9 yrs) with Alzheimer's disease (AD) and to determine whether any such contextual effects were mediated solely through automatic processes or whether attentional processes were also involved. Three tasks were applied to examine the effect of semantic context on the performance of 18 normal elderly Ss (mean age 67.2 yrs), 18 normal young Ss (mean age 24.1 yrs), and the AD Ss. When normal and AD Ss were asked to decide whether a given item was a member of a certain category, their response times were equally affected by the item's dominance in the category. The time that AD Ss took to recognize a word was actually affected more by the semantic context provided by a priming sentence than was that of normal Ss. When asked to generate the final word of an incomplete sentence, AD Ss performed very poorly unless potential responses were highly constrained by sentence context. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensionality and clustering in the semantic network of patients with Alzheimer's disease.

Investigated the organization of semantic memory in patients with Alzheimer's disease (AD) with a triadic comparison task. A multidimensional scaling statistic was used to analyze proximity data and to generate 3-dimensional cognitive maps that were then compared by a discriminant function analysis. Results suggest that the structure of semantic memory in AD Ss differs from that of elderly normal controls (NCs) in 2 ways. First, AD Ss are less consistent in using the attributes (predation, domesticity, and size) of concepts. Second, AD Ss focus primarily on concrete perceptual information (size), whereas NCs stress abstract conceptual knowledge (domesticity). Results are consistent with the notion that AD is characterized by a breakdown in the structure of semantic knowledge. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Word identification in reading proceeds from spelling to sound to meaning.

Van Orden (1987) reported that false positive errors in a categorization task are elevated for homophonic foils (e.g., {hare} for {a part of the human body}). Two new experiments replicate this finding and extend it to nonword homophone foils (e.g., {sute} for {an article of clothing}). False positive errors to nonword homophone foils substantially exceed false positive errors to nonhomophonic nonword spelling controls, showing that the phonological characteristics of the nonword foils are critical. Because nonwords are not represented in the lexicon, this new result implicates computed phonological codes as a source of the categorization errors. Additionally, in each of two experiments, matched word and nonword homophones produced virtually identical error rates. If stimulus nonword homophones are viewed as extremely unfamiliar words, compared with the relatively familiar stimulus word homophones, then our failure to observe an effect of stimulus familiarity strengthens the case that phonological coding plays a role in the identification of all printed words. The fact that the results are obtained in a categorization task that requires reading for meaning (rather than a lexical decision task) makes it difficult to avoid the conclusion that phonological mediation plays a role in normal reading of text for meaning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning the spelling of strange words in Dutch benefits from regularized reading.

In 2 experiments, the authors tested the effect of 2 types of reading on the spelling memory of strange or sound-spelling inconsistent words in Dutch students with and without learning disabilities: standard reading and regularized reading. Standard reading refers to reading the word the way it has to be read. Regularized reading refers to reading a sound-spelling inconsistent word as if it is sound-spelling consistent. In Experiment 1, both groups showed a short-term effect. Shortly after training, all students who participated in the regularized-reading condition showed better spelling performance than students who took part in a standard-reading condition. One week after training, spelling knowledge of students without learning disabilities appeared to be more stable than that of students with learning disabilities. In Experiment 2, only students with learning disabilities participated. The results reveal that more training substantially enhanced spelling performance in the long term, and repetition of the regularized word was even more effective. A recurrent network account served as the guiding principle to explain the results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)