Stroke and dementia are associated with greatest disease burden (i.e., morbidity and mortality) of all neurologic disorders (Seshadri & Wolf, 2007) and share the same risk factors, including advanced age, cerebrovascular disease, socioeconomic status, health behaviors, sex, race, cerebral white matter lesions and the APOE genotype. Despite overlapping risk factors, cognitive abilities in individuals with stroke/aphasia are typically investigated separately from cognitive abilities in individuals with dementia or mild cognitive impairment (MCI). A goal of this project is to expand our understanding of verbal STM and language processing impairments through studies that consider stroke/aphasia, dementia, and cognitive aging within a single conceptual framework focused on cognitive processing abilities. To that end, we will examine the potential of a test of language and verbal STM abilities in stroke-aphasia to detect mild impairment of these abilities in older adults without brain damage and individuals with MCI. We will also determine the extent to which the cognitive differences in this group reflect the integrity of white and gray matter pathology along a continuum of severity.
The aim of the parent project (R01DC01694) is to develop a clinical version of a test of language and verbal STM abilities of individuals with stroke-based aphasia, the Temple Assessment of Language and Short-term memory in Aphasia (TALSA; Martin et al., 2018). The TALSA reflects advances in our understanding of cognitive models of language processing that incorporate roles of STM and executive functions in language function and its impairment in aphasia. It provides measures of verbal STM capacity and the effects of increased memory load on processing of linguistic representations. In this supplement, we will determine whether the TALSA measures of verbal STM in healthy older adults are associated with known risk factors for development of MCI and dementia. We will test two hypotheses: (1) stroke/dementia risk factors, including socioeconomic status, race/ethnicity, and vascular health will be associated with verbal STM abilities in older adults without stroke or dementia and (2) structural MRI measures of white matter integrity will be strongly associated with verbal STM abilities in older adults without dementia or stroke and individuals with MCI. The outcomes of this study would offer (1) precise behavioral measures to improve risk detection for MCI and dementia; (2) targets for early behavioral interventions for those at risk for stroke or dementia; 3) a clearer understanding of the potential role of premorbid STM difficulties that might exacerbate stroke outcomes and preclude recovery. The data will also motivate a longitudinal study to determine if measures of white matter integrity mediate the relation between dementia risk factors and measures of verbal STM abilities in older adults. Ultimately, we aim to identify unique contributions of white and gray matter pathology to cognitive abilities that will enable us to propose a unifying theory of risk factors (STM-cognitive, neural, socioeconomic, race and vascular health) that are relevant for both stroke and dementia.
share behaviors, cognitive-linguistic potentially and dementia are associated with the greatest disease burden of all neurologic disorders and the same risk factors, including advanced age, cerebrovascular disease, socioeconomic status, health sex, race, cerebral white matter lesions and the APOE genotype. This project aims to determine if factors (verbal short-term memory) are associated with these risk factors and if they are predictive of the development of mild cognitive impairment and dementia. Stroke
| Martin, Nadine; Minkina, Irene; Kohen, Francine P et al. (2018) Assessment of linguistic and verbal short-term memory components of language abilities in aphasia. J Neurolinguistics 48:199-225 |
