Biomedical subjects

Bernadette Ska

Publications and source records attributed to Bernadette Ska.

10 recordsLinked to original sources

PubMed2006

[Normal aging and cognition].

It is now well documented that normal aging modifies the cognitive functioning and most observations suggest that cognition evolves in the direction of deterioration. The more frequently impaired functions are memory, attention and visual-spatial abilities. On the other hand, some abilities seem to increase, such as vocabulary. Considering the aging effect on cognition, questions remain regarding directionality, universality and reversibility. A great variability in aged related impacts is observed among subjects and among cognitive domains. Some individuals evolved more rapidly than others. Some cognitive functions are more affected by aging than others. General and specific factors are hypothesized to explain the aged related cognitive decline. Among them, educational level, health, cognitive style, life style, personality, are likely to modulate the aged related cognitive evolution by influencing attentional resources and cerebral plasticity. Cognitive resources are essential to develop adaptative strategies. During the life span, resources are activated and increased by learning and training. Considering the role of cognitive resources, successful aging is dependent on several conditions : absence of disease leading to a loss of autonomy, maintenance of cognitive and physical activities, and active and social engaged lifestyle.

Aged↗

PubMed2005

The heterogeneity of picture-supported narratives in Alzheimer's disease.

This study describes discourse patterns produced by 46 Alzheimer disease (AD) patients and 53 normal elderly subjects in two picture-supported narratives. Nine measures derived from a cognitive model of discourse processing were obtained and submitted to cluster analysis. Results indicate that discourse patterns elicited from both stimuli were heterogeneous. Further, they fail to clearly differentiate between normal aging and AD in half of the AD patients. Discourse patterns are examined in light of various sources of heterogeneity including severity of cognitive impairment, subject characteristics, and task demands. The usefulness of discourse as a diagnostic and therapeutic tool is discussed.

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PubMed2005

Assembling a toolkit to measure geriatric rehabilitation outcomes.

OBJECTIVE: To gather and assemble relevant patient-based outcome measures with emphasis placed on the older adults' level of functioning and activity performance. DESIGN: The study was conducted in two phases. First, a set of relevant measurement instruments was identified, and their was value analyzed according to general characteristics and metrologic criteria. Second, this "toolkit" was pretested on 22 older adults with respect to the burden of assessment and the quality of the data. RESULTS: The toolkit includes eight measurement instruments related to mobility, basic activities of daily living, independent living, leisure, physical functioning, psychologic functioning, social functioning, and caregiver status. Participants' acceptance of the toolkit was high, with all subjects completing the toolkit in two sessions (30-90 mins each). The leisure participation and satisfaction measure was the most difficult to complete. Distributional properties were adequate to ascertain variability between subjects, except for a ceiling effect found for the social functioning measure. CONCLUSION: Measurement tools that are used in combination are needed to optimize the applicability and utility of outcome results. The toolkit has the potential to become a valuable method for researchers and clinicians reporting geriatric rehabilitation outcomes.

Activities of Daily Living↗

PubMed2005

[Communication, discourse and dementia].

The construction-integration model (Kintsch, 1988) offers a frame for discourse analysis. This model defines four representation levels: the surface level or linguistic form, the base text or semantic level, the situation model built by combining information from the text and personal world knowledge, and the organization level. This study describes discourse produced by 46 Alzheimer patients and 53 normal elderly subjects in two picture-elicited production tasks: a single picture and a sequence of pictures. Globally, the single picture task is a more difficult situation for Alzheimer patients. The impaired levels in dementia are surface level, situation model and organization. Therefore, Kintsch model allows a distinction among discourse productions by normal elderly and mild to moderate Alzheimer patients.

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PubMed2003

Discourse about discourse: what is it and how does it progress in Alzheimer's disease?

Discourse about discourse or a subject's comments about his/her performance during a discourse task can be defined as modalizing discourse (discours modalisateur; [Nespoulous, 1980]; [Nespoulous et al., 1998]). Since it does not convey the expected content of the discourse task (referential discourse), modalizing discourse has often been considered non-informative, and as such, has received little interest. The present study investigated the modalizing aspect of discourse production and its evolution in Alzheimer's disease (AD). Five AD patients produced a picture-induced narrative across five consecutive assessments. Two measures were derived: the modalizing/referential ratio (M/R ratio) and the percentage of repeated ideas. Results revealed that, compared to a group of 27 normal controls matched for age and education, AD patients: (1) obtained higher M/R ratios that tended to diminish as the number of assessments increased, and (2) produced higher percentages of repeated ideas throughout all assessments. These results suggest that modalizing discourse makes up a large proportion of AD patients' discourse and should be included in further studies to accurately describe their discourse behavior. The implications of modalizing discourse on preserved pragmatic abilities and its inclusion in comprehensive management programs of AD patients are discussed.

Aged↗

PubMed2003

Diagnosis and rehabilitation attempt of a patient with acquired deep dyslexia.

This study presents a patient (JH) suffering from acquired deep dyslexia. According to a cognitive model of reading, JH exhibited a significant impairment in both the phonological and lexical routes to reading. A rehabilitation program was proposed. We decided to focus on the lexical route using a priming paradigm. The written words were associated with a picture and the patient was invited to construct a mental association between the written word and the image. During five sessions, JH was trained to read 50 words. A pre-test, a post-test, and an 8-month follow-up session consisted of reading 140 written words including the 50 trained words. At the post-test, 90% of the trained words were accurately read. At the follow-up session, JH's reading performance for the trained words was still highly accurate at 84%. This strong effect is discussed and ways of increasing the patient's abilities to read are proposed.

Association↗

PubMed2003

Language following functional left hemispherectomy in a bilingual teenager.

A detailed language assessment was conducted with MM, a 17-year-old bilingual teenager with Rasmussen syndrome who had undergone a left functional hemispherectomy. Results revealed important deficits in French and English, affecting expressive and receptive language in both the written and the oral modality. MM's linguistic profile was coherent with previous description of language function following left hemispherectomy, and what is known of the linguistic potential of the right hemisphere (RH). The impairment pattern showed overall similarities between French and English, thus supporting the existence of a common underlying system for these two languages. However, the profiles in each language were not identical, implying that distinct subsystems may also be at play. These findings support previous descriptions of acquired language impairments and recovery in bilingual individuals.

Adolescent↗

PubMed2002

Characterization of visuoconstructional disabilities in patients with probable dementia of Alzheimer's type.

The goal of this study was to systematically examine alterations underlying the graphical copying performance of Alzheimer's patients at different stages of cognitive decline, in light of a theoretical framework of visuoconstructional processing (Guérin, Ska, & Belleville, 1999). Eight patients with a diagnosis of probable Alzheimer's disease were studied. A group of 24 elderly subjects, of similar age to the patient group and slightly higher education, served as controls. The severity of the cognitive decline of each patient was measured with a standard neuropsychological battery. All subjects were administered a copying task and tasks measuring visual exploration, judgment of spatial relations and graphical planning. Group and individual results were analyzed. The group results suggested that visuoconstructional apraxia in patients with Alzheimer's type dementia is characterized by impaired visual exploration and judgment of spatial relations. Individual results revealed between-patient variability related to the severity of cognitive decline. Given the small number of patients, these observations need to be replicated with a larger-scaled study.

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PubMedDate not supplied

Development of a conceptual framework for the assessment of geriatric rehabilitation outcomes.

The objective of the study was to develop a conceptual framework of key assessment areas for the evaluation of rehabilitation outcomes in older persons. The study was designed in four stages. First, a review of the literature generated a list of 84 potential outcome variables. Second, semi-structured interviews were conducted with older adults informants (n = 19) to record their thoughts about important rehabilitation outcomes. From the analyses of the transcripts, 20 recurrent themes became apparent. Third, relevant assessment areas were determined based on the merged data from the literature and the interviews. Fourth, a focus group was held with a panel of eight interdisciplinary experts with strong involvement in geriatric rehabilitation to evaluate, improve, and validate the preliminary work. As a result of the study, the conceptual framework for the assessment of geriatric rehabilitation outcomes (FAGRO) is composed of four primary outcome domains related to important activities for community-living older persons: mobility activities, basic activities of daily living, activities of independent living, and leisure activities. The models also allows for four brief evaluations of underlying functioning components, including: physical functioning, psychological functioning, social functioning, and factors related to the caregiver status and available resources. The model has the potential to become a valuable additional tool for outcome assessment, researched and developed specifically for geriatric rehabilitation.

Activities of Daily Living↗

PubMedDate not supplied

Text structure and content modulate the recall of patients with dementia of the Alzheimer's type.

Two descriptive and two narrative texts were constructed. The basic forms of each type of text comprised 27 micropropositions, while the detailed forms incorporated an additional 24 micropropositions. Forty DAT patients and 14 control subjects were asked to read and recall the 4 texts and the total number of micropropositions recalled was recorded. Recall performance among DATs was always inferior to that of controls. For both groups, the narrative texts yielded superior recall than the descriptive texts, while the detailed text forms elicited inferior recall than the basic forms. However, the addition of details to the narrative text increased the recall of the basic propositions of DATs, bringing it to similar levels as controls. Results are discussed with reference to the influence of text structure and the situation model on text recall.

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