Forty-four elderly patients of both sexes (mean age 76.5 years) suffering from depressive pseudodementia were intensively treated for the depression. When that cleared up, cognitive function reverted to premorbid level. Patients were regularly interviewed and retested at six months intervals for four to 18 years (average 8). Some patients experienced, during the follow-up period, a recurrence of the depression for which they were again successfully treated. At the end of the observation period, 39 of the 44 patients (89%) had developed a dementia syndrome of the Alzheimer type.
In order to contribute to the definition of the structure of cognitive deficits in major depression/unipolar, language processing was studied in 20 elderly persons with major depression/unipolar, 23 elderly with SDAT, and 20 normal elderly. Measures administered included the Western Aphasia Battery, Test for Syntactic Complexity, and Chomsky Test of Syntax. Results indicate that depressed elderly performance on structural language variables of repetition, naming, auditory verbal comprehension, syntax, and reading is significantly better than performance of the SDAT sample. In contrast, results suggest that in comparing normal and depressed elderly, the normal elderly have the edge. On three measures of eleven, there are significant differences between depressed and normal elderly language processing. In analyzing the measures of significant difference, it is determined that complexity is an intervening variable. It is concluded that although the reason for language deficits in major depression/unipolar is as yet unknown, it is not justifiable at present to rule out an organic hypothesis.
Research relating to language disorder in senile dementia of the Alzheimer type (SDAT) has focused primarily on naming impairment, formally termed anomia or nominal aphasia/dysphasia. Data resulting from this research have been insufficiently informed by a comparative linguistic framework in which performance on naming tasks is contrasted with performance on other forms of language tasks. The present study involves the comparison of 21 adults with SDAT and 18 demographically controlled normal elderly adults on the Test for Syntactic Complexity and fifteen subtests of the Western Aphasia Battery. Performance on naming is compared with performance on oral language variables of repetition, yes/no response, auditory word recognition, sequential commands, syntactic processing, as well as with performance on reading tasks and non-verbal tasks. Findings relating to oral language tasks show that structured syntactic processing requiring explicit interpretation and sequential commands are significantly more difficult for the SDAT sample than are three of four naming tasks. Further, significant SDAT performance variability is found across naming tasks. The generative categorical naming task is found to be significantly more difficult for the SDAT patient than are the other three naming tasks. It is concluded that the generative categorical naming task should be regarded as a meta-naming task. In sum, it is found that although language dysfunction in SDAT has anomic components, the essential character of the language disorder is not best conceptualized as a problem of naming.
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