Background Progressive difficulties with spoken language occur across the spectrum of degenerative dementia. When not a primary presenting and dominant symptom, language difficulties may be overlooked in favor of more prominent cognitive, behavior, or motor deficits. The aim of this scoping review is to examine the extent and nature of the research evidence describing (1) the spoken language impairments found in non‐language led dementias, (2) their impact on everyday living, and (3) the reported language interventions. Methods We searched PubMed, MEDLINE, OVID‐EMBASE, PsycINFO, and SpeechBITE using terms related to spoken language for the following dementia types: Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), cortico‐basal syndrome (CBS), behavior variant frontotemporal dementia (bvFTD), early‐onset Alzheimer's disease (EOAD), posterior cortical atrophy (PCA), and motor neuron disease associated with FTD (MND+FTD). Risk of bias was assessed with the QualSyst tool. Results Seventy‐three eligible studies were included. A wide range of spoken language impairments were reported, involving both linguistic (e.g., syntactic processing) and other cognitive (e.g., sustained attention) underlying mechanisms. Although the severity of these deficits was scarcely reported, in some cases they manifested as non‐fluent, dynamic, and global aphasias. No papers in the review described either the impact of these language impairments on everyday living or language therapies to treat them. Discussion There is a need to understand better the level of disability produced by language impairment in people living with non–language‐led dementias. Our findings suggest three calls for action: (1) research studies should assess the clinical relevance of any spoken language deficits examined, (2) both linguistic and cognitive underlying mechanisms should be fully described (to inform the design of effective language and behavioral interventions), and (3) trials of language therapy should be conducted in those groups of individuals where significant language impairment is proved.
Background Progressive language difficulties arise in many neurodegenerative conditions, causing significant impact upon patients and families. This occurs most obviously in primary progressive aphasia (PPA) but can also occur within other forms of progressive disease. In these cases, language decline may be significant, but as they are not the presenting or dominant symptom, may be overlooked in favour of more prominent cognitive, behaviour or motor deficits. To date, there has been no systematic investigation into non-primary progressive aphasia. This scoping review aims to describe the currently reported language impairments found in non-language-led dementias and identify their clinical relevance, defined as the impact on everyday living. It also seeks to identify the reported interventions for language impairment in this patient group to-date. Method We will conduct a scoping review of published studies that have assessed and/or treated aphasia in people diagnosed with a neurodegenerative condition other than primary progressive aphasia. The systematic search will include the electronic databases PubMed, MEDLINE, OVID-EMBASE, PsycINFO, and speechBITE, using search terms for specific non-language-led dementia subtypes. Findings will be mapped and described according to the type of language difficulties identified and rehabilitation approaches employed. Intervention studies will be evaluated for their methodological rigour using validated scales. Discussion This scoping review will provide an overview of the types of aphasia found in neurodegenerative conditions where language dysfunction is not the primary focus. Current treatment approaches (and gaps in the provision of treatment) will be identified.
BACKGROUND About 70% of mental disorders emerge in late childhood and young peo-ple bear the burden of these disorders throughout life. Yet, to date there has been com-paratively little research on mental health interventions for young people in India and not many attempts have been made to collate the existing literature. This systematic review aims to synthesize the available evidence on school- and community-based mental health interventions for young people in India. METHODS A range of major electronic databases were searched systematically, and the abstracts of relevant papers were independently examined for possible inclusion. Selected papers were read in full text and a standardized set of data items were extracted. RESULTS Four papers met inclusion criteria for the analysis; two studies of school-based interventions for adolescents and two studies evaluating out-of-school community interventions for youth were reviewed. The quality of evidence from the interventions in Indian school and community settings were poor. While two studies evidence the effectiveness of a school-based life skills programme and a community based multicomponent intervention designed to promote youth health, two other studies do not offer sufficient data. CONCLUSION The review findings indicate that the number of interventional studies conducted in India to address youth mental health issues are very limited. Hence, it is extremely difficult to ensure the feasibility and effectiveness of school and community-based interventions in India. Further research is warranted to establish whether interventions promoting youth mental health people can be implemented effectively in Indian settings with positive mental health outcomes. Given the possibility of a huge population of young people at-risk or experiencing mental disorders, evidence for the efficacy of youth mental health interventions is crucial.
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