Assessing cognitive communication skills in dementia: a scoping review

Abstract

Background: Cognitive communication difficulties are a characteristic feature of dementia. These deficits have negative effects on all aspects of daily life. Yet, there are few options for standardized assessment of cognitive communication skills in people with dementia. Aims: To review published cognitive-communication assessments to determine what psychometrically sound assessments exist that are applicable to all people with dementia. Methods & Procedures: A scoping review of the literature was conducted using an established scoping review model. Cognitive-communication assessments validated in English with people with dementia were sought. A comprehensive search of eight relevant electronic databases was undertaken. Two reviewers independently analysed and assessed the psychometric quality of instruments that met inclusion criteria. Outcomes & Results: Four cognitive-communication assessments were included in the review. Although psychometrically sound, none was suitable for administration at all stages of dementia. Only one was validated for different dementia types. None included subtests for evaluation of conversation ability, and none involved the evaluation of communication partners' communication. Conclusions & Implications: There are limited options for standardized communication assessment for individuals with dementia and their communication partners. Directions for the development of new measures are provided to facilitate research and improve clinical practice. What this paper addsWhat is already known on the subject People with dementia experience deterioration in communication function with the progression of the disease, but they retain functional communication abilities. Speech and language therapists have few assessments for evaluating the cognitive communication ability of people with dementia. What this paper adds to existing knowledgeThis scoping review has identified and summarized the cognitive communication assessments that have been validated for use with people with dementia and has synthesized their validity, reliability, acceptability and comprehensiveness. What are the potential or actual clinical implications of this work?Currently, speech and language therapists must use assessments that are validated for use on specific subtypes of dementia and not across severity levels. Given that interventions typically include a focus on the listener's

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“…App developers may wish to further emphasize and develop the community-building aspects of cognitive training technologies. However, it should be noted that communication abilities may decline with the progression of dementia [ 40 , 41 ]; hence, the social aspects of gaming may not be as relevant to those with severe clinical symptoms.…”

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“…exponentiell an, so dass in Verbindung mit der gestiegenen Lebenserwartung und der älterwerdenden geburtenstarken Jahrgänge die medizinische und pflegerische Versorgung von Menschen mit Erkrankungen des demenziellen Spektrums zukünftig eine noch höhere Relevanz haben wird [2]. Dies ist auch aus sprachtherapeutischer Sicht von großer Bedeutung, da mit dem kognitiven Abbau zunehmend Sprachund Kommunikationsstörungen auftreten können, die sich ungünstig auf die Lebensqualität auswirken [1,3,4,5,6]. Somit ist ein steigender Bedarf an Sprachtherapie bei PmD zu erwarten.…”

“…Logopädie wird dort lediglich zur Behandlung von Dysphagien empfohlen, nicht zur Förderung der Kommunikation [4]. Dabei stellen die Kommunikationsstörungen aufgrund ihrer Progredienz ein deutliches Hemmnis für die Interaktion mit Familie, Freunden sowie medizinisch-therapeutischem Fachpersonal dar [1,3,6]. Sie beeinträchtigen die soziale und gesellschaftliche Teilhabe sowie die selbstbestimmte Lebensgestaltung der Betroffenen nachhaltig [1,3,6].…”

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