A study on assessment of communication in dementia

本研究的第一个目的是修订我们以前编制的《痴呆症话语评定量表》，并提高其简便性。除了检测痴呆患者的沟通障碍外，我们的目的是将其扩展为一个临床有用的评估量表，它也可以评估临床干预的有效性。首先，我们编制了一个新版的话语评估量表，其内容与原量表相同，但为了使评估工作更容易，我们对其进行了修改。其次，我们对不同严重程度的阿尔茨海默病患者进行了话语评估和简易精神状态检查，并检验了话语表现与简易精神状态检查量表测量的一般认知能力之间的相关性。话语量表的阶梯值与MMSE评分之间存在显著的统计学相关。我们还收集了日本言语-语言-听力治疗师(SLHT)对痴呆的评估和干预的实际情况。结果发现，许多二语习得者在进行评估和有效干预时遇到了困难，我们开发了一种沟通干预工具--记忆幻灯片，并利用该工具对沟通的变化进行了初步研究。研究表明，幻灯片对会话是有用的，但由于环境的不同，沟通绩效会有所波动。此外，我们计划阐明幻灯片对会话的影响，并使用我们的评价量表，根据听者/照顾者、谈话主题、沟通环境等因素来检验沟通绩效的变化。

The first object of this study was to revise our previously developed "Discourse Assessment Scale for Dementia" and improve its simplicity and handiness. In addition to detect communication deficits of people with dementia, we aimed at expanding it into a clinically useful assessment scale, which would also be able to evaluate the effectiveness of clinical intervention.In the first place, we made up a new version of the discourse assessment scale, which included the same contents as the original scale, but was modified in order to make assessment work easier. We compared the two scales in terms of inter-rater reliability and handiness, and found little difference between them.Second, we administered the discourse assessment and MMSE to people with Alzheimer's disease of a wide range of severity, and examined the correlation between the discourse performance and the general cognitive abilities measured by MMSE. There were statistically significant correlation coefficients between the step values of the discourse scale and MMSE score.We also gathered information on the actual state of dementia assessment and intervention by speech-language-hearing therapists (SLHT) in Japan. It turned out that many SLHTs experienced difficulty in conducting assessment and effective intervention.As a tool for communication intervention, we developed "the Memory Slide Show" and carried out a preliminary study to investigate the change of communication by the use of this tool. It was suggested that the slide show was useful for conversation, but that the communication performance fluctuated due to environmental differences.Further, we are planning to clarify the influence of the slide show on conversation and to examine the change of communication performance according to the listeners/caregiver, the topic of conversation, the communication setting, and other factors using our assessment scale.