Assessment of Language and Cognition in Older Deaf Signers

这个拟议的项目将开发测试和方法，用于评估耳聋老年人的认知状态 (aged≥65），主要集中在那些谁使用美国手语（ASL）和书面英语， communicate.在口语双语者中，对阿尔茨海默病（AD）的敏感性最大化， 测试是以主导语言进行的，但不知道这是否适用于双语聋人老年人，这是一个 对评估和诊断提出了许多挑战。几乎没有开发出用于管理的测试 与聋人签名者，和消失很少知道的行为表现，AD在这一人群。在 目标1我们将开发语言能力、列表记忆和执行功能（即，斯特鲁），可以 以英语或英语进行管理。我们将调查哪种语言最大限度地提高聋人的测试成绩 ASL-英语双语者，我们认为这些信息对于避免AD的假阳性诊断至关重要。许多 语言失聪前的老年人遭受语言剥夺，这可能会改变他们的行为表现， 由于他们缺乏充分的口头语言，而且不鼓励他们使用手语，因此，他们对AD的认识是有限的。在 目的2我们将测试一小部分可能患有AD的聋人手语者，以确定测试的语言 最大化患者和对照组之间的差异（在目标1中测试），如果可能患有AD的聋人签名者 表现出听力AD中发现的损伤模式（包括延迟回忆减少，首因效应减少， 列表记忆测试中的主动干扰增加，Stroop测试中的错误增加）。我们还将 进行详细的探索性语言分析的能力叙述，旨在确定AD如何影响 在聋人手语中产生更复杂和自然的语言形式。在目标3中，我们将研究 语言剥夺和言语/手势双语对认知储备的可能影响 认知健康的单语老年人的额外对照组：听力正常的人和 迟发性衰老性耳聋在晚年失去听力的人， 语言互动，因为他们的听力损失，这增加了他们患痴呆症的风险。比较 这些小组将提供一个独特的透镜，了解早期和近期语言剥夺对儿童的可能影响。 认知.老年性耳聋患者的参与也将增加 建议的工作，提供书面英语测试的数据，这可能有助于评估单语 老年听力损失患者该项目将构成测试和程序的重大进步， 老年聋人手语者是一个历史上的弱势群体，对他们的认知评估将提高他们对 不同的语言背景如何改变AD的行为表现，并将有助于NIA 使命是“了解与老龄化有关的健康差距，并制定改善健康状况的战略 ”（《研究战略方向》，目标F）。

This proposed project will develop tests and methods for assessment of cognitive status in deaf older adults (aged ≥65), focusing primarily on those who use both American Sign Language (ASL) and written English to communicate. In spoken language bilinguals, sensitivity to Alzheimer’s disease (AD) is maximized when testing occurs in the dominant language, but it is not known if this applies to bilingual deaf seniors, a group that presents many challenges for assessment and diagnosis. Few tests have been developed for administration with deaf signers, and vanishingly little is known about the behavioral presentation of AD in this population. In Aim 1 we will develop tests of language proficiency, list memory, and executive function (i.e., Stroop) that can be administered in ASL or English. We will investigate which language maximizes test performance in deaf ASL-English bilinguals, information we believe is critical for avoiding a false-positive diagnosis of AD. Many seniors who were pre-lingually deaf suffered language deprivation that could alter the behavioral presentation of AD since they lacked full access to a spoken language and their use of sign language was discouraged. In Aim 2 we will test a small sample of deaf signers with probable AD to determine which language of testing maximizes differences between patients and controls (tested in Aim 1), and if deaf signers with probable AD exhibit patterns of impairment found in hearing AD (including reduced delayed recall, reduced primacy effects, increased proactive interference on list memory tests, and increased errors on Stroop tests). We will also conduct a detailed exploratory linguistic analysis of proficiency narratives, aiming to identify how AD affects production of more complex and naturalistic forms of language in deaf signers. In Aim 3 we will examine the possible effects of language deprivation and speech/sign bilingualism on cognitive reserve by recruiting 2 additional comparison groups of cognitively healthy monolingual seniors: those with normal hearing and those with late-onset aging-related deafness. Individuals who lost their hearing late-in-life have reduced exposure to linguistic interactions because of their hearing loss, and this increases their dementia risk. Comparison of these groups will provide a unique lens on the possible effects of early versus recent language deprivation on cognition. Participation of seniors with aging-related deafness will also increase the potential significance of the proposed work by providing data on written English tests which may be useful for assessment of monolingual seniors with late-life hearing loss. This project will constitute a major advancement in tests and procedures for cognitive assessment of older deaf signers, a historically disadvantaged group, will improve understanding of how diverse linguistic backgrounds may alter the behavioral presentation of AD, and will contribute to the NIA mission to “Understand health disparities related to aging and develop strategies to improve the health status of older adults in diverse populations” (in Strategic Directions for Research, Goal F).