Assessment of Language and Cognition in Older Deaf Signers

老年聋人手语者的语言和认知评估

• 批准号: 10551287
• 负责人: Tamar Gollan
• 金额: $ 68.85万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-15 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10551287
• 关键词: Address; Adult; Affect; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Alzheimer' s disease risk; American Sign Language; Assessment tool; Behavioral; Cognition; Cognitive; Cognitive deficits; Communication; Communities; Compensation; Complex; Counseling; Data; Diagnosis; Disparity population; Early Diagnosis; Elderly; English Language; Exclusion; Exhibits; Exposure to; Future; Goals; Health Status; Hearing; Impaired cognition; Impairment; Individual; Knowledge; Language; Language Disorders; Language Tests; Life; Linguistics; Literature; Measures; Memory; Memory Loss; Methods; Mission; Names; National Institute on Deafness and Other Communication Disorders; Neuropsychological Tests; Parents; Patients; Pattern; Performance; Persons; Population; Population Heterogeneity; Poverty; Prevalence; Proactive Inhibition; Probability; Procedures; Production; Research; Sampling; Schools; Semantics; Sign Language; Speech; Testing; Vocabulary; Work; Writing; bilingualism; cognitive reserve; cognitive testing; cohort; comparison group; deaf; deafness; dementia risk; deprivation; diagnostic accuracy; early experience; executive function; health disparity; hearing impairment; human old age (65+); improved; lens; non-verbal; normal hearing; performance tests; prevent; recruit; response; verbal

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).

该拟议项目将开发用于评估聋哑老年人状况的测试和方法 （年龄≥65 岁），主要关注那些同时使用美国手语 (ASL) 和书面英语 在双语者进行口语交流时，对阿尔茨海默病 (AD) 的敏感性最高。 测试以主导语言进行，但尚不清楚这是否适用于双语聋哑老年人，该群体 为评估和诊断带来了许多挑战，但几乎没有开发出用于管理的测试。 对于聋哑人的手语者来说，人们对 AD 在这一人群中的行为表现知之甚少。 目标 1 我们将开发语言能力、列表记忆和执行功能（即 Stroop）测试，这些测试可以 我们将调查哪种语言可以最大限度地提高聋哑人的测试成绩。 对于 ASL-英语双语者，我们认为这些信息对于避免 AD 假阳性诊断至关重要。 语前聋的老年人遭受语言剥夺，这可能会改变行为表现 由于他们无法充分接触口语，并且不鼓励他们使用手语。 目标 2 我们将测试一小部分可能患有 AD 的聋人手语者样本，以确定测试哪种语言 最大化患者和对照之间的差异（在目标 1 中测试），并且如果耳聋手语者患有可能的 AD 表现出听力 AD 中发现的损害模式（包括延迟回忆减少、首要效应减少、 增加了对列表内存测试的主动干扰，并增加了 Stroop 测试的错误）。 对熟练程度叙述进行详细的探索性语言分析，旨在确定 AD 如何影响 在目标 3 中，我们将研究聋哑人能产生更复杂、更自然的语言形式。 通过招募 2 语言剥夺和言语/手语双语对认知储备可能产生的影响 认知健康的单语老年人的其他比较组：听力正常的人和那些 患有晚发性衰老相关耳聋的人在晚年失去听力的情况下，接触的环境会减少。 由于他们的听力损失而导致的语言互动，这增加了他们患痴呆症的风险。 这些小组将提供一个独特的视角来研究早期和近期的语言剥夺对儿童可能产生的影响。 患有老年性耳聋的老年人的参与也将增加该项目的潜在意义。 通过提供书面英语测试数据来提出工作，这可能有助于评估单语能力 该项目将在测试和程序方面取得重大进展。 对老年聋人手语者（历史上处于弱势群体）的认知评估将提高对聋人手语者的理解 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“了解与老龄化相关的健康差异并制定改善健康状况的策略” 不同人群中老年人的情况”（研究战略方向，目标 F）。