使用中文之輕度認知功能障礙長者的語言缺損表現

Abstract

過去研究顯示在輕度認知功能障礙者中，特別是以記憶障礙為主之高齡者（亦稱失憶型輕度認知功能障礙）的語言缺損表現，主要出現在詞彙和語意處理的層面。然而基於中文與英文語系有不同的語言處理特徵，目前對於使用中文之輕度認知功能障礙高齡者的語言表現仍有待探討。因此，本研究旨在透過一個初步建立的語言測驗組，探討相對於認知正常高齡者，使用中文之輕度認知功能障礙長者的語言缺損表現。此研究包含23位輕度認知功能障礙長者與29位認知正常高齡者，皆受測於本研究之語言測驗組，共包含五個語言功能領域（口語產出、聽覺與文字理解、閱讀、覆誦以及書寫）。結果發現輕度認知功能障礙長者，相較於認知正常高齡者，在口語產出領域以及聽覺與文字理解領域的語言測驗表現顯著較差，特別是涉及高度詞彙與語意處理資源的作業表現最為顯著。此外，輕度認知功能障礙長者產生的語意命名錯誤顯著較認知正常長者多，以及在處理具生命性物體相關題目具有更多困難的傾向。這些結果顯示臨床工作者可以結合與詞彙及語意處理相關的語言測驗，協助評估使用中文之輕度認知功能障礙長者的語言功能。

Prior studies have discovered English speaking older adults with amnestic mild cognitive impairment (aMCI) exhibited language impairments mostly at the lexical and semantic level. It remained unresolved how previous findings could generalize to the Mandarin Chinese speakers with aMCI given the language processing of Mandarin Chinese is different from alphabetic languages. Herein, the study aimed to profile the multifaceted language functions in Mandarin Chinese speakers with aMCI relative to cognitively unimpaired older adults through a newly developed language battery. The battery comprised five language domains (oral production, auditory and written comprehension, reading aloud, repetition, and writing). This study included 23 older adults with aMCI and 29 cognitively unimpaired older adults. Results demonstrated that relative to the controls, individuals with aMCI exhibited poorer performance in the oral production, and auditory and written comprehension domains, especially for tests involving effortful lexical and semantic processing. Moreover, the aMCI group exhibited a higher number of semantic naming errors than that in their counterparts, and a tendency of difficult processing items of living objects. Overall, the present study identified a similar pattern to English-speaking individuals with aMCI across multiple language domains. To incorporate language tests involved lexical and semantic processing into clinical practice is essential and can help to identify early language dysfunctions in Chinese speakers with aMCI.