Análise dos aspectos macrolinguísticos e desenvolvimento de um índice de avaliação de discurso oral em pacientes com doença de Alzheimer
Data
2014
Autores
Lira, Juliana Onofre de 
Orientadores
Minett, Thaís Soares Cianciarullo
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A demencia por doenca de Alzheimer (DA) e uma sindrome degenerativa que compromete as funcoes cognitivas incluindo a linguagem. O discurso e uma forma natural de comunicacao que permite analisar o processamento da linguagem, organizado nas dimensoes microlinguisticas e macrolinguisticas, e que portanto, pode ser util para avaliacao na DA. Objetivos: Identificar a ocorrencia de alteracoes da dimensao macrolinguistica no discurso oral em pacientes com DA e; desenvolver uma ferramenta de avaliacao do discurso oral nestes pacientes que inclua as dimensoes microlinguisticas e macrolinguisticas. Metodos: Foi realizado um estudo transversal com 121 individuos idosos, com escolaridade igual ou superior a 4 anos, divididos nos grupos DA e controle. Os sujeitos, submetidos ao Mini-exame do Estado Mental (MEM) e a subescala cognitiva da Escala de Avaliacao da doenca de Alzheimer (ADAS-cog), foram solicitados a emitir uma narrativa a partir de sete figuras que formam uma historia. Foi realizada uma analise dos aspectos macrolinguisticos e foi proposto o Indice de Avaliacao do Discurso Oral para DA, utilizando itens das dimensoes macrolinguisticas e microlinguisticas. Resultados: O grupo DA apresentou desempenho inferior em relacao aos controles para proposicoes completas relacionadas ao conteudo, proposicoes incompletas, macroproposicoes, unidades de informacao principais, elos coesivos, rupturas coesivas relativas aos aspectos macrolinguisticos. O Indice de Avaliacao do Discurso Oral para DA foi formado pelos cinco componentes que melhor diferenciaram os grupos: alteracoes lexicais e complexidade sintatica para a dimensao microlinguistica e; proposicoes completas relacionadas ao conteudo, macroproposicoes e elos coesivos referentes a dimensao macrolinguistica. Conclusoes: Foram verificadas alteracoes macrolinguisticas no discurso oral em pacientes com DA e com este estudo, foi possivel propor uma metodologia de avaliacao do discurso oral capaz de identificar alteracoes discursivas em idosos com DA
Background: Alzheimer’s disease (AD) is a degenerative illness characterized by memory impairment and other cognitive functions, which might include language. Discourse is a natural form of communication, which can analyze language processing, organized in microlinguistic and macrolinguistic dimensions and therefore could be useful for evaluation in AD. Purposes: To Identify the occurrence of disturbances in macrolinguistic dimension in oral discourse and to develop an assessment tool for oral discourse in AD patients including microlinguistic and macrolinguistic dimensions. Methods: It was performed a crosssectional study with 121 subjects of both genders, aged 60 years and schooling equal or higher than four years. The sample was divided into two groups: control, consisting of 61 subjects and AD, 60 patients. The participants were submitted to MiniMental State Examination (MEM), the cognitive subscale of the Alzheimer's disease assessment scale (ADAScog) and they were asked to produce a narrative elicited by a history based on sequence of pictures. It was developed an analysis of macrolinguistic aspects and it was proposed an index of evaluation of oral discourse in AD, using items by microlinguistic and macrolinguistic dimensions. Results: The AD group has performed lower performance than controls in complete propositions related to content, incomplete propositions, macropropositions, main information units, cohesive devices and cohesive disruption. The Oral discourse evaluation index for AD was composed by five variables which best differentiated the groups: lexical errors, syntactic complexity (microlinguistic dimension), complete propositions related to content, macropropositions and cohesive devices (macrolinguistic dimension). Conclusions: Macrolinguistic deficits were seen in oral discourse in AD patients as well as it was possible to purpose a methodology for oral discourse evaluation which was capable to identify discursive alterations in elderly patients with AD.
Background: Alzheimer’s disease (AD) is a degenerative illness characterized by memory impairment and other cognitive functions, which might include language. Discourse is a natural form of communication, which can analyze language processing, organized in microlinguistic and macrolinguistic dimensions and therefore could be useful for evaluation in AD. Purposes: To Identify the occurrence of disturbances in macrolinguistic dimension in oral discourse and to develop an assessment tool for oral discourse in AD patients including microlinguistic and macrolinguistic dimensions. Methods: It was performed a crosssectional study with 121 subjects of both genders, aged 60 years and schooling equal or higher than four years. The sample was divided into two groups: control, consisting of 61 subjects and AD, 60 patients. The participants were submitted to MiniMental State Examination (MEM), the cognitive subscale of the Alzheimer's disease assessment scale (ADAScog) and they were asked to produce a narrative elicited by a history based on sequence of pictures. It was developed an analysis of macrolinguistic aspects and it was proposed an index of evaluation of oral discourse in AD, using items by microlinguistic and macrolinguistic dimensions. Results: The AD group has performed lower performance than controls in complete propositions related to content, incomplete propositions, macropropositions, main information units, cohesive devices and cohesive disruption. The Oral discourse evaluation index for AD was composed by five variables which best differentiated the groups: lexical errors, syntactic complexity (microlinguistic dimension), complete propositions related to content, macropropositions and cohesive devices (macrolinguistic dimension). Conclusions: Macrolinguistic deficits were seen in oral discourse in AD patients as well as it was possible to purpose a methodology for oral discourse evaluation which was capable to identify discursive alterations in elderly patients with AD.
Descrição
Citação
LIRA, Juliana Onofre de. Análise dos aspectos macrolingüísticos e desenvolvimento de um índice de avaliação de discurso oral em pacientes com doença de Alzheimer. 2014. 151 f. Tese (Doutorado em Ciências) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2014.