The Main Concept Analysis: Validation and sensitivity in differentiating discourse produced by unimpaired English speakers from individuals with aphasia and dementia of Alzheimer type

摘要

Purpose. Discourse from speakers with dementia and aphasia is associated with comparable but not identical deficits, necessitating appropriate methods to differentiate them. The current study aims to validate the Main Concept Analysis (MCA) to be used for eliciting and quantifying discourse among native typical English speakers and to establish its norm, and investigate the validity and sensitivity of the MCA to compare discourse produced by individuals with fluent aphasia, non-fluent aphasia, or dementia of Alzheimer's type (DAT), and unimpaired elderly. Method. Discourse elicited through a sequential picture description task was collected from 60 unimpaired participants to determine the MCA scoring criteria; 12 speakers with fluent aphasia, 12 with non-fluent aphasia, 13 with DAT, and 20 elderly participants from the healthy group were compared on the finalized MCA. Results. Results of MANOVA revealed significant univariate omnibus effects of speaker group as an independent variable on each main concept index. MCA profiles differed significantly between all participant groups except dementia versus fluent aphasia. Correlations between the MCA performances and the Western Aphasia Battery and Cognitive Linguistic Quick Test were found to be statistically significant among the clinical groups. Conclusions. The MCA was appropriate to be used among native speakers of English. The results also provided further empirical evidence of discourse deficits in aphasia and dementia. Practitioners can use the MCA to evaluate discourse production systemically and objectively.