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Inference comprehension from reading in individuals with mild cognitive impairment

Abstract

Inference comprehension is a complex ability that recruits distinct cognitive domains, such as language, memory, attention, and executive functions. Therefore, it might be sensitive to identify early deficits in subjects with MCI. To compare the performance of subjects with mild cognitive impairment (MCI) in an inference reading comprehension task, and to analyze the correlations between inferential comprehension and other cognitive functions. We studied 100 individuals aged 60 and over, divided into MCI (50) [aMCI (35), naMCI (15)], and cognitively healthy individuals [controls (50)]. The Implicit Management Test (IMT) was used to assess inference in reading comprehension in five categories: explicit, logical, distractor, pragmatic, and “others”. MCI group performed worse than controls in logical, pragmatic, distractor, and “others” questions (p < 0.01). The aMCI and naMCI subgroups presented a similar performance in all types of questions (p > 0.05). We observed significant correlations between the total IMT score and the TMT-A in the naMCI group (r = − 0.562, p = 0.036), and the Rey–Osterrieth Complex Figure and RAVLT tasks in the aMCI group (r = 0.474, p = 0.010 and r = 0.593, p = 0.0001, respectively). The MCI group as a whole performed worse than controls on the logical, pragmatic, other and distractor questions, and consequently on the total score. There were no differences in explicit questions, which impose lower inferential demands. The aMCI group suffered a significant impact from memory on inference comprehension, and difficulties in executive functions impacted naMCI performance. The IMT was useful to differentiate MCI patients from cognitively healthy individuals, but not MCI subgroups among themselves.

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Acknowledgments

This study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development (CNPq) (Process number: 557887/2009-7). The authors would like to thank Marcos Maeda for the statistical analysis.

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All authors contributed to the study conception and design. MLS collected the language data and wrote the paper; VUR assisted with the collection of language data; MOO collected neuropsychological data; EST nd SMDB conducted clinical evaluation and diagnosis; MR carried out statistical analysis and revised the manuscript; LLM designed the study and supervised the data collection. ML Silagi wrote the first draft of the manuscript, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Márcia Radanovic.

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Appendix: performance of the aMCI and naMCI groups in neuropsychological evaluation

Appendix: performance of the aMCI and naMCI groups in neuropsychological evaluation

  aMCI
M (SD)
naMCI
M (SD)
p value
Matrix Reasoning - WAIS III 10.7(4.7) 8.7(4.2) 0.201
ROCF (copy) 30.4(5.8) 31.6(4.3) 0.608
TMT A (time) 46.1(16.3) 61.5(21.1) 0.008
TMT A (errors) 0.1(0.3) 0.0(0.2) 0.689
TMT B (time) 140.3(67.0) 168.2(69.1) 0.228
TMT B  (errors) 1.8(1.8) 2.1(2.3) 0.748
Digit span forward 5.2(1.2) 5.4(1.1) 0.434
Digit span backwards 3.8(1.0) 4.1(0.9) 0.350
Stroop I 17.2(4.1) 18.6(6.4) 0.793
Stroop II 24.1(6.9) 23.2(6.1) 0.486
Stroop III (time) 37.5(10.5) 37.8(11.9) 0.988
Stroop III (errors) 1.4(1.5) 1.0(1.1) 0.511
Logical Memory I - WMS-R 17.9(6.0) 19.7(8.5) 0.512
Visual Reproduction I - WMS-R 28.8(6.8) 31.4(3.8) 0.249
Logical Memory II (delayed recall) - WMS-R 11.9(6.3) 14.1(8.9) 0.688
Visual Reproduction II (delayed recall) - WMS-R 11.5(9.2) 20.0(8.0) 0.013
ROCF (delayed recall) 8.1(4.5) 13.2(7.7) 0.027
RAVLT (total) 36.0(10.4) 42.0(9.6) 0.092
RAVLT (interference) 6.5(3.6) 8.3(2.5) 0.045
RAVLT (delayed recall) 6.3(3.6) 8.5(2.7) 0.053
RAVLT (recognition) 8.5(4.9) 12.6(5.3) 0.236
FAS-COWA 19.5(4.5) 24.3(7.3) 0.563
Animal fluency 15.9(5.2) 16.6(4.6) 0.505
BNT 41.6 (4.1) 45.5 (9.1) 0.536
  1. ROCF Rey–Osterrieth Complex Figure; TMT Trail Making Test, RAVLT Rey Auditory Verbal Learning Test, FAS Phonemic Verbal Fluency (letters FAS), BNT Boston Naming Test

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Silagi, M.L., Romero, V.U., de Oliveira, M.O. et al. Inference comprehension from reading in individuals with mild cognitive impairment. Acta Neurol Belg 121, 879–887 (2021). https://doi.org/10.1007/s13760-019-01264-7

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Keywords

  • Mild cognitive impairment
  • Reading
  • Comprehension
  • Inferences
  • Memory
  • Executive functions