School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Australia.
Int J Speech Lang Pathol. 2020 Jun;22(3):359-371. doi: 10.1080/17549507.2020.1747542. Epub 2020 Apr 22.
Positive outcomes following reminiscence therapy have been reported for older adults with mild cognitive impairment and dementia in cognition and quality of life and, in a small number of studies, communication. Despite the close relationship between cognition and language, the impact on communication has received limited attention. This study aimed to investigate whether the spoken discourse of older adults with mild cognitive impairment or dementia could be improved within the genre of following group reminiscence therapy, and whether change generalised to everyday discourse. Four females (mean: 87 years, SD: 7.3) who lived in a residential aged care facility and were diagnosed with mild ( = 2) or major ( = 2) neurocognitive impairment were recruited to attend a group reminiscence programme delivered in eight one-hour treatment sessions over four weeks. Multiple baseline samples of discourse were obtained in the week prior to intervention to monitor stability. Macrostructure, rate, informativeness and efficiency of discourse production were measured to identify change within nostalgic recounts and monitor evidence of generalised change in everyday discourse genres. Cognitive performance and quality of life were also monitored. While variability was evident, significant increases in macrostructure and richness of nostalgic recounts were found for two participants, with significant generalisation to everyday discourse. Both participants had diagnoses of mild cognitive impairment. No significant improvements were seen in cognition or quality of life with all participants. This study provides promising evidence for the spoken recall of memories having the potential to improve the communication of people with neurocognitive disorders, with some indication that people with milder impairment may be more amenable to this form of intervention. Nostalgic recounts may provide an explicit context in which speech-language pathologists can facilitate the planning of spoken production in people with cognitive impairment, and influence speaking in everyday contexts.
已有研究报道，怀旧疗法可改善轻度认知障碍和痴呆老年人的认知和生活质量，在少数研究中还可改善沟通能力。尽管认知和语言密切相关，但沟通能力的影响却很少受到关注。本研究旨在调查在小组怀旧疗法的主题框架内，是否可以改善轻度认知障碍或痴呆老年人的口语话语，以及这种改善是否可以泛化到日常话语中。4 名女性（平均年龄：87 岁，标准差：7.3 岁），居住在养老院，被诊断为轻度（ = 2）或重度（ = 2）神经认知障碍，参加了为期四周的八次一小时小组怀旧疗法。在干预前一周收集了多个基线样本的话语，以监测稳定性。测量话语的宏观结构、语速、信息量和效率，以识别怀旧叙述中的变化，并监测日常话语体裁中普遍变化的证据。还监测了认知表现和生活质量。虽然存在变异性，但两名参与者的怀旧叙述的宏观结构和丰富度有显著增加，并且有明显的泛化到日常话语。这两名参与者都被诊断为轻度认知障碍。所有参与者的认知或生活质量均无显著改善。本研究为改善神经认知障碍患者的沟通能力提供了有前景的证据，表明轻度认知障碍患者可能更适合这种干预形式。怀旧叙述可能为言语语言病理学家提供一个明确的语境，帮助认知障碍患者规划口语表达，并影响日常语境下的说话能力。
