The relationship of language and attention in elders with nonfluent aphasia

Abstract

Background: Researchers have questioned whether aphasia coincides with deficiencies in the non-linguistic executive functions needed to coordinate cognitive-linguistic skills. Attention, an important component of executive function, may be compromised in the presence of aphasia. The relationship of attention to recovery of functional language skills in aphasia requires additional investigation. Aims: This exploratory multiple case comparison investigated whether a measurable weakness in attention is present in elderly persons with nonfluent aphasia and whether there is a trend for these measures that coincides with the severity of the nonfluent aphasia. Methods and procedures: Three female and five male participants, ages 57–79 with nonfluent aphasia, completed tests of language and attention: the Western Aphasia Battery Bedside Screener-Revised, the Test of Everyday Attention, the Cognitive Linguistic Quick Test, and the Leiter International Performance Scale-Revised. Outcomes and results: All participants demonstrated deficits in language and attention to varying degrees. Overall, the data did not establish a trend between measures of language and attention. The degree to which participants’ attentional skills were affected was not consistently related to their severity of aphasia. Each participant demonstrated unique strengths and weaknesses. For two participants, language was a strength in relation to attention. For three participants, attention was a strength in relation to language. Three participants did not demonstrate a relative strength in either language or attention. Conclusions: This report concludes with multiple case comparisons that describe each participant’s performance in detail. Implications for diagnosis and treatment arise from these case interpretations. Clinicians need to consider the how attention may be uniquely affected in each person with nonfluent aphasia. Limited attentional skills present a possible barrier to rehabilitation. Attention is integral to learning and for responsiveness to interventions, and lesser attentional skills may inhibit a person’s ability to respond to interventions geared toward recovery of language skills. Knowledge of the attentional skills of persons with nonfluent aphasia may allow clinicians to capitalize on strengths and rehabilitate weaknesses.

Keywords

• aphasia
• acquired language disorder
• attention
• multiple case study
• geriatrics