Preliminary assessment of connected speech and language as marker for cognitive change in late middle-aged Black/African American adults at risk for Alzheimer’s disease

ABSTRACT

Background

Connected speech-language (CSL) has been a promising measure of assessing cognitive decline in populations at-risk for Alzheimer’s disease and related dementias (ADRD) populations. A common way to obtain CSL is through using picture description tasks such as the most frequently used image, “Cookie Theft” (CT). However, questions have been raised about using CT for diverse communities. Little is known about the CSL produced in response to this task in late-middle aged Black/African American (BAA) adults.

Goals

The present study’s goals were to characterize CSL in BAA adults by sex and APOE-ε4 status from Milwaukee in the Wisconsin Registry for Alzheimer’s Prevention (WRAP) study when presented with the CT picture description task, and to identify differences in CSL output between BAAs and non-Hispanic Whites (NHW).

Methods and Procedures

We collected CSL samples from the CT picture from 48 BAA participants and 30 NHW participants from the WRAP participants in Milwaukee, WI group. CSL was analyzed using chi-square tests, T-tests, and ANCOVA. Linear mixed effect regression models were used to determine the association between cognitive status and longitudinal CSL in BAA participants with more than 1 timepoint.

Outcomes and Results

Declines in CSL of BAA participants were associated with subtle declines in cognition. Among BAA participants, we found no significant differences in speech measures in terms of sex and APOE-ε4 status. Our results showed no significant differences in total words between BAA and NHW groups.

Conclusions

CSL analysis provides an inexpensive way to evaluate preclinical changes in cognitive status that may not be as affected by other factors as traditional cognitive tests, such as ethnocultural background. Future studies with larger sample sizes and participants from other geographic locations can clarify these findings.

KEYWORDS:

• Alzheimer’s disease
• African Americans
• Language
• Speech
• Discourse

Acknowledgments

We would like to express our very great appreciation to the Milwaukee Community Advisory Board and to the Black Leaders for Brain Health. We thank Rebecca L. Koscik, PhD and Carey E. Gleason, PhD for their guidance and support throughout this project. We gratefully acknowledge the WRAP study team who have carefully acquired the longitudinal data, especially Nia Norris, Celena Ramsey, and Ian Cannovi. Our deepest gratitude to the WRAP participants who make this research possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Supported by the Office of the Vice Chancellor for Research and Graduate Education - Fall Competition Grant, and National Institutes of Health awards R01 AG027161, R01 AG054047, UL1 TR000427, AG054059, Bader Philanthropies, Wisconsin Registry for Alzheimer’s Prevention NIH-NIA AG027161 and the African Americans Fighting Alzheimer’s in Midlife NIH-NIA AG054059;National Institute on Aging [AG027161,AG054059];University of Wisconsin-Madison [OVCRGE AAG5896]