Benefit of Phonemic Cueing in Alzheimer's Disease Patients' Naming Performance: Baseline Correlates and Predictive Utility
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Word-finding difficulty, especially when confronted with naming items, is a well-known problem that many individuals with Alzheimer’s disease (AD) encounter. The use of neuropsychological measures, imaging technology, and genetic research has all contributed to the understanding of naming deficits in AD and the underlying cognitive processes involved. The effects of providing cues during confrontation naming tasks have also been studied, and research has suggested overall benefits of phonemic cueing. This research project further investigated the benefits of phonemic cueing cross-sectionally and longitudinally among a large sample (N = 1104) of individuals with mild to moderate AD. Cross-sectionally, the study examined neuropsychological and socio-demographic correlates of phonemic cueing benefit, as well as potential modifying effects of genetic vulnerability and dementia severity. Longitudinally, the study determined whether phonemic cueing benefit predicts rate of decline on several dementia severity measures. Results indicated that, consistent with previous literature, mild AD subjects benefited from phonemic cues significantly more than moderate AD subjects. Individuals with higher premorbid IQ were found to benefit more from phonemic cueing, which was expected given research findings on the effects of education on cognitive reserve. Women and men were comparable in overall confrontation naming ability, which contradicted current literature, and women were found to benefit more than men from phonemic cues. Confrontation naming ability accounted for the observed inverse relationship between age and phonemic cueing benefit. Observed differences in PCI between carriers and noncarriers of the ApoE ε4 allele were also accounted for by confrontation naming ability, with carriers performing better on naming tasks compared to noncarriers. Phonemic cueing benefit uniquely contributed to baseline cognitive performance on some semantic measures, phonemic fluency, and one non-semantic visuospatial task. Only lower levels of baseline dementia severity and older age predicted less cognitive impairment at 2-year follow-up.