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Self-Perception of Language Abilities in Older Adults
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Abstract:
Thesis (Ph.D.)--University of Rochester. School of Nursing. Dept. of Health Practice Research, 2016. ; Purpose: To examine awareness of language abilities in cognitively healthy older adults and those with cognitive decline. Methods: A conceptual model of Awareness of Language Abilities (ALA) was developed to contribute to the limited existing research and to provide a framework for the analyses for this study and for future research. A descriptive, longitudinal secondary data analysis using the Alzheimer’s Disease Neuroimaging Initiative dataset was conducted, incorporating a series of generalized estimating equations to model the relationship between language abilities and self-perception of language performance across cognitive subgroups. Results: Within-group results: All subgroups showed measureable declines in language abilities; however, none of the groups showed measurable decline in self-perception of language performance over time. Between-group results: There were significant between-group differences in language abilities and self-perception of language performance at baseline. Adults in the Alzheimer’s disease (AD) group declined the fastest. Interaction between objective language abilities and self-perception of language performance: Compared to healthy elders, those with mild cognitive impairment underestimated their language abilities; those with AD overestimated their language abilities. Individual characteristics related to self-perception of language abilities: Presence of depressive symptoms was negatively correlated with and was the only individual characteristic associated with self-perception of language performance. Results situated within ALA model: The ALA model partially explained awareness of language abilities, but is in need of revision and further research. Clinical and Research Implications: These findings have important implications for assisting older adults in optimizing safety, decision-making and quality of life. When language deficits are present and awareness is high, older adults may socially withdraw, thereby accelerating decline. They may benefit from interventions to promote meaningful linguistically-rich social interactions. When language deficits are significant and awareness is low, older adults may profit from interventions to support communication of important linguistic content. Further research, guided by the ALA model, is needed to further clinical and theoretical understanding of awareness of language abilities. Conclusions: Awareness of language abilities has the potential to moderate the effects of language deficits by providing an opportunity for compensation. If awareness is impaired as a function of cognitive decline, opportunities for compensation can be lost.
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Keyword:
Aging; Awareness; Dementia; Language; Mild cognitive impairment
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URL: http://hdl.handle.net/1802/31550
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