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Discriminative validity of selected measures for differentiating normal from aphasic performance.

Katherine B Ross1, Robert T Wertz

  • 1Carl T. Hayden Medical Center, 650 E. Indian School Road, CS/126, Phoenix, AZ 85012, USA. katherine.ross3@med.va.gov

American Journal of Speech-Language Pathology
|September 16, 2003
PubMed
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Distinguishing between normal aging and mild aphasia is challenging. While expressive language and performance efficiency showed differences, all tests had overlapping results, suggesting a need for broader diagnostic information.

Area of Science:

  • Neurology
  • Linguistics
  • Psychology

Background:

  • Elderly individuals and those with mild aphasia can present with similar communication difficulties.
  • The ability of standardized tests to differentiate between normal aging and aphasia requires further investigation.

Purpose of the Study:

  • To evaluate the discriminative validity of general language and functional communication measures in distinguishing between aphasic and normal elderly adults.
  • To identify which aspects of language performance are most effective in differentiating these groups.

Main Methods:

  • A comparison was made between 18 adults with aphasia and 18 neurologically healthy elderly adults.
  • Performance was assessed using the Porch Index of Communicative Ability (PICA), Western Aphasia Battery (WAB), Communication Activities of Daily Living (CADL-2), and the American Speech-Language-Hearing Association's Functional Assessment of Communication Skills for Adults (ASHA FACS).

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Main Results:

  • All tested measures demonstrated significant differences in summary scores between the aphasic and normal groups.
  • Expressive language abilities and the efficiency of communication performance were the strongest discriminators.
  • A notable overlap (at least 10%) in performance ranges was observed across all measures, indicating potential diagnostic ambiguity.

Conclusions:

  • Standardized language assessments can differentiate between aphasia and normal aging, particularly in expressive domains.
  • The overlap in performance suggests that formal test results alone may be insufficient for definitive diagnosis.
  • Supplementing standardized testing with subjective and objective evidence is crucial for accurate differential diagnosis of aphasia.