A Study On The Relationship Between Alzheimer's Disease And Non-verbal Listening Comprehension

Objective: Alzheimer's disease(AD)is the most common type of dementias,which mainly is the recent memory impairment and accompanied with other cognitive dysfunction.Mild cognitive impairment(MCI)is memory or other cognition impairment,but doesn't affect the ability of daily life and doesn't meet the diagnostic criteria of dementia.Most of MCI convert to AD,especially amnestic MCI(a-MCI).The earlier you can identify MCI,the earlier you can identify AD.Recent studies have shown that the central listening comprehension obstacle is one of the early signs of cognitive decline,and it can be used to monitor the progress of MCI to dementia.Based on these clinical and basic researches,AD or MCI patients indeed have difficulties about listening comprehension obstacle.But the previous research methods are mostly in verbal ways,rarely in non-verbal sound ways,such as animals sound,music etc.Non-verbal sound recognition is also an important part of the central listening comprehension.The foreign researches about non-verbal listening comprehension mostly use these methods such as categorizing and naming sound,recognizing tone and rhythm,judging melody pleasure,etc.These methods are mostly involving non-verbal semantic aspects and music aspects.Based on these,we set up a series of non-verbal listening comprehension tests.Through these tests,we are to investigate the relationship between AD and non-verbal listening comprehension,to analyze whether a-MCI and AD patients having non-verbal listening comprehension obstacle.Not only that,we are toobserve these specific performances of different stages of AD in these tests,and to analyze the diagnostic value of theses tests.Methods: 1.Choose the subjects from the patients with memory loss as the main complaint coming from Sichuan Provincial People 's Hospital from January to December 2016,the accompanying staffs and the nearby residents.According to the inclusion and exclusion criteria,these subjects are divided into a normal control group(NC),a a-MCI group,a mild AD group and a moderate AD group.2.Learning from the relevant information at home and abroad,we develop a series of central non-verbal listening comprehension tests,including categorizing according sound(referred to as sound categorized),judgment the emotion of melody(referred to as emotion judgment),judgment the rhythm of melody(referred to as rhythm judgment),naming according the sound(referred to as sound named).Among these tests,sound categorized and named involve the non-verbal semantic aspect while the emotion and rhythm judgment involve the music aspect.3.The subjects receive the sound categorized tests,the emotion judgment tests,the rhythm judgment tests,the sound named tests.4.The data of age,sex,culture and the scores of each group in each test are collected and recorded.Statistical analysis is performed by SPSS 20 software.Results: 1.There are no significantly statistical differences in age,sex and culture among the four groups(P>0.05),but there are statistical differences among the scores of four groups in the MMSE and MOCA(P<0.05).2.The scores of MMSE have a medium level or more positive correlation with the total scores,the sound categorized scores,the emotion judgment scores,the rhythm judgment scores,the sound named scores(rs>0.4,P <0.01),and so does MOCA(rs>0.4,P<0.01).Among these,the sound named and categorized tests are better than the emotion and rhythm judgment tests.3.The scores of four groups in these tests,normal control group >a-MCI group >mild AD group > moderate AD group,these differences among the four groups have statistically significant(P<0.05).When compared with each other,the sound named tests can identify a-MCI group and normal control group(P<0.008).The sound categorized,rhythm judgment and sound named tests can identify mild AD from normal control group and a-MCI group(P<0.008),but the emotion judgment tests can't do that(P>0.008).when compared moderate AD from normal control group and a-MCI group,all of the tests have statistically significant(P<0.008).But when compared moderate AD from mild AD,only the emotion judgment,rhythm judgment and sound named tests have statistically significant(P<0.008).4.In the discussion about the diagnostic value,a-MCI group can be diagnosed from normal group by the sound named tests(ROC=0.851,P<0.001).Mild AD can be diagnosed from normal group by the sound categorized tests,rhythm judgment tests and sound named tests,in which the sound categorized and named tests are better than the rhythm judgment tests(ROC=0.912,P<0.001;ROC=0.971,P<0.001;ROC=0.730,P=0.003).In the identification of mild AD from a-MCI,the sound categorized and named tests also have better diagnostic value than the rhythm judgment tests(ROC=0.836,P<0.001;ROC=0.858,P<0.001;ROC=0.719,P=0.004).The emotion judgment,the rhythm judgment and the sound named tests can monitor AD from the mild converting to the moderate,in which the sound named tests are better than the rhythm and emotion judgment tests(ROC=0.867,P<0.001;ROC=0.796,P<0.001;ROC=0.694,P=0.017).Conclusion: 1.AD and even a-MCI patients can appear non-verbal listening comprehension obstacle,which is aggravated with the degree of cognitive impairment increased.2.The ability of non-verbal listening comprehension in the non-verbal semantic aspect declines more obvious than the music aspect at the early period of AD.3.Non-verbal listening comprehension tests can be used to identify AD,even a-MCI,and they can be used to observe the progress of AD.In the non-verbal listening comprehension tests,these items which involving non-verbal semantic aspects are more valuable than that involving music aspects,especially the sound named tests.4.Non-verbal listening comprehension tests have a good prospect because they can partially exclude the interference of language and culture,especially suitable for AD patients with visual disturbance.