Browsing by Subject "Alzheimerin tauti"

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  • Kaski, Sanna (Helsingin yliopisto, 2017)
    Alzheimerin tautiin sairastunut yksityishenkilö lahjoitti laajan päiväkirja-aineistonsa Helsingin yliopistolle tutkimusta varten. Tämä tutkimus on yksi niistä, joilla Alzheimerin tautiin liittyviä kielellisiä muutoksia pyritään kyseisen päiväkirjatekstin kautta kartoittamaan. Tarkastelun kohteena on se, miten kirjoittaja viimeisten kymmenen kirjoitusvuoden aikana asennoituu tuntemiinsa henkilöihin. Tutkimuskysymyksiä on kaksi: 1) Muuttuuko muihin ihmisiin asennoituminen päiväkirjan loppua kohden? 2) Jos muutoksia on havaittavissa, minkälaisin kielellisin tavoin ne tulevat esiin? Aineistoa jäsennellään J.R. Martinin ja P.R.R. Whiten suhtautumisen teorian (Appraisal in English) pohjalta. Tähän tutkimukseen sovelletaan kahta asennoitumisen haaraan kuuluvaa alaluokitelmaa: tunteita sekä inhimillisen toiminnan arvottamista, joka jakautuu sosiaaliseen arvostukseen ja sosiaaliseen hyväksyttävyyteen. Vaikka kirjoittaja loppua kohden tuottaa vähemmän tekstiä, ilmaisee hän enemmän asennoitumistaan tuntemiinsa ihmisiin. Kirjoittajan oirekuvaan on viimeisinä kirjoitusvuosina potilasasiakirjamerkintöjen mukaan kuulunut estottomuuden lisääntyminen, joka kirjallisuudessa mainitaan muistisairauden etenemiseen liittyväksi persoonallisuuden muutokseksi. Estottomuus voi olla yhteydessä pidättyneisyyden vähenemiseen kirjoitustyylissä. Varhaisemmissa vuosissa kirjoittaja perustelee enemmän asennoitumisen ilmauksiaan. Loppua kohden esiintymissä, joihin liittyvät tunteet ja vähintään yksi kirjoittajan tuntema henkilö, tunnetilan ilmaisemisen selkeys, itsenäisyys ja jäsentyneisyys vähenevät. Samalla lisääntyy oman tunnetilan ilmaiseminen osana toiseen ihmiseen kohdistuvaa negatiivista asennoitumista siten, että sitä käytetään esimerkiksi lievittämään syytöstä. Viimeisimpinä vuosina kirjoittaja myös enenevässä määrin kuvailee, miltä puolison tunnetila ulospäin näyttää. Toisen ihmisen inhimillisen toiminnan arvottaminen on varhaisemmissa vuosissa usein tilanne-, asia- ja ominaisuuskohtaista. Kirjoittaja aikaisemmissa vuosissa myös pehmentää ja tuo arvottamiseen monitasoisuutta muun muassa litoteesin, metonymian, eksplisiittisen referoimisen ja ironian keinoin. Samoin kirjoittaja kuvailee arvottamiseen liittyviä asioita usein omasta näkökulmastaan siten, että painopiste ei ole siinä, mitä toinen ihminen tekee, vaan siinä, miten hän itse kyseiseen tekemiseen reagoi. Myöhäisemmissä vuosissa kirjoittaja siirtyy henkilön kokonaisvaltaisempaan arvottamiseen ja toteavampaan tyyliin. Muiden ihmisten arvottaminen ulkopuolisen tarkkailijan näkökulmasta myös lisääntyy. Toisaalta hän myöhäisemmissa vuosissa myös peilaa asioita enemmän itsensä kautta vertaamalla itseään arvottamisen kohteisiin. Tutkimus on kvalitatiivisin menetelmin tehty tapaustutkimus aiheesta, jota ei tiettävästi ole aiemmin tutkittu. Aineisto on rajattu eikä muutoksien syynä voida varmuudella pitää Alzheimerin tautia, sillä myös ikääntyminen ja muut olosuhteet ovat varmasti vaikuttaneet. Jatkotutkimusten aiheeksi jääkin saman aiheen tutkiminen suuremmalla aineistolla, koska se tarjoaa tietoa Alzheimerin taudin aiheuttamien kielellisten muutosten lisäksi myös sosiaalisissa ajatusprosesseissa tapahtuvista muutoksista. Tutkimustiedon kerryttäminen Alzheimerin taudin kielellisistä muutoksista on tärkeää, koska se auttaa diagnostisten työkalujen luomisessa. Muutosten ja niiden syiden tunteminen auttaa sairauden varhaisessa tunnistamisessa sekä niiden keinojen löytämisessä, joilla sairastuneen henkilön kommunikointikykyä voi tukea.
  • Vähä-Kouvola, Saana (Helsingfors universitet, 2011)
    Literature review: There is a need for new disease modifying therapies for Alzheimer disease. In order to develop these, animal models with better Alzheimer disease pathology are required. Old rat models like giving scopolamine or MK-801 or using aged rats don't have many of the characteristics of Alzheimer disease although they diminish cognitive functions in different models. Newer models like transgenic and Aβ-injected or -infused rats have much more analogy to the pathology of Alzheimer disease - at least when Aβ-pathophysiology is concerned. Taupathophysiology however doesn't occur in either of the models. On the other hand Aβ has a bigger role in the pathophysiology of Alzheimer disease so it's more important to have that in both models. These two models seem to be quite similar in modelling the disease. Injecting or infusing Aβ to the brain of the rat may be easier to conduct in practice than to create a transgenic rat line. However in transgenic rats Aβ-pathophysiology is developed intracellularly like in Alzheimer disease instead of giving aggregated Aβ outside of the brain. Still both of the models can be used as well to study new therapies especially affecting Aβ-pathophysiology. Experimental part: The purpose of the study was to validate elevated plus-maze (EPM) as a cognition model with a Trial1/Trial2-protocol (T1/T2) in mice. In this experiment a-five-minute-trial was used and thus different parameters related to cognition were measured. The memory of the mice was tried to be disrupted with time delay (1-18 d) between trials or with muscarinic receptor antagonist scopolamine (0.1-0.8 mg/kg i.p.) 30 minutes pre-T1. These experiments were conducted in C57BL/6J- and ICR:(CD-1)-mice. The only group in the time interval experiment that had a trend of forgetting was the 18 d group of ICR:(CD-1)-mice. Thus 21 d interval was also studied, but clear signs of forgetting couldn't be seen. Scopolamine didn't disrupt memory in ICR:(CD-1)-mice but in C57BL/6J-mice it did significantly with doses 0.2-0.8 mg/kg. Based on this 0.2 mg/kg was selected to be used in further studies in C57BL/6J-mice. In this model the nootropic effects of donepezile (0.3, 0.8 and 1.5 mg/kg s.c.), memantine (5.0 and 10.0 mg/kg s.c.) and an experimental 5-HT6-antagonist SB742457 (1.5 and 6.0 mg/kg s.c.) were studied. These compounds were allocated 40 minutes pre-T1 and scopolamine 30 minutes pre-T1. Memantine (5.0 mg/kg) clearly and donepezile (1.5 mg/kg) with a strong trend enhanced cognition disrupted by scopolamine. These results suggest that EPM can be used when testing nootropic effects.
  • Kokkonen, Tuomo (Helsingin yliopisto, 2023)
    Alzheimer’s disease (AD) weakens the concerned person’s ability to repair their own speech. AD has also been shown to affect the use of gestures during speech. This study looks at the actions of persons with AD during self-repair sequences in a group context. and examines the length of the repair sequences, the number of repair initiations and repairs and their distribution among the people taking part in the discussions. The study also investigates how people with AD use manual gestures during self-repair sequences. The connection between word-searching and gestures was also examined. The research method is based on the theoretical frameworks of conversation analysis, multimodal interaction analysis and repair sequence theory. The research material consisted of self-repair sequences and the manual gestures within those sequences recorded from group therapy sessions directed at people diagnosed with dementia. The participants of the study were six females with AD. The video recordings were analyzed using ELAN- computer program. The speech and gestural interaction of the participants was annotated in temporal synchronicity. ELAN was able to provide numeric data, but some of the data was calculated manually. Due to a lack of research on this study’s topic, it was necessary to develop the method to be used in the study. The research data comprises 183 self-repair sequences. 91,8 % of those consisted of a single turn. The mean length of the sequences was 6,2 seconds. Within the self-repair sequences, there were 496 self-initiations and 26 other-initiations. Within the self-repair sequences, 216 self-repairs and 22 other-repairs were detected. Word-search was the most common type of self-repair (37 %). Three out of six subjects produced 92,9 % of the repair-sequences. Half of the self-repair-sequences contained manual gestures. 177 gestures were observed. Three of the subjects produced 96,6% of all the gestures. Two of them produced gestures during 60 % of their repair sequences while producing 87% of all gestures. The subject producing third most gestures did so in about one third of her repair sequences. The most-used gesture type was rhythmic gesture (37,2%). Of all gestures 67,8% were produced during word-searches. The method made it possible to describe, at a general level, the gesture use of persons with AD during repair-sequences containing self-repair. According to the results, there is a lot of individual diversity in the phenomenon. However, the skewness and small number of participants in the study make this assumption uncertain. The results imply that persons with AD use gestures to support their speech. It is possible that more gestures occur during word-searches. Therefore, the use of gestures must be taken into consideration during speech repair. It can also be assumed that persons with moderate stage of AD are able to perceive the problematic parts in their own speech and are able to produce repairs if they are given enough time to process.
  • Pihlajapiha, Sanna-Mari (Helsingin yliopisto, 2019)
    Objective. Difficulties in naming are common already in the very early stages of Alzheimer's Disease, and the difficulties increase as the disease progresses. There are few studies of naming errors in confrontation naming tests by Finnish persons with Alzheimer's disease to date. The purpose of this study was to examine the naming errors and correction attempts produced in the Boston Naming Test (BNT) by Finnish speaking persons with mild and moderate Alzheimer's disease, and how those naming errors and correction attempts change both quantitatively and qualitatively as the disease progresses. Methods. Participants in this study were Finnish speaking persons with mild (n=20) and moderate (n=20) Alzheimer's disease, and healthy age-matched controls (n=30). Participants were given the Boston Naming Test in 1994–1997. Patients with probable Alzheimer's disease came from the Memory Research Unit of the Department of Neurology, Helsinki University Hospital. Control subjects were volunteers from the Helsinki Aging Brain Study which started in 1989, and the controls were chosen from various age groups (55, 60, 65, 70, 75, and 80 years) by random sampling. All the participants underwent complete neurological and neuropsychological examinations. Naming errors and correction attempts produced in the BNT were classified, and the scores were analyzed with the non-parametric Kruskal-Wallis one-way analysis of variance, as well as with chi-square test and Mann-Whitney U test for post hoc pairwise comparisons between groups. Results and conclusions. Compared to healthy age-matched controls, patients with Alzheimer's disease made more naming errors and naming attempts, the number of which increased distinctly as the severity of the disease progressed. Several kinds of semantic naming errors were the most common errors in all three study groups. Patients with Alzheimer's disease gave a particularly large number of descriptions of the target word, as well as unrelated answers. The results show that naming errors change both quantitatively and qualitatively in the course of Alzheimer's disease, and the changes continue as the disease progresses. These results are congruent with earlier studies. A new observation in this study was that during confrontation naming the quantity of empty speech which was included in the correction attempts was almost twice as high in the group with mild Alzheimer's disease compared to healthy controls. Future research is needed to detect at which point of the trajectory of Alzheimer's disease the aforementioned changes are observable.
  • Kangas-Lumme, Jertta (Helsingin yliopisto, 2014)
    There is very little research on the effects of memory illnesses such as Alzheimer's disease (AD) on the linguistic performance of congenitally deaf sign language users. With spoken language users the effects of AD are often first found in semantics and pragmatics. Deteriorated naming skills are often an early symptom of AD. As the disease progresses the linguistic skills are widely affected and communicating becomes difficult. When studying sign language users results have shown that people with AD have corresponding difficulties of comprehending and producing signed language as spoken language users with Dementia have with spoken language. The aim of this research was to study how two Finnish Sign Language (FSL) users with AD perform in object and action naming tests. The participants were evaluated with the Boston Naming Test (BNT) and the Action Naming Test (ANT) in two consecutive years. Of each performance, the researcher recorded the total score, the number of immediate answers, the time the participant spent on the task and how the answers were given. An analysis of naming errors was made. As a result it was noted that both object and action naming skills of the participants deteriorated as Dementia progressed. Action naming skill were less affected than object naming skill. The participants made more errors and gave less immediate responses in the BNT than in the ANT. Both the signed responses and the method of answering varied with the FSL users with a memory illness: the answers were given either in varying signs, by speaking only or by both speaking and signing simultaneously, or with signs created spontaneously in test situation. Most of the errors were Other errors, especially "I don't know" –answers in both tests. As a result of this study it is clear that there is a need for assessment tests which have been translated into sign language, since the existing naming tests are not necessarily suitable for testing signed language users without a culturally-sensitive translation. This study is the first longitudinal study in Finland focusing on evaluating Finnish Sign Language users with Dementia and the changes in their linguistic skills. It is also one of the first studies internationally on the linguistic changes of sign language users with a memory illness.
  • Järvinen, Tanja (Helsingfors universitet, 2011)
    Tutkimuksessa tarkastellaan dementiakuolleisuutta sekä siihen vaikuttavia sosiaalisia tekijöitä. Dementia on oireyhtymä, jota pääasiassa sairastavat yli 65-vuotiaat henkilöt. Väestön ikääntyessä sekä elinajanodotteen kasvaessa on odotettavissa, että dementiaa sairastavien määrä tulee kasvamaan merkittävästi lähivuosina. On viitteitä siitä, että dementiaan sairastumisen riskiin vaikuttavat erilaiset sosiaaliset tekijät kuten koulutus, mutta varsinkin dementiakuolleisuudesta tiedetään vähän. Tutkielman aineistona käytettiin Tilastokeskuksen muodostamaa Elinolot ja kuolinsyyt -rekisteriaineistoa, joka koostuu väestölaskentatiedoista sekä työssäkäyntitilaston pitkittäisaineistosta, johon on liitetty kuolinsyytietoja. Peruskuolinsyyn lisäksi aineistossa oli tieto korkeintaan kolmesta myötävaikuttavasta syystä. Dementiakuolleisuuden on esitetty aliarvioituvan peruskuolinsyynä, joten dementiakuolleisuuden määrittelyssä käytettiin myös tietoa myötävaikuttavista syistä. Rajausten jälkeen aineistossa on 317 944 henkilöä, joista 128 562 on miehiä ja 189 382 naisia. Pääanalyysimenetelmänä on käytetty elinaikamalleihin kuuluvaa Coxin regressiota. Dementiakuolleisuudessa oli vaihtelua kaikkien tutkimuksessa käytettyjen muuttujien, eli koulutuksen, sosiaaliluokan, tulojen, siviilisäädyn sekä perhemuodon mukaan. Koulutuksen vaikutus välittyi osin ammattiasemaan perustuvan sosiaaliluokan kautta. Suurimpia ryhmien väliset suhteelliset erot olivat nuoremmissa ikäryhmissä sekä sosiaaliluokan ja siviilisäädyn kohdalla. Eronneilla ja naimattomilla oli selvästi kohonnut riski suhteessa naimisissa oleviin. Myös työntekijöillä havaittiin kohonnut riski suhteessa ylempiin toimihenkilöihin. Siviilisääty vaikutti olevan merkittävä tekijä siinä mielessä, että koulutuksen, sosiaaliluokan ja tulojen tuominen malliin ei juuri vaikuttanut siviilisäätyryhmien välillä havaittuun vaihteluun. Dementiakuolleisuudessa havaitut ryhmien väliset suhteelliset erot olivat hieman pienempiä kuin muissa syissä, mutta kuitenkin hyvin samaa suuruusluokkaa. Tulosten perusteella on identifioitavissa tekijöitä, jotka suojaavat dementialta. Erityisesti avioliitto, korkea koulutus sekä ylemmät toimihenkilöammatit vaikuttavat olevan dementialta suojaavia tekijöitä. Avioliiton suojaavan vaikutuksen voidaan tulkita liittyvän sosiaaliseen kanssakäymiseen sekä puolison tukeen ja läsnäoloon. Korkea koulutus sekä toimihenkilöammatit indikoivat virikkeellisempää työympäristöä, mutta niiden vaikutus voi myös kulkea ylipäänsä aktiivisemman ja kognitiivisesti virikkeellisemmän elämäntavan kautta. Aktiivisen ja kognitiivisesti haastavan elämäntavan on esitetty suojaavan dementiaan sairastumiselta. Tuloksia voidaan tulkita elämänkaarinäkökulman kautta. Jo nuoruudessa vaikuttavilla tekijöillä, kuten koulutuksella, on vaikutusta. Tämän lisäksi elämänkaaren aikana myöhemmin vaikuttavat tekijät ovat merkityksellisiä. Näiden tekijöiden on esitetty vaikuttavan aivojen hermoverkostoon ja -yhteyksiin ja luovan kognitiivista reserviä, minkä on esitetty ehkäisevän tai lykkäävän dementiaan sairastumista.
  • Hyytiä, Tuuli (Helsingin yliopisto, 2019)
    Aims. The number of persons suffering from Alzheimer’s disease is increasing significantly during the decades to come. Finding means to identify the disease as early as possible is very important. Research concerning changes in written language may produce relevant information since Alzheimer’s disease weakens the ability to write already in the early stage of the disease. Changes in the amount of information conveyed have been researched internationally by measuring idea density rates. It has been found that the idea density of the persons suffering from Alzheimer’s disease is lower than that of healthy adults and that the disease accelerates the decline of idea density. Low idea density in early life is a strong predictor of Alzheimer’s disease. This study aims to determine the possible changes in the idea density of diary entries written by a person suffering from Alzheimer’s disease. Methods. The data of this study consist of diary entries written by a person who developed Alzheimer’s disease later in her life. The entries were written between 1967–2012. This study considers entries written in June of 1986, 1991, 1996, 2001, 2006, 2008, 2010, and 2012. A method for measuring idea density of Finnish written language was developed on the basis of the methods used for English and Czech. The method is manual, and it is described in detail. Idea density for each year was measured using the method. Idea density is the number of expressed propositions divided by the number of the words. Correlation between idea density and years was measured with Spearman’s rank correlation coefficient. Results and conclusions. Idea density was nearly stable until the year 2010. In 2012, idea density was lower than in other years but the change was not statistically significant. If data would have been available after the year 2012, when Alzheimer’s disease had advanced to its moderate stage, a greater change in the idea density of the diary entries might have emerged. The method developed for the study can be tested, re-developed and used in other studies regarding idea density of any text written in Finnish.
  • Rinta-Kanto, Jenni (Helsingfors universitet, 2016)
    Background: Development of cognitive abilities involves both environmental and genetic factors. Childhood socioeconomic status (SES) associates with cognitive abilities later in life; however there is only little research on the interaction of SES and genes on cognitive ability. Specific genomic loci associating with cognitive abilities are scarce and potential candidates might be genetic variants linked with Alzheimer's disease such as APOE ε4 isomorph and rs405509 located in the APOE promoter region. I studied how childhood SES and APOE ε4 and rs405509 and their interactions associate with cognitive abilities in late adulthood in the Helsinki Birth Cohort Study (HBCS) sample. Methods: The participants of this study consisted of 607 men belonging to the HBCS who were born in Helsinki, Finland between 1934 and 1944. They participated in the test for general cognitive abilities at the average age of 68, and who were successfully genotyped. Associations and interactions of childhood SES, APOE and rs405509 on cognitive ability were studied. Results and conclusions: Lower childhood SES associated with lower verbal subscale score and total score. APOE ε4 was not independently associated with cognitive abilities. The number of G-alleles in rs405509 associated with lower verbal subscale score and total score when adjusted for age, but no longer after adjusting for adulthood SES. Interactions of rs405509 and childhood SES were not associated with cognitive ability. Socioeconomically less advantaged childhood environment has long-term consequences on cognitive abilities, and the effects last until late adulthood. The study suggests that rs405509 G-allele might have an independent effect on cognitive ability before the outset of Alzheimer's disease, but the results require further replication with larger sample size.
  • Byckling, Mari (Helsingin yliopisto, 2019)
    Muistisairauksien määrä niin Suomessa kuin maailmanlaajuisesti kasvaa kiihtyvällä tahdilla, sillä eliniänodote kasvaa eikä parantavaa hoitoa vielä ole kehitetty. Ennaltaehkäisyn lisäksi on tärkeää kehittää kuntoutuskeinoja, jotka ylläpitävät kognitiivisia kykyjä ja mahdollistavat hyvän elämän-laadun muistisairailla henkilöillä. Kognitiivinen stimulaatioterapia (CST) on tutkimustietoon perus-tuva, mahdollisesti vaikuttava ja kustannustehokas hoitomuoto muistisairauksiin. Tässä tutkimuk-sessa tutkitaan minkälaisia muutoksia osallistuminen CST-ryhmään aiheuttaa suomalaisten muisti-sairaiden henkilöiden kielellisiin taitoihin ja elämänlaatuun. Tämä tutkimus tehtiin käyttämällä yhden ryhmän ennen-jälkeen -tutkimusasetelmaa. Tutkimuk-seen osallistui yhteensä 12 muistisairasta henkilöä, joista yhdeksän tulokset otettiin mukaan ana-lyysiin. Osallistujien kognitiivisia ja kielellisiä kykyjä sekä elämänlaatua arviointiin ennen ja jälkeen kuntoutukseen osallistumisen. Kuntoutusta järjestettiin kolmessa eri paikassa noudattaen Aguirren ym. (2011) luoman CST-manuaalin ohjeita. Tutkimuksessa käytettiin seuraavia testejä kognitiivis-ten, kielellisten ja elämänlaadun muutosten arvioimiseen: Bostonin diagnostinen afasiatesti (BDAT), Bostonin nimentätesti, CERAD-testi, Token-testi sekä Quality of Life – Alzheimer’s Di-sease -testi. Tulosten analyysi tehtiin IBM SSPS Statistics 24 -ohjelmaa käyttäen ja nonparametris-ta Wilcoxonin testiä käytetiin vertailemaan ryhmien keskiarvoisia tuloksia ennen ja jälkeen kuntou-tuksen. Erot ryhmän keskiarvoisissa tuloksissa ennen ja jälkeen kuntoutuksen olivat pieniä. Tilastollisesti merkitseviä eroja ei löydetty yhdessäkään arvioiduista ominaisuuksista. Yksittäisten tutkittavien kohdalla nähtiin kuitenkin positiivisia muutoksia osassa testeistä. Puheen ymmärtämistä ja puheil-maisua arvioineissa osatesteissä nähtiin heikko positiivinen muutos ryhmien keskiarvoissa, mutta tulos ei ollut tilastollisesti merkitsevä. Tämän tutkimuksen perusteella ei voida tehdä yleistyksiä tämän kuntoutusmuodon soveltuvuudesta suomalaisten muistisairaiden henkilöiden kuntoutuk-seen. Suurimmalla osalla tutkittavista näiden osatestien tulos parani. Saadut tulokset olivat osittain positiivisia ainakin yksittäisten tutkittavien kohdalla, joten laajempi tutkimus tästä aiheesta olisi tarpeellista.
  • Jauhiainen, Katja (Helsingin yliopisto, 2017)
    Alzheimer’s disease is the most common type of dementia in Finland. Very early on, it can impair the linguistic and cognitive abilities. Dysgraphia, the disorder in writing, is a common symptom in Alzheimer’s disease. There has been little research on dysgraphia and texts written by people suffering from dementia in Finland, and presumably no research has been done previously regarding the cohesion of written texts. The aim of this study is to examine, if the number of cohesive devices, the linguistic devices creating cohesion, changes in the diary entries written by a person with Alzheimer’s disease as the disease progresses, and if it is possible to see the outset of the possible changes. The data of this study were the diaries written by a person with Alzheimer’s disease during the years 1967–2012. The diary entries written in June 1986, 1991, 1996, 2001, 2006, 2008, 2010 and 2012 were selected for the analysis. The number of grammatical and lexical cohesive devices as well as the number of exophoric pronouns or the pronouns referring to the extralinguistic situation in the diary entries was counted. The IBM SPSS Statistics 24 program was used for the quantitative analysis of the data. A scatter diagram of the number of the cohesive devices was created, and a line of best fit was added to the diagram in order to demonstrate the temporal changes. The correlation between the number of cohesive devices and years was measured with Spearman’s rho or Spearman’s rank correlation coefficient. The study showed that the number of all grammatical cohesive devices, exophora, anaphora or the expression that depends upon an antecedent expression and reiteration seemed to have increased as time passed by. The number of all lexical cohesive devices, collocation or the semantically related words and ellipsis or the omission of words seemed to have decreased. The results were not statistically significant. The changes seemed to have begun year 2001, but the result was inaccurate, because the data varied considerably. The writing style of the person with Alzheimer’s disease resembled note taking, which influenced the occurrence of cohesive devices. Examining the spontaneously written texts by people with dementia provides more knowledge of the effects of dementia on the linguistic abilities and the possibility to develop diagnostic tools for the speech-language pathologists.
  • Laakso, Meri (Helsingfors universitet, 2015)
    Objectives. The ability to detect and to resolve disturbances of interaction is an important conversational skill. In the field of conversation analytic research, the practices of repairing troubles of speaking, hearing and understanding are known as repair sequences. Individuals with Alzheimer's disease have growing difficulties to recognize their own linguistic deficiencies and to understand the interactional intensions of others. As the disease progresses, the repair initiations made by the demented individuals decrease, and their healthy conversation partners are given a central role in maintaining mutual understanding. Using conversation analytic approach, this qualitative research describes repair sequences caused by different kinds of conversational trouble sources in institutional group conversations between individuals with middle to late-stage Alzheimer's disease and their healthy conversation partners. Methods. The database of the study consisted of videotaped meetings of a conversation group held by speech and language pathology students in a day care center for demented people. Two individuals with middle to late-stage Alzheimer's disease and 15 healthy conversation partners took part in the study. Four group meetings from both demented individuals were chosen for the analysis. The conversation sessions were transcribed using conversation analytic conventions. Repair initiators and the attempts to repair following them were used to identify the repair sequences caused by the troubles of speaking of the individuals with Alzheimer's disease. Every repair sequence was then analysed according to the type of the trouble source and the progression of the repair. Results and conclusions. Three main trouble source categories were recognised from the conversations. The most common trouble type resulting in repair was problems of the content of the language while problems of the form and the use of language were less prominent. The lexico-semantic troubles of the content of the language, such as word finding problems, were dealt with collaborative but often ineffective repair efforts. Repair sequences dealing with troubles of the form of the language (e.g. phonological paraphasias and morpho-syntactic distortions) were quick and successful self-initiated self-repairs, whereas the responsibility of clarifying wider troubles with language use was left solely to the healthy conversation partners. The results of this study emphasise healthy conversation partners' active role in maintaining mutual understanding while conversing with individuals with Alzheimer's disease.
  • Saranpää, Aino (Helsingin yliopisto, 2020)
    Objectives. The semantic fluency task is a widely used clinical tool for diagnosing Alzheimer’s disease (AD). Performance differences between semantic categories such as animals versus tools have been widely studied, but in the present study, we examine finer-grained performance within the animal-category. We compare amnestic Mild Cognitive Impairment (aMCI) and very early AD patients with healthy controls to investigate whether the groups move in semantic space differently and examine whether the patient groups exhibit decline in discrimination of semantically similar objects, which is putatively a very early sign of AD. Methods. In the semantic fluency task, participants (42 healthy, 24 aMCI, 18 AD) named as many animals as they could within a minute. We condensed the semantic space using a dimensionality reduction algorithm (t-SNE) on the word2vec vector-model. Sub-categories were formed of the t-SNE result based on visual inspection. Moving in semantic space was estimated with the number of words, sub-categories, and switches and returns to sub-categories. Multinomial logistic regression models were used to predict the diagnostic group with these independent variables. Results and conclusions. We discovered eight meaningful sub-categories inside the animal-category and found differences between groups in how they utilised the semantic space. Our results did not provide direct support for decline in processing semantically similar objects in prodromal AD. In classifying the groups, only returning to sub-category provided additional information on top of the number of words produced. Our findings provide new perspectives on navigation in sub-category level fine-grained semantic space in the context of prodromal AD.
  • Pitkälä, K; Savikko, N; Pöysti, M; Laakkonen, M-L; Kautiainen, H; Strandberg, T; Tilvis, R (Kela, 2013)
    Tutkimuksen tavoitteena oli selvittää satunnaistetulla,kontrolloidulla asetelmalla liikunnallisen harjoittelun vaikuttavuutta kotona asuvien, Alzheimerin tautia sairastavien toimintakyvyn eri ulottuvuuksiin, heidän omaishoitajiensa elämänlaatuun sekä molempien palveluiden käyttöön ja niiden kustannuksiin vuosina 2008–2011. Tutkimukseen osallistui 210 pariskuntaa, joista toinen puoliso oli muistisairaan omaishoitaja. Pariskunnat randomoitiin kolmeen yhtä suureen ryhmään: 1) ryhmäkuntoutusryhmään (liikuntaharjoittelua neljä tuntia kaksi kertaa viikossa päiväkeskuksessa vuoden ajan), 2) kotikuntoutusryhmään (tunti kaksi kertaa viikossa kotona vuoden ajan fysioterapeutin ohjauksessa) ja 3) vertailuryhmään (tavallinen kunnallinen hoito). Tutkimushoitajan haastattelut tehtiin lähtötilanteessa sekä 3:n, 6:n, 12:n ja 24 kuukauden kohdalla. Päätulosmuuttujat olivat muistisairaan ihmisen toimintakyky (mitattiin FIM-toimintakykymittarilla) sekä liikuntakyky (mitattiin Guralnikin liikuntakyky- ja tasapainotesteillä = SPPB). Kotona annetulla räätälöidyllä kuntoutuksella voidaan hidastaa muistisairaiden fyysisen toimintakyvyn (mitattu FIM-mittarilla) heikkenemistä merkitsevästi. Liikuntatesteissä (SPPB) ei ollut eroja ryhmien välillä. Myös kognitiossa näkyi myönteinen muutos toiminnanohjauksen osalta kellotestillä mitattuna kotikuntoutusryhmässä. Ryhmäkuntoutuksessa palveluiden kokonaiskustannusten säästöt olivat merkittävät, joskaan muutokset toimintakyvyssä eivät saavuttaneet tilastollista merkitsevyyttä. Omaisten elämänlaadussa tai muissa mittareissa ei ollut merkitseviä eroja interventioryhmien ja vertailuryhmien välillä. Kaatumiset vähenivät molemmissa interventioryhmissä. Kuolemanvaara näytti pienentyneen kotikuntoutusryhmässä. Tutkimuksessa luotiin kuntoutusmalli, joka parantaa Alzheimerin tautia sairastavien toimintakykyä lisäämättä sosiaali- ja terveyspalveluiden kokonaiskustannuksia.
  • Savolainen, Mari (Helsingfors universitet, 2011)
    Neuronal nicotinic receptors are widely expressed throughout the brain and they facilitate fast synaptic neurotransmission. They are also involved in regulation of the release of other neurotransmitters like GABA, dopamine and glutamate. The most common subtypes are alfa4beta2 and alfa7 subunits containing receptors. Neuronal nicotinic receptors are involved in nicotine addiction but also in many neurological diseases like Alzheimer's disease, schizophrenia, depression and attention deficit/hyperactivity disorder. The cholinergic stimulation enhances cognition in vivo and in human. There is not many drugs on the market that act via nicotinic receptors but many drug companies have new nicotinic agonists and antagonist under clinical research. When using nicotinic receptor agonists the problem is desensitization, which occurs in alfa7 nicotinic receptor rapidly after agonist exposure. When desensitized the receptor no longer responds to agonist even if it is there available to bind to receptor. The desensitization may lead to tachyphylaxis and losing of the clinical effect. Conventional agonists, like acetylcholine, bind to the binding site located in the extracellular part on nicotinic receptor subunit. There is also some other binding sites, which are called allosteric binding sites. It has been found out, that allosterically binding ligands, for example PNU-120596, can cause potentiation of agonist induced responses and/or prevent desensitization of receptor. These kinds of agents are called positive allosteric modulators and they are considered to be a new therapeutic option for CNS diseases containing cholinergic deficits. The mechanism of action of positive allosteric modulators is so far unclear. The purpose of my study was to characterize positive allosteric modulators on alfa7 nicotinic receptor. It had been found out earlier in the Millar laboratory that mutation L247T in the transmembrane domain converts positive allosteric modulators to agonists. The aim was to use site-directed mutagenesis to generate mutation in the agonist-binding site of alfa7 and alfa7L247T receptors and see how it effects on the ability of PNU-120596 to act as an agonist on the receptor. Second aim was to generate a mutation in the transmembrane part of the receptor to an assumed binding site of allosteric potentiators' and test how it effects on allosteric potentiator's ability to act as an agonist on the alfa7L247T. Mutated receptors were expressed on oocytes by microinjeting the mRNA into oocyte. The function of receptors was studied with electrophysiology using two-electrode voltageclamp technique. All the mutations were successfully inserted in nicotinic receptor alfa7 and alfa7L247T. Mutation in orthosteric agonist binding site had a very profound effect on wild type alfa7 receptor; it had an effect on either acetylcholine binding or receptor gating. It was not possible to record any proper responses neither with acetylcholine nor with PNU-120596. In the double-mutated receptor alfa7W149M/L247T the W149M mutation had a much greater effect on dose-response curves than it had on PNU-120596 curves compared with alfa7L247T. The transmembrane domain mutation M253L did not have much effect on PNU-120596's ability to act as an agonist to alfa7L247T and either it did not effect on acetylcholine dose-response curves. The results from this study support the previous results that the binding site of positive allosteric modulators is located in the transmembrane domain of the alfa7 receptor. The results are little controversial with the M253L mutation but because the L247T mutation has so profound effect on the function on alfa7 receptor it might be that it masks the other mutation which is located quite close to it. On the other hand it might be so that the amino acid M253 has only effect on the receptor's ability to be potentiated not the allosteric binding.
  • Alenius, Minna (Helsingfors universitet, 2017)
    Objectives – Ageing is progressing worldwide. Cognitive decline and dementia are highly associated with age and have significant economic impacts. Alzheimer's disease (AD) is the major cause of dementia. In Finland the 'baby boomer' generation (born 1945-1949) shall already during the 2020s increase the amount of the very old substantially. The CERAD (The Consortium to Establish a Registry for Alzheimer's Disease) neuropsychological battery (nb) is used as an evaluation tool for dementia. In Finland, CERAD-nb was introduced in 1999 and has been used in primary health care as a screening instrument to detect memory deficits. The continuum would benefit of updated clinical dementia/MCI assessment tools, norms and methodologies for the larger scale cognitive screening as the amount of the very old is soon growing remarkably. The main focus of this study is the overall performance of general population on selected CERAD-nb variables and how it fits to previously established Finnish cut-off scores. Materials and Methods – The study data is derived from the Finnish nationwide Health 2011 health examination survey (Health 2011), which was carried out in 2011. The study population consisted of a sample (n=4544) of Finnish subjects aged from 30 to 100 years belonging to either the lowest, middle or highest education class. Because of health-related factors possibly affecting cognitive performance, medical exclusion criteria were used and due to the high prevalence of dementia at older age, a cognitive status-screening test was used for subjects aged 55 and over. The final sample size was 4174 subjects. A weighted variable was used and thus the statistical analyses (weighted n=3389) prepared are estimations of population quantities. The sample underwent a CERAD-nb investigation for variables Verbal Fluency Animal Category (VFA), Word List Memory (WLM), Word List Recall (WLR) and Word List Savings (WLS) as a part of a wider Health 2011 examination procedure. Results – The total effect size of demographic variables was largest and clearest in WLM (30%) and WLR (27%) and the independent effect size of age (11% in both) was noticeable, as well. The results showed a continuous downward slope by advancing age steps: in the age groups 30-54 years, 55-64 years, 65-74 years and ≥75 years in WLM, in age groups 30-49, 50-54 years, 55-64 years, 65-74 years and ≥75 years in WLR, in age groups 30-49 years, 50-69 years, 70-74 years and ≥75 years in VFA, and finally the mildest effect in WLS in the group ≥55 with only age groups of 55-74 years and ≥75 years showing a decline. Education had the largest independent effect (5%) in VFA and WLM. The highest education class differed (p < .001) from other education classes for all variables. Gender had only a mild effect, largest in WLM (3%) and women mainly performing better. In total 25% (854 subjects) fell below the previously established cut-off scores. To the group <55 years belonged 26% (221 subjects) of those and 74% (633 subjects) to the group ≥75, of which 59% were in the lowest education class, 52% men and 32% were 75 years and over. Conclusions – Significant differences in performance between the age and education groups and minor differences between genders are found. Proposals for new normative scores for VFA, WLM, WLR and WLS are presented in Appendices. Indications of differences in the education-age-gender synergetic effect are found in affected variables for performance falling below the previously established cut-off scores. Most importantly, a clear indication for need of an update of the national normative and cut-off scores of the whole CERAD-nb for the age 55 is found.
  • Laakso, Milja (Helsingfors universitet, 2016)
    Objectives. Studies have shown that word finding difficulties form a significant trouble source in speech of individuals with moderate Alzheimer's disease (AD). However systematic research has focused typically in naming tests even though managing in test situations does not reveal how word finding difficulties really affect in conversational interaction. Analysis of conversation have shown that continuing word finding difficulties complicates person's possibilities to participate in an interaction. The aim of this study is to report what kind of word searches appear in a conversational interaction of individuals with moderate AD. Using conversation analytic approach this study focuses on what kind of traits typically appear in word searches and how speakers deal with word searches. Methods. Participants of this study were four individuals with moderate AD who participated in a conversation group. Database was formed from two filmed appointments and the total duration was 70 minutes 16 seconds. Conversation group appointments were held by two speech and language therapist students and their instructor. Appointments were transcribed and word searches were identified by using verbal and nonverbal traits that indicates word search. Using conversation analytic approach word searches were analyzed and each indicating trait was classified. Results and conclusions. Nearly three thirds of all word searches found in this data were solved successfully. Approximately half of them were solved by the speaker with AD himself and a bit less than fifth of word searches were solved in co-operation with the communication partner. However solution was not always completing target word but reformulating the trouble source or elaboration made by the communication partner. Around fourth of word searches were left unsolved and persons with AD had great difficulties to handle the trouble source. This study has given knowledge about conversational interaction of individuals with moderate AD and results highlights the significance of conversation partner in maintaining a conversation.
  • Kesti, Tiia (Helsingin yliopisto, 2018)
    Tässä tutkielmassa tarkastelen katkonaisesti kirjoitettuja saneita Alzheimerin tautiin sairastuneen henkilön päiväkirjateksteissä. Tutkimuksen kohteena ovat moneen osaan katkenneet sanat, kuten aurin gon kukat. Tarkastelen katkonaisia saneita kolmen tutkimuskysymyksen kautta: Yleistyvätkö katkonaisesti kirjoitetut saneet ajan ja sairauden edetessä? Millaisissa saneissa katkonaisuutta esiintyy? Missä saneen kohdissa katkoja tarkalleen ottaen esiintyy? Katkonaisten saneiden ominaisuuksia selvitän leksikon, morfologian ja fonologian näkökulmista. Katkojen tarkkoja paikkoja puolestaan tarkastelen morfeemien ja tavujen rajojen sekä katkoja edeltävien grafeemien kautta. Tutkielman aineisto on peräisin 1930-luvulla syntyneen kirjoittajan päiväkirjateksteistä. Päiväkirjat on kirjoitettu käsin perinteisiin muistikirjoihin, ja tekstejä on olemassa runsaasti vuosilta 1968–2012. Tekstit on litteroitu digitaaliseen muotoon mahdollisimman tarkasti alkuperäisten tekstien pohjalta. Tutkielmassa käyttämäni aineisto koostuu kahdeksan kesäkuun päiväkirjamerkinnöistä vuosien 1986 ja 2012 välillä. Näissä merkinnöissä on yhteensä yli 4500 sanetta. Aineistossani esiintyy yhteensä 291 katkonaisesti kirjoitettua sanetta. Ne puolestaan edustavat 232 eri lekseemiä, eli katkonaisuus liittyy sanastoon varsin laaja-alaisesti. Tulokseni osoittavat, että katkonaiset saneet yleistyvät ajan ja sairauden edetessä. Aineistoni ensimmäisessä tarkastelupisteessä vuonna 1986 katkonaisia saneita on vain 2 %, kun taas aineistoni viimeisessä tarkastelupisteessä vuonna 2012 niitä on jopa 24 %. Huomattavinta katkonaisten saneiden yleistyminen on vuosina 2010 ja 2012, mikä kertonee nopeasti lisääntyneistä kielen ja kognition ongelmista. Olen tarkastellut katkonaisten saneiden ominaisuuksia vertaamalla niitä samasta päiväkirja-aineistosta kokoamaani vertailuotokseen. Aineistot ovat pitkälti samankaltaisia: substantiivit ovat yleisin sanaluokka, ja taivutuksessa yleisimpiä muotoja ovat nominien nominatiivimuodot ja verbien finiittimuodot. Aineistojen välillä on kuitenkin joitain huomattavia eroavaisuuksia: Katkonaisissa saneissa substantiivien ja kompleksisten sanojen osuus on selvästi vertailuotosta suurempi. Lisäksi katkonaisuutta esiintyy enemmän pidemmissä kuin lyhyemmissä saneissa vertailuotoksen saneisiin verrattuna. Mahdollisina katkonaisuuden kannalta tyypillisinä taivutusmuotoina katkonaisista saneista erottuvat substantiivien monikon partitiivimuodot, adjektiivien yksikön genetiivi- ja partitiivimuodot sekä verbien infinitiivimuodot. Täten ilmiön voi tulkita liittyvän monitavuisuuteen ja morfologiseen kompleksisuuteen. Katkot sijoittuvat tavallisimmin tavujen rajalle tai tavun ensimmäisen grafeemin jälkeen. Katkojen sijainnin suhteen on havaittavissa mielenkiintoinen tendenssi: lyhyemmissä saneissa katkojen paikkojen variaatiota on enemmän, ja mitä pidempiin saneisiin siirrytään, sitä vähemmän esiintyy variaatiota. Myös morfeemien rajoille sijoittuvat katkot ovat melko tavallisia. Vaikka katkonaisuutta esiintyy sanastossa laajasti, aineistossa usein esiintyvistä lekseemeistä käy ilmi, että näissä lekseemeissä katkot sijoittuvat lähes poikkeuksetta samaan kohtaan taivutuksesta riippumatta. Sanojen katkeaminen ei siis ole sattumanvaraista. Tutkielmani tarjoaa erilaisine näkökulmineen suuntaviivoja mahdollisen jatkotutkimuksen tekoon. Alzheimerin taudin ja kielen suhteen tutkiminen on arvokasta työtä, sillä tässä sairaudessa varhainen taudinmääritys on ensiarvoisen tärkeää. Mikäli laajempi jatkotutkimus osoittaisi sairauden ja sanarakenteen muutosten yhteyden kiistattomasti, siitä saisi suuren avun nykyisten tutkimusmenetelmien rinnalle varhaisen taudinmäärityksen tekoon.
  • Sorvari, Salla (Helsingfors universitet, 2013)
    Alzheimer's disease is a neurodegenerative brain disease and it is the leading cause of dementia worldwide. However, there are not any medical treatments available to slow down or cure the disease. The typical microscopic changes in Alzheimer patients' brain are extracellular amyloid deposits and intracellular neurofibrillary tangles. Serine/threonine kinases are protein kinases that take part in the regulation of cellular functions. At least protein kinase C (PKC), glycogen synthase kinase 3 (GSK-3), cyclin-dependent kinase 5 (CDK5) and Ca2+/calmodulin-dependent protein kinase II (CaMKII) are involved in the pathogenesis of Alzheimer's disease. There are currently molecules in development that either activate or inhibit these protein kinases in order to stop the progression of the disease. PKC is an interesting kinase considering this project. It has been shown that PKC activation prevents the formation of amyloid deposits and protects neurons from premature death. This could slow down or prevent the progression of the disease. The purpose of this study was to investigate the effects of dialkyl 5-(hydroxy-methyl)isophthalates (HMI-1a3 and HMI-1b11) on SH-SY5Y-neuroblastoma cell proliferation and morphology with live cell imaging and to Alzheimer's disease-related Wnt, ERK1/2 and PKC signaling pathways with Western blotting. The main purpose was to evaluate the potential of the compounds for further in vitro and in vivo experiments. According to the results of this study both isophthalates, HMI-1a3 and HMI-1b11, had good binding affinities to PKCα and PKCδ. Both of them caused a dramatic increase in ERK1/2 phosphorylation which may be due to PKC activation and may thus suggest a PKC-dependent mechanism of action. However, the possible PKC activation did not cause downregulation of the PKC-isoforms α, β and δ. In addition, both HMI-1a3 and HMI-1b11 inhibited SH-SY5Y cell proliferation. HMI-1a3 was cytotoxic at 20 µM, while HMI-1b11 did not cause any cell death. Both compounds also induced neurite outgrowth. In addition, HMI-1a3 increased the amount of β-catenin. That could indicate the activation of Wnt-signaling, which is inhibited in Alzheimer's disease. Both of the compounds have potential for further studies because of the good binding to PKC and the beneficial effects on neurite outgrowth and Wnt signaling.
  • Kirvesmäki, Nelli (Helsingin yliopisto, 2019)
    Tässä tutkielmassa tarkastellaan Alzheimerin tautiin sairastuneen henkilön päiväkirjatekstien syntaktisia muutoksia ja pyritään tavoittamaan Alzheimerin taudin vaikutuksia kirjoitettuun kieleen. Tekstejä tarkastellaan kognitiivisen kielentutkimuksen teoreettisessa viitekehyksessä skeemojen ja skemaattisuuden näkökulmasta; aineistosta pyritään havainnoimaan, kuinka konstruointi ja asiaintilojen kuvaus muuttuvat aikojen saatossa – mahdollisesti Alzheimerin taudin seurauksena. Tarkasteltavia (rakenne)skeemoja ovat syntaktiset lausetyypit: analyysissa tarkastellaan lausetyyppien jakaumaa ja siinä tapahtuvia muutoksia sekä transitiivilauseiden erilaisten rakenteiden variaatiota. Tekstien skemaattisuutta arvioidaan transitiivilauseiden lausekkeiden määrän ja funktioiden sekä substantiivilausekkeiden sisältämien määritteiden kautta. Skemaattisuuden analysoinnin lähtökohtina ovat seuraavat periaatteet: 1) mitä useampi lauseke, sitä spesifimpi kuvaus, 2) adverbiaalillinen lause on adverbiaalitonta spesifimpi ja 3) määritteen sisältävä lauseke on määritteetöntä spesifimpi. Koska tutkimus keskittyy rakenteiden tarkasteluun, semantiikka jää pääosin tutkimuksen ulkopuolelle. Tutkimusaineisto koostuu Helsingin yliopistolle tutkimuskäyttöön lahjoitetun päiväkirja-aineiston teksteistä vuosilta 1985, 2000 ja 2012. Aineisto on rajattu siten, että mukana on aineistoa ajalta ennen AT-diagnoosia ja ajalta sen jälkeen – näin taudin mahdolliset vaikutukset nousevat parhaiten esiin. Tutkimuksessa yhdistyvät kvalitatiiviset ja kvantitatiiviset tutkimusmenetelmät, kun aineistossa tapahtuvia muutoksia tarkastellaan syntaktiseen analyysiin perustuvien määrällisten tilastojen avulla. Aiemmissa tutkimuksissa syntaksin on osoitettu pysyvän suhteellisen muuttumattomana, mutta tässä tutkimuksessa tavoitetut syntaktiset muutokset ovat selkeitä. Lausetyyppien jakaumassa tapahtuu vuosien saatossa muutoksia: monikäyttöisten lausetyyppien osuus kasvaa ja erikoislausetyyppien osuus vastaavasti pienenee. Merkittävimmät muutokset näkyvät kopulalauseissa, joiden osuus kasvaa 10,6 %:sta 18,5 %:iin, ja tilalauseissa, joiden osuus laskee 20,6 %:sta 14,8%:iin. Kaikki tulokset viittaavat siihen, että skemaattisuus lisääntyy vuodesta 1985 vuoteen 2012: lausekkeiden määrä vähenee, adverbiaalillisten lausekkeiden osuus pienenee ja substantiivilausekkeiden edussanat saavat aiempaa harvemmin määritteitä. Transitiivilauseiden skeemojen tarkastelu puolestaan osoittaa, että läpi aineiston yleisimmiksi nousevat prototyyppistä transitiivilauseen skeemaa lähinnä olevat rakenteet ja että kirjoittaja käyttää loppuvaiheessa aiempaa vähemmän erilaisia rakenteita – skeemojen varioiminen vähenee. Skeemoihin liittyvien muutosten trendi on tasainen, kun taas skemaattisuuden lisääntyminen painottuu vuosien 2000–2012 väliin. Alzheimerin taudin vaikutuksia kirjoitettuun kieleen on tutkittu toistaiseksi melko vähän, ja siten tarvetta jatkotutkimuksille on vielä monella saralla. Tämän tutkimuksen tulokset herättävätkin paljon uusia tutkimuskysymyksiä, ja esimerkiksi perehtyminen ilmiöiden semanttiseen puoleen rakenteellisen ohella saattaisi olla yksi tapa viedä tätä tutkimusta eteenpäin.
  • Marques, Pirita (Helsingfors universitet, 2015)
    Goals. Event schema or a script is a knowledge structure that describes appropriate sequences of events in a particular context. Script contains components which are vertically and horizontally connected to each other. A person may learn about scripts by personal experience, reading about them, hearing about them and seeing them done. Therefore, scripts contain information from episodic and semantic memory. Script research provides information about memory functions and the representation and the damage of the systems in different diseases affecting the neural systems, such as in Alzheimer's disease (AD). With increasing theoretical knowledge it is possible to develop differential diagnostic and rehabilitation methods for the patients in clinical work. The purpose of the study is to examine the script production of two different scripts in the mild and moderate stage of AD. Methods. The material of AD patients was gathered in 1994-1997 at the Department of Neurology (Memory Clinic) of the Helsinki University Central Hospital. The normal control subjects were from the pool of participants of the Helsinki Aging Brain Study which started in 1989. Ten people with mild AD (LiAT), ten with moderate AD (KoAT) and ten matched normal controls (NoI) were asked to produce as many script events as possible for two scripts: What do you do between waking up and having lunch? (The Morning script) representing episodic memory and What happens at a doctor's appointment? (The Doctor script) representing semantic memory. Sixty seconds were allotted for each script. The scripts were scored for the total number of events, the number of event repetitions, the informativeness of the contents and the plausibility and the centrality of the events. Statistical methods used were the Kruskal-Wallis one way variance analysis and the Mann-Whitney U –test post hoc –test. Results and conclusions. The results showed that the number of events for the both script types was statistically significantly lower for the people with AD compared to the control group. In addition, the ratio of informativeness was statistically significantly poorer for the people with AD. Depending on the script type, people with AD produced less plausible and central events than the control group. The results of the study are consistent in many aspects with the literature and the studies of AD suggesting that episodic memory is first impaired in AD, followed by the impairment of semantic memory.