Skip to main content
SpringerLink
Log in

Inference comprehension from reading in individuals with mild cognitive impairment

  • Original article
  • Published:
Acta Neurologica Belgica Aims and scope Submit manuscript

Abstract

Inference comprehension is a complex ability that recruits distinct cognitive domains, such as language, memory, attention, and executive functions. Therefore, it might be sensitive to identify early deficits in subjects with MCI. To compare the performance of subjects with mild cognitive impairment (MCI) in an inference reading comprehension task, and to analyze the correlations between inferential comprehension and other cognitive functions. We studied 100 individuals aged 60 and over, divided into MCI (50) [aMCI (35), naMCI (15)], and cognitively healthy individuals [controls (50)]. The Implicit Management Test (IMT) was used to assess inference in reading comprehension in five categories: explicit, logical, distractor, pragmatic, and “others”. MCI group performed worse than controls in logical, pragmatic, distractor, and “others” questions (p < 0.01). The aMCI and naMCI subgroups presented a similar performance in all types of questions (p > 0.05). We observed significant correlations between the total IMT score and the TMT-A in the naMCI group (r = − 0.562, p = 0.036), and the Rey–Osterrieth Complex Figure and RAVLT tasks in the aMCI group (r = 0.474, p = 0.010 and r = 0.593, p = 0.0001, respectively). The MCI group as a whole performed worse than controls on the logical, pragmatic, other and distractor questions, and consequently on the total score. There were no differences in explicit questions, which impose lower inferential demands. The aMCI group suffered a significant impact from memory on inference comprehension, and difficulties in executive functions impacted naMCI performance. The IMT was useful to differentiate MCI patients from cognitively healthy individuals, but not MCI subgroups among themselves.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Salthouse TA (2009) When does age-related cognitive decline begin? Neurobiol Aging 30:507–514. https://doi.org/10.1016/j.neurobiolaging.2008.09.023

    Article  PubMed  PubMed Central  Google Scholar 

  2. Small BJ, Dixon RA, McArdle JJ (2011) Tracking cognition-health changes from 55 to 95 years of age. J Gerontol B Psychol Sci Soc Sci 66:153–161. https://doi.org/10.1093/geronb/gbq093

    Article  Google Scholar 

  3. Portet F, Ousset PJ, Visser PJ, Frisoni GB, Nobili F, Scheltens P et al (2006) Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer’s disease. J Neurol Neurosurg Psychiatry 77:714–718. https://doi.org/10.1136/jnnp.2005.085332

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Petersen RC (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med 256:183–194. https://doi.org/10.1111/j.1365-2796.2004.01388.x

    Article  PubMed  CAS  Google Scholar 

  5. Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO et al (2004) Mild cognitive impairment: beyond controversies, towards a consensus—report of the International Working Group on Mild Cognitive Impairment. J Intern Med 256:240–246. https://doi.org/10.1111/j.1365-2796.2004.01380.x

    Article  PubMed  CAS  Google Scholar 

  6. Petersen RC, Negash S (2008) Mild cognitive impairment: an overview. CNS Spectr 13:45–53. https://doi.org/10.1017/s1092852900016151

    Article  PubMed  Google Scholar 

  7. Kelley B, Petersen RC (2007) Alzheimer’s disease and mild cognitive impairment. Neurol Clin 25(3):577–609. https://doi.org/10.1016/j.ncl.2007.03.008

    Article  PubMed  PubMed Central  Google Scholar 

  8. Feldman H, Levy AR, Hsiung GY, Peters KR, Donald A, Black SE et al (2003) A Canadian cohort study of cognitive impairment and related dementias (ACCORD): study methods and baseline results. Neuroepidemiology 22:265–274. https://doi.org/10.1159/000071189

    Article  PubMed  CAS  Google Scholar 

  9. Jacinto AF, Brucki SMD, Porto CS, Martins MA, Nitrini R (2011) Detection of cognitive impairment in the elderly by general internists in Brazil. Clinics 66:1379–1384. https://doi.org/10.1590/S1807-59322011000800012

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ávila-Villanueva M, Maestú F, Fernández-Blázquez MA (2018) Internal consistency over time of subjective cognitive decline: drawing preclinical Alzheimer’s Disease trajectories. J Alzheimers Dis 66:173–183. https://doi.org/10.3233/JAD-180307

    Article  PubMed  Google Scholar 

  11. Taler V, Phillips NA (2008) Language performance in Alzheimer’s disease and mild cognitive impairment: a comparative review. J Clin Exp Neuropsychol 30:501–556. https://doi.org/10.1080/13803390701550128

    Article  PubMed  Google Scholar 

  12. Singer M, Leon J (2007) Psychological studies of higher language process: behavioral and empirical approaches. In: Schmalhofer F, Perfetti CA (eds) Higher level language process in the brain. Erlbaum, Mahwah, pp 9–25

    Google Scholar 

  13. Brown G, Yule G (1983) Discourse analysis. Cambridge University Press, Cambridge

    Book  Google Scholar 

  14. Gutiérrez-Calvo ML (1999) Inferences in the comprehension of language [Inferencias en la Comprensión del Lenguaje]. In: Vegas M, Vegas FC (eds) Psicolinguistica del Español. Trotta, Madrid, pp 231–270

    Google Scholar 

  15. Schmitter-Edgecombe M, Creamer S (2010) Assessment of strategic processing during narrative comprehension in individuals with mild cognitive impairment. J Int Neuropsychol Soc 16:661–671. https://doi.org/10.1017/S1355617710000433

    Article  PubMed  Google Scholar 

  16. Gaudreau G, Monetta L, Macoir J, Poulin S, Laforce R Jr, Hudon C (2015) Mental state inferences abilities contribution to verbal irony comprehension in older adults with mild cognitive impairment. Behav Neurol 2015:685613. https://doi.org/10.1155/2015/685613

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. McNamara DS, de Vega M, O´Reilly T (2007) Comprehension skill, inference making and the role of knowledge. In: Schmalhofer F, Perfetti CA (eds) Higher level language process in the brain. Erlbaum, Mahwah, pp 233–254

    Google Scholar 

  18. Silagi ML, Radanovic M, Conforto AB, Mendonça LIZ, Mansur LL (2018) Inference comprehension in text reading: performance of individuals with right- versus left-hemisphere lesions and the influence of cognitive functions. PLoS ONE 13:e0197195. https://doi.org/10.1371/journal.pone.0197195

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  19. Graesser AC, Singer M, Trabasso T (1994) Constructing inferences during narrative text comprehension. Psychol Rev 101(3):371–395. https://doi.org/10.1037/0033-295x.101.3.371

    Article  PubMed  CAS  Google Scholar 

  20. Rumelhart DE (1980) Schemata: the building blocks of cognition. In: Spiro RL, Bruce BC, Brewer WF (orgs) Theoretical issues in reading comprehension: perspectives from cognitive psychology, linguistics, artificial intelligence, and education. Lawrence Erlbaum Associates, New Jersey

  21. Calvo MG (2001) Working memory and inferences: evidence from eye fixations while reading. Memory 9(4):365–381. https://doi.org/10.1080/09658210143000083

    Article  PubMed  CAS  Google Scholar 

  22. Virtue S, Broek P, Linderholm T (2006) Hemispheric processing of inferences: the effects of textual constraint and working memory capacity. Memory & Cognition 34(6):1341–1354. https://doi.org/10.3758/bf03193276

    Article  Google Scholar 

  23. Pérez AI, Paolieri D, Macizo P, Bajo T (2014) The role of working memory in inferential sentence comprehension. Cogn Process 15(3):405–413. https://doi.org/10.1007/s10339-014-0611-7

    Article  PubMed  Google Scholar 

  24. Barreyro JP, Cevasco J, Burín D, Molinari Marotto C (2012) Working memory capacity and individual differences in the making of reinstatement and elaborative inferences. Span J Psychol 15(2):471–479

    Article  PubMed  Google Scholar 

  25. Carriedo N, Corral A, Montoro PR, Herrero L, Ballestrino P, Sebastián I (2016) The development of metaphor comprehension and its relationship with relational verbal reasoning and executive function. PLoS ONE 11:1–20. https://doi.org/10.1371/journal.pone.0150289

    Article  CAS  Google Scholar 

  26. Uekermann J, Channon S, Daum I (2006) Humor processing, mentalizing, and executive function in normal aging. J Int Neuropsychol Soc 12:184–191. https://doi.org/10.1017/S1355617706060280

    Article  PubMed  Google Scholar 

  27. Goodglass H, Kaplan E (2001) The assessment of aphasia and related disorders. Lea & Febiger, Philadelphia

    Google Scholar 

  28. Radanovic M, Mansur LL, Scaff M (2004) Normative data for the Brazilian population in the Boston Diagnostic Aphasia Examination: influence of schooling. Braz J Med Biol Res 37:1731–1738. https://doi.org/10.1590/S0100-879X2004001100019

    Article  PubMed  CAS  Google Scholar 

  29. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198. https://doi.org/10.1016/0022-3956(75)90026-6

    Article  CAS  PubMed  Google Scholar 

  30. Brucki SM, Nitrini R, Caramelli P, Bertolucci PH, Okamoto IH (2003) Suggestions for the utilization of the Mini-Mental State Examination in Brazil. [Sugestões para o uso do Mini Exame do estado Mental no Brasil]. Arq Neuropsiquiatr 61:777–781. https://doi.org/10.1590/S0004-282X2003000500014

    Article  PubMed  Google Scholar 

  31. Damin AE, Nitrini R, Brucki SMD (2015) Cognitive Change Questionnaire as a method for cognitive impairment screening. Dement Neuropsychol 9:237–244. https://doi.org/10.1590/1980-57642015dn93000005

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sheikh JI, Yesavage JA (1986) Geriatric Depression Scale (GDS): recent evidence and development of a short version. Clin Gerontol 5:165–173. https://doi.org/10.1300/J018v05n0109

    Article  Google Scholar 

  33. Almeida OP, Almeida SA (1999) Reliability of the Brazilian version of the Geriatric Depression Scale (GDS) short form. [Confiabilidade da versão brasileira da Escala de Depressão em Geriatria (GDS) forma reduzida]. Arq Neuropsiquiatr 57:421–426. https://doi.org/10.1590/S0004-282X1999000300013

    Article  PubMed  CAS  Google Scholar 

  34. Pfeffer RI, Kurosaki TT, Harrah CH Jr, Chance JM, Filos S (1982) Measurement of functional activities in older adults in the community. J Gerontol 37:323–329. https://doi.org/10.1093/geronj/37.3.323

    Article  PubMed  CAS  Google Scholar 

  35. Sanchez MADS, Correa PCR, Lourenço RA (2011) Cross-cultural adaptation of the “Functional Activities Questionnaire—FAQ” for use in Brazil. Dement Neuropsychol 5:322–327. https://doi.org/10.1590/S1980-57642011DN05040010

    Article  PubMed  PubMed Central  Google Scholar 

  36. Petersen RC (2011) Clinical practice. Mild cognitive impairment. N Engl J Med 364:2227–2234. https://doi.org/10.1056/NEJMcp0910237

    Article  PubMed  CAS  Google Scholar 

  37. Spreen O, Strauss E (1998) A compendium of neuropsychological tests. Administration, norms, and commentary, 2nd edn. Oxford University Press, Oxford

    Google Scholar 

  38. Machado TH, Fichman HC, Santos EL, Carvalho VA, Fialho PP, Koenig AM et al (2009) Normative data for healthy elderly on the phonemic verbal fluency task—FAS. Dement Neuropsychol 3:55–60. https://doi.org/10.1590/S1980-57642009DN30100011

    Article  PubMed  PubMed Central  Google Scholar 

  39. Wechsler D (1987) Wechsler Memory Scale—Revised Manual. The Psychological Corporation, San Antonio

    Google Scholar 

  40. Rey A (1964) The clinical examination in psychology [L’examen clinique en psychologie]. Presses Universitaires de France, Paris

    Google Scholar 

  41. Diniz LFM, Lasmar VAP, Gazinelli LSR, Fuentes D, Salgado JV (2007) The Rey Auditory-Verbal Learning Test: applicability for the Brazilian elderly population. Braz J Psychiatry 29:324–329. https://doi.org/10.1590/S1516-44462006005000053

    Article  Google Scholar 

  42. Rey A (1941) The psychological examination in cases of traumatic encephalopathy [L’examen psychologique dans les cas d’encéphalopathie traumatique]. Arch Psychol (Geneve) 28:215–285

    Google Scholar 

  43. Osterrieth P (1944) Test of copying a complex figure; contribution to the study of perception and memory [Le test de copie d’une figure complexe; contribution à l’étude de la perception et de la mémoire]. Arch Psychol (Geneve) 30:206–356

    Google Scholar 

  44. Stroop JR (1935) Studies of interference in serial verbal reactions. J Exp Psychol 18:643–662

    Article  Google Scholar 

  45. Wechsler D (1997) Wechsler Adult Intelligence Scale-III. The Psychological Corporation, San Antonio

    Google Scholar 

  46. Nascimento E (2004) Adaptation, validation and normatization of the WAIS-III in a Brazilian sample. [Adaptação, validação e normatização do WAIS-III para uma amostra brasileira]. In: Wechsler D WAIS-III: Manual para administração e avaliação, Casa do Psicólogo, São Paulo

  47. Bondi MW, Edmonds EC, Jak AJ et al (2014) Neuropsychological criteria for mild cognitive impairment improves diagnostic precision, biomarker associations, and progression rates. J Alzheimers Dis 42:275–289. https://doi.org/10.3233/JAD-140276

    Article  PubMed  PubMed Central  Google Scholar 

  48. Smith GE, Ivnik RJ (2003) Normative neuropsychology. In: Petersen RC (ed) Mild cognitive impairment. Oxford University Press, New York, pp 63–68

    Google Scholar 

  49. May-Carle AD (2000) The implicit management [La gestion de l’implicite]. Ortho Édition, Paris

    Google Scholar 

  50. Silagi ML, Romero VU, Mansur LL, Radanovic M (2014) Inference comprehension during reading: influence of age and education in normal adults. CoDAS 26:407–414. https://doi.org/10.1590/2317-1782/20142013058

    Article  PubMed  Google Scholar 

  51. Creamer S, Schmitter-Edgecombe M (2010) Narrative comprehension in Alzheimer’s disease: assessing inferences and memory operations with a think-aloud procedure. Neuropsychology 24:279–290. https://doi.org/10.1037/a0018107

    Article  PubMed  Google Scholar 

  52. Pell MD, Monetta L, Rothermich K, Kotz SA, Cheang HS, McDonald S (2014) Social perception in adults with Parkinson’s disease. Neuropsychology 28:905–916. https://doi.org/10.1037/neu0000090

    Article  PubMed  Google Scholar 

  53. Montemurro S, Mondini S, Signorini M, Marchetto A, Bambini V, Arcara G (2019) Pragmatic language disorder in Parkinson’s Disease and the potential effect of cognitive reserve. Front Psychol 10:1220. https://doi.org/10.3389/fpsyg.2019.01220

    Article  PubMed  PubMed Central  Google Scholar 

  54. Rankin KP, Salazar A, Gorno-Tempini ML, Sollberger M, Wilson SM, Pavlic D et al (2009) Detecting sarcasm from paralinguistic cues: anatomic and cognitive correlates in neurodegenerative disease. Neuroimage 47:2005–2015. https://doi.org/10.1016/j.neuroimage.2009.05.077

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development (CNPq) (Process number: 557887/2009-7). The authors would like to thank Marcos Maeda for the statistical analysis.

Author information

Authors and Affiliations

  1. Department of Physical Therapy, Speech-Language Pathology and Audiology, and Occupational Therapy, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil

    Marcela Lima Silagi, Vivian Urbanejo Romero & Leticia Lessa Mansur

  2. Department of Neurology, School of Medicine, Universidade de Sao Paulo, Sao Paulo, Brazil

    Maira Okada de Oliveira, Eduardo Sturzeneker Trés & Sonia Maria Dozzi Brucki

  3. Department of Psychiatry, School of Medicine, Universidade de Sao Paulo, Rua Dr. Ovídio Pires de Campos, 785, Sao Paulo, SP, 05403-903, Brazil

    Márcia Radanovic

Authors
  1. Marcela Lima Silagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vivian Urbanejo Romero
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maira Okada de Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eduardo Sturzeneker Trés
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sonia Maria Dozzi Brucki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Márcia Radanovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Leticia Lessa Mansur
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. MLS collected the language data and wrote the paper; VUR assisted with the collection of language data; MOO collected neuropsychological data; EST nd SMDB conducted clinical evaluation and diagnosis; MR carried out statistical analysis and revised the manuscript; LLM designed the study and supervised the data collection. ML Silagi wrote the first draft of the manuscript, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Márcia Radanovic.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix: performance of the aMCI and naMCI groups in neuropsychological evaluation

Appendix: performance of the aMCI and naMCI groups in neuropsychological evaluation

 

aMCI

M (SD)

naMCI

M (SD)

p value

Matrix Reasoning - WAIS III

10.7(4.7)

8.7(4.2)

0.201

ROCF (copy)

30.4(5.8)

31.6(4.3)

0.608

TMT A (time)

46.1(16.3)

61.5(21.1)

0.008

TMT A (errors)

0.1(0.3)

0.0(0.2)

0.689

TMT B (time)

140.3(67.0)

168.2(69.1)

0.228

TMT B  (errors)

1.8(1.8)

2.1(2.3)

0.748

Digit span forward

5.2(1.2)

5.4(1.1)

0.434

Digit span backwards

3.8(1.0)

4.1(0.9)

0.350

Stroop I

17.2(4.1)

18.6(6.4)

0.793

Stroop II

24.1(6.9)

23.2(6.1)

0.486

Stroop III (time)

37.5(10.5)

37.8(11.9)

0.988

Stroop III (errors)

1.4(1.5)

1.0(1.1)

0.511

Logical Memory I - WMS-R

17.9(6.0)

19.7(8.5)

0.512

Visual Reproduction I - WMS-R

28.8(6.8)

31.4(3.8)

0.249

Logical Memory II (delayed recall) - WMS-R

11.9(6.3)

14.1(8.9)

0.688

Visual Reproduction II (delayed recall) - WMS-R

11.5(9.2)

20.0(8.0)

0.013

ROCF (delayed recall)

8.1(4.5)

13.2(7.7)

0.027

RAVLT (total)

36.0(10.4)

42.0(9.6)

0.092

RAVLT (interference)

6.5(3.6)

8.3(2.5)

0.045

RAVLT (delayed recall)

6.3(3.6)

8.5(2.7)

0.053

RAVLT (recognition)

8.5(4.9)

12.6(5.3)

0.236

FAS-COWA

19.5(4.5)

24.3(7.3)

0.563

Animal fluency

15.9(5.2)

16.6(4.6)

0.505

BNT

41.6 (4.1)

45.5 (9.1)

0.536

  1. ROCF Rey–Osterrieth Complex Figure; TMT Trail Making Test, RAVLT Rey Auditory Verbal Learning Test, FAS Phonemic Verbal Fluency (letters FAS), BNT Boston Naming Test

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Silagi, M.L., Romero, V.U., de Oliveira, M.O. et al. Inference comprehension from reading in individuals with mild cognitive impairment. Acta Neurol Belg 121, 879–887 (2021). https://doi.org/10.1007/s13760-019-01264-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-019-01264-7

Keywords

Search

Navigation