Signs on Pathological Aging - Tests of Cognitive Functioning in Dementia Evaluations among Signing Elderly Deaf People

Dementia is a major and rapidly growing cause of disability among the elderly. According to the National Board of Health and Welfare, 160,000 are affected and this figure is set to double by 2050. Further, there is a lack of knowledge at all levels of the healthcare service regarding cognitive tests of individuals with dementia. This ignorance is particularly acute as regards the prelingually deaf who communicate using Swedish Sign Language (SSL).  There are 10,000 people with early deafness in Sweden, and pediatric cochlear implantation (allowing early access to sound) was not available to the over 50s. Thus, elderly deaf people generally communicate using SSL, which differs from Swedish in both vocabulary, grammar and culture. Neuropsychological tests must not be changed or adapted during interpretation but lose their reliability because sign language demonstrates gesturally an instruction such as “fold the paper in half”. There are no validated translations of neuropsychological test instruments in SSL. Above all, to date, there has been no validation of methods of the tests included in diagnosing dementia among deaf sign language users in Sweden. In the UK, however, new methods have been successfully developed and validated. This allows more reliable diagnosis of dementia among deaf users of British Sign Language, improving their access to appropriate treatment and care, and promoting quality of life. In the proposed project, we intend to build on the work of our UK colleagues and develop validated tools for reliable diagnosis of dementia in SSL users. We will achieve this in three studies:

1. Charting current methods 2. Adapting current methods guided by experiences of the UK project 3. Evaluating adapted methods by comparing outcomes and using conversational analysis (CA) of videorecorded test administration.

The proposed project will result in reliable tools for diagnosing dementia among deaf SSL users and increase our knowledge of cognition in elderly deaf signers.