Cognitive-Pragmatic Language Assessment for Normal Aging : Study of Assessment Tools and Content Validity

노년층의 인지-화용언어 능력 평가 : 평가도구 및 내용타당도 연구

  • 이미숙 (연세대학교 대학원 언어병리학협동과정) ;
  • 김향희 (연세대학교 의과대학 재활의학교실 및 재활의학연구소)
  • Received : 2012.02.24
  • Accepted : 2012.04.12
  • Published : 2012.05.28


Cognitive-pragmatic language ability decreases during the normal aging process. Evaluating the ability might be useful in testing predicting cognitive level and diseases such as dementia. The aim of this study is to analyze various assessment protocols for normal aging, and evaluate the content validity of the currently developing cognitive-pragmatic language test domains and items. Content Validity Index(CVI) was calculated based on ratings judged by 17 experts including speech-language pathologists and clinical psychologists. As a result, it was found that CVIs of all 7 domains including attention, memory, organization, reasoning, problem solving, executive function, pragmatic language were above .75. It was concluded that the test items contained the appropriate content validity to assess cognitive-pragmatic language for normal aging.


Cognitive-pragmatic Language;Normal Aging;Assessment;Content Validity


Supported by : 한국연구재단


  1. D. B. Howieson, D. W. Loring, and H. J. Hannay, Neurobehavioural variables and diagnostic issues, In: Lezak MD, ed. Neuropsychological assessment (4th eds.), New York, Oxford Univ. Press, 2004.
  2. J. E. Graham, "Prevalence and severity of cognitive impairment with and without dementia in an elderly population," The Lancet, Vol.349, No.9068, pp.1793-1796, 1997.
  3. H. J. Woodford and J. George, "Cognitive assessment in the elderly: a review of clinical methods," The Quarterly Journal of Medicine, Vol.100, pp.469-484, 2007.
  4. M. Boutsani, "Screening for dementia in primary care: a summary of the evidence for the U.S. preventative services task force," Annals of Internal Medicine, Vol.138, pp.927-937, 2003.
  5. M. S. Albert, Age-related changes in cognitive function, In Albert MS & Knoefel JE (eds.), Clinical neurology of aging, Oxford: Oxford Univ. Press, 1994.
  6. R. Vohn, Functional networks of within-and cross-modal divided attention, Rheinisch-Westfalischen Technischen Hochschule Aachen, Philosophie genehmigte Dissertation, 2008.
  7. R. Parasuraman, The attentive brain: issues and prospects, Cambridge: MIT Press, 1998.
  8. W. Sturm, Aufmerksamkeitstorungen. In Lehrbuch der Klinischen Neuropsychologie (2nd eds.), 2007.
  9. D. J. Madden and L. K. Langley, "Age-Related Changes in Selective Attention and Perceptual Load During Visual Search," Psychology and Aging, Vol.18, No.1, pp.54-67, 2003.
  10. J. H. Michael, A. M. K. Clare, and I. M. C. Fergus, "The effects of attention switching on encoding and retrieval of words in younger and older adults," Experimental Aging Research, Vol.32, pp.153-183, 2006.
  11. A. F. Kramer, S. Hahn, and D. Gopher, "Task coordination and aging: explorations of executive control processes in the task switching paradigm," Acta Psychologica(Amst), Vol.101, pp.339-378, 1999.
  12. C. Jonker, M. I. Geerlings, and B. Schmand, "Are memory complaints predictive for dementia? A review of clinical and population based studies," International Journal of Geriatric Psychiatry, Vol.15, pp.983-991, 2000.<983::AID-GPS238>3.0.CO;2-5
  13. J. Wall, "Does Your Age Affect Your Short Term Memory?," ezinearticles, 2006.
  14. J. V. Filoteo and W. T. Maddox, "A Quantitative Model-Based Approach to Examining Aging Effects on Information-Integration Category Learning," Psychology and Aging, Vol.19, No.1, pp.171-182, 2004.
  15. J. D. Smith and J. P. Minda, "Journey to the center of the category: The dissociation in amnesia between categorization and recognition," Journal of Experimental Psychology: Learning, Memory, and Cognition, Vol.27, pp.984-1002, 2001.
  16. T. M. Hess, S. M. Pullen, and K. A. McGee, "Acquisition of prototype-based information about social groups in adulthood. Psychology and Aging," Vol.11, pp.179-190, 1996.
  17. T. A. Salthouse, "Item Analyses of Age Relations on Reasoning Tests," Psychology and Aging, Vol.15, No.1, pp.3-8, 2000.
  18. T. A. Salthouse, Effects of aging on reasoning. In Holyoak KJ, Morrison RG (eds.), Cambridge handbook of thinking and reasoning, NY; Cambridge Univ. Press, 2005.
  19. L. Emery, S. Hale, and J. Myerson, "Age differences in proactive interference, working memory, and reasoning," Psychology and Aging, Vol.23, No.3, pp.634-645, 2008.
  20. P. Verhaeghen and T. A. Salthouse, "Meta-analysis of age-cognition relations in adulthood: Estimates of linear and non-linear age effects and structural models," Psychological Bulletin, Vol.122, pp.231-249, 1997.
  21. 이미숙, 김향희, "외상성 뇌손상 및 우반구 손상환자의 인지-의사소통 능력 평가도구에 관한 문헌 고찰", 한국콘텐츠학회논문지, 제11권, 제4호, pp.253-262, 2011.
  22. M. L. Gilhooly, "Real-world problem solving and quality of life in older people," British Journal of Health Psychology, Vol.12, pp.587-600, 2007.
  23. S. Garden, L. H. Phillips, and S. E. MacPherson, "Mid-life aging, open-ended planning and laboratory measures of executive function," Neuropsychology, Vol.15, pp.472-482, 2001.
  24. L. H. Phillips, M. MacLeod, and M. Kliegel, Age, the frontal lobes and executive functioning, In G. Ward and R. Morris (eds.), The cognitive psychology of planning, Hove, UK: Psychology Press, 2005.
  25. F. Blanchard-Fields, A. Mienaltowski, and R. B. Seay, "Age differences in everyday problem-solving effectiveness: older adults select more effective strategies for interpersonal problems," The Journals of Gerontology, Series B, Psychological Sciences and Social Sciences, Vol.62, No.1, pp.61-64, 2007.
  26. T. A. Salthouse, T. M. Atkinson, and D. E. Berish, "Executive Functioning as a Potential Mediator of Age-Related Cognitive Decline in Normal Adults," Journal of Experimental Psychology: General, Vol.132, No.4, pp.566-594, 2003.
  27. L. Hasher, R. T. Zacks, and C. P. May, Inhibitory control, circadian arousal, and age. In Gopher D & Koriat A (eds.), Attention and performance XVII, Cognitive regulation of performance: Interaction of theory and application(pp. 653-675), Cambridge, MA: MIT Press, 1999.
  28. M. K. M. Martin, M. A. McDaniel, and L. H. Phillips, "Adult age differences in errand planning: the role of task familiarity and cognitive resources," Experimental Aging Research, Vol.33, pp.145-161, 2007.
  29. E. M. Zelinski and J. C. Hyde, "Old words, new meanings: Aging and sense creation," Journal of memory and Language, Vol.35, pp.689-707, 1996.
  30. S. E. MacPherson, L. H. Phillips, and S. Della Sala, "Age, executive function, and social decision making: a dorsolateral prefrontal theory of cognitive aging," Psychology and Aging, Vol.17, No.4, pp.598-609, 2002.
  31. P. W. Foos, "Working memory resource allocation by young, middle-aged, and old adults," Experimental Aging Research, Vol.21, pp.239-250, 1995.
  32. S. L. Thompson-Schill, "Effects of frontal lobe damage on interference effects in working memory," Cognitive, Affective, and Behavioural Neuroscience, Vol.2, No.2, pp.109-120, 2002.
  33. C. D. Qualls and J. L. Harris, "Age, working memory, figurative language type, and reading ability: influencing factors in African American adults' comprehension of figurative language," American Journal of Speech-language Pathology, Vol.12, No.1, pp.92-102, 2003.
  34. F. H. Treitz, K. Heyder, and I. Daum, "Differential course of executive control changes during normal aging," Neuropsychology, Development and Cognition. Section B: Aging Neuropsychology and Cognition, Vol.14, pp.370-393, 2007.
  35. M. E. Gregory and J. E. Waggoner, "Factors that influence metaphor comprehension skills in adulthood," Experimental Aging Research, Vol.22, pp.83-98, 1996.
  36. T. T. Kircher, "Neural correlates of metaphor processing in schizophrenia," Neuroimage, Vol.34, pp.281-289, 2007.
  37. J. Uekermann, P. Thoma, and I. Daum, "Proverb interpretation changes in aging," Brain and Cognition, Vol.67, No.1, pp.51-57, 2008.
  38. C. D. Qualls, "Idiom and proverb interpretation: An indication of metaphoric processing in aging," RAAM IV, Tunis, Tunisia(North Africa), 2001.
  39. M. A. Nippold, L. D. Uhden, and I. E. Schwarz, "Proverb explanation through the lifespan: A developmental study of adolescents and adults," Journal of Speech, Language, and Hearing Research, Vol.40, pp.245-253, 1997.
  40. T. S. Braver, "Context processing and context maintenance in healthy aging and early stage dementia of the Alzheimer's type," Psychology and Aging, Vol.20, No.1, pp.33-46, 2005.
  41. R. J. Fehring, "Methods to validate nursing diagnoses," Heart and Lung, Vol.16, No.6, pp.625-629, 1987.
  42. V. Chung, E. Wong, and S. Griffiths, "Content validity of the integrative medicine attitude questionnaire: Perspectives of a Hong Kong Chinese expert panel," Journal of Alternative and Complementary Medicine, Vol.13, No.5, pp.564-569, 2007.
  43. R. C. Mohs, Administration and Scoring Manual for the Alzheimer's Disease Assessment Scale(Revised Edition), The Mount Sinai School of Medicine, 1994.
  44. B. J. Sahakian, "A comparative study of visuospatial memory and learning in Alzheimer-type dementia and Parkinson's disease", Brain, Vol.111(Pt. 3), pp.695-718, 1988.
  45. G. Blessed, B. E. Tomlinson, and M. Roth, "The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects," The British Journal of Psychiatry: the journal of mental science, Vol.114, pp.797-811, 1968.
  46. M. M. Sohlberg, Attention Process Training-2 Test (2nd eds.), Wake Forest, NC: Lash & Associates, 2001.
  47. N. Helm-Estabrooks and G. Hotz, Brief Test of Head Injury, Chicago, IL: The Riverside Publishing Company, 1990.
  48. C. Randolph, Repeatable battery for the assessment of neuropsychological status(RBANS), San Antonio, TX: Psychological Corporation, 1998.
  49. P. Pimental and J. Knight, Mini-Inventory of Right Brain Injury-2, Pro-Ed, 2000.
  50. K. A. Bayles and C. K Tomoeda, Arizona Battery for Communication Disorders of Dementia, Pro-Ed, 1993.
  51. R. J. Kiernan, J. Mueller, and J. W. Langston, Neurobehavioral Cognitive Status Examination, Northern California Neurobehavioral Group, Inc., 1988.
  52. M. Roth, The Cambridge Examination for Mental Disorder of the Elderly-revised, Cambridge: Cambridge Univ. Press; 1998.
  53. M. F. Folstein, S. E. Folstein, and P. R. McHugh, "Mini-mental state: A practical method for grading the cognitive state of patients for the clinician," Journal of psychiatric research, Vol.12, No.3, pp.189-198, 1975.
  54. D. G. Ross-Swain, Ross Information Processing Assessment, Austin, TX: Pro-Ed, 1996.
  55. B. B. Adamovich and J. Henderson, Scales of Cognitive Ability for Traumatic Brain Injury. Austin, Tex: Pro-Ed, 1992.
  56. E. H. Wiig and W. Secord, Test of Language Competence-Expanded Edition, New York: Psychological Corporation, 1989.
  57. K. Bryan, The Right Hemisphere Language Battery, Whurr, London, 1995.
  58. H. Gardner and H. H. Brownell, Right Hemisphere Communication Battery, Boston: Psychology Service, VAMC, 1986.
  59. C. Frattali, American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults, Rockville: ASHA, 1995.
  60. A. L. Holland, C. Frattali, and D. Fromm, Communication Activities of Daily Living-2, Austin, Tex: Pro-Ed, 1999.
  61. R. L. Towne and L. M. Entwisle, "Metaphoric comprehension in adolescents with traumatic brian injury and in adolescents with language learning disability", Language, Speech and Hearing Services in Schools, Vol,24, pp.100-107, 1993.
  62. D. B. Howieson, D. W. Loring, and H. J. Hannay, Neurobehavioural variables and diagnostic issues, In: Lezak MD, ed. Neuropsychological assessment (4th eds.), New York, Oxford University Press, 2004.
  63. S. Sparks and T. Lien-Gieschen, "Modification of the diagnostic content validity model," Nursing Diagnosis, Vol.5, pp.31-35, 1994.

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