Cognitive-Communicative Differences Between Mild Cognitive Impairment and Healthy Aging: A Comparative Study Using the SCCAN

Kostadin Chompalov

Medical University of Plovdiv https://orcid.org/0000-0002-4636-1384 (unauthenticated)

DOI: https://doi.org/10.33700/jhrs.5.1.207

Abstract

Aim: To examine cognitive-communicative functioning in adults with Mild Cognitive Impairment due to Alzheimer’s disease (MCI-AD) and compare performance with cognitively healthy older adults using the Bulgarian-adapted version of the Scales of Cognitive and Communicative Ability for Neurorehabilitation (SCCAN-BG).

Methods: This cross-sectional comparative study included 60 participants: 30 individuals with MCI-AD and 30 cognitively healthy controls comparable in education. Cognitive-communicative functioning was assessed across SCCAN domains, including orientation, memory, attention, oral expression, auditory and reading comprehension, writing, and problem solving. Group differences were analysed using non-parametric statistical methods.

Results: Overall SCCAN performance was lower in the MCI-AD group. Consistent group differences were observed in memory, attention, oral expression, and problem solving. These differences suggest reduced efficiency in tasks that require integrated cognitive-communicative processing. Reading comprehension and writing were largely preserved. Auditory comprehension showed a non-significant trend towards lower performance in the MCI-AD group.

Conclusion: Cognitive-communicative changes are evident at the MCI-AD stage and extend beyond memory impairment alone. The SCCAN-BG captures early, functionally relevant vulnerability in everyday communication. This supports its use for clinical monitoring and rehabilitation-oriented decision-making in populations at risk for Alzheimer’s disease–related cognitive decline.

Keywords: cognitive-communicative functioning, Mild Cognitive Impairment due to Alzheimer’s disease, healthy aging, clinical monitoring, SCCAN

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Clinical Application of the Bulgarian Version of the SCCAN: Pilot Data From Patients with Alzheimer’s Disease and Ischemic Stroke

Kostadin Chompalov
Department of Neurology, Medical University of Plovdiv, Plovdiv, Bulgaria
https://orcid.org/0000-0002-4636-1384

Penka Atanassova 

1. Department of Neurology, Medical University of Plovdiv, Plovdiv, Bulgaria 2. Research Institute at Medical Univeristy of Plovdiv, Plovdiv, Bulgaria

https://orcid.org/0009-0002-2410-4114

Dobrinka Georgieva 

1. Department of Neurology, Medical University of Plovdiv, Plovdiv, Bulgaria 2. Research Institute at Medical Univeristy of Plovdiv, Plovdiv, Bulgaria

https://orcid.org/0000-0001-5029-9723

https://doi.org/10.33700/jhrs.4.1.149

Abstract

Aim: This study evaluated the clinical utility of the Scales of Cognitive and Communicative Ability for Neurorehabilitation (SCCAN) upon assessing Bulgarian in-patients who present with either ischemic stroke or Alzheimer's disease (AD). The aim was to determine whether this tool could detect cognitive-communicative problems that may be missed by customary screening tools.

Methods: We conducted two independent pilot studies: one with 14 AD patients, and a second with 19 stroke patients and 31 healthy controls. All participants completed the Bulgarian SCCAN, which assesses eight domains including oral expression, orientation, memory, auditory and reading comprehension, writing, attention, and problem-solving. Stroke and control participants also underwent the Mini-Mental State Examination (MMSE). Descriptive statistics were used so group performance and correlations could be examined. Tests that are non-parametric were also used.

Results: SCCAN revealed domain-specific deficits in clinical cohorts. In the AD group, memory and orientation were the most impaired domains. Stroke patients, on the other hand, showed significant impairments, particularly in memory, oral expression, and auditory comprehension, while orientation and attention were relatively preserved. Overall, stroke patients performed significantly better on the SCCAN than the AD group. These findings reveal distinct cognitive–communicative profiles in AD versus stroke populations.

Conclusion: SCCAN's Bulgarian version identified cognitive-communicative deficits with clinical sensitivity in patients with AD as well as with those with ischemic stroke. The tool may guide individualized neurorehabilitation and complement standard screening methods. Additional verification is advised.

Keywords: SCCAN, cognitive-communicative disorders, Alzheimer’s disease, ischemic stroke, neurorehabilitation, screening

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