Effects of cognitive and language decline on communication in mild cognitive impairment: An integrative systematic review

Effective communication is fundamental to quality of life and social participation. Individuals with mild cognitive impairment (MCI) frequently experience subtle communication difficulties that may foreshadow neurodegenerative decline. The cognitive-linguistic underpinnings of communication impairments in MCI remain unclear. This systematic review aimed to synthesize current evidence on how language and cognitive functions contribute to expressive and receptive communication abilities. A systematic search of literature identified studies examining associations between cognitive or linguistic domains and communication performance in MCI. Across studies, communication impairments in MCI were linked to deficits in multiple cognitive and language domains. Expressive communication difficulties were consistently associated with impairments in memory, executive functions, attention, and naming. Several discourse measures, including global coherence and propositional density, showed strong associations with episodic memory, verbal fluency, and inhibition. Receptive communication, primarily assessed through facial emotion recognition, was related to executive, visuospatial, and attentional abilities, with weaker or inconsistent links to memory and language. Heterogeneity in diagnostic criteria, assessment tools, and communication tasks limited cross-study comparability. Findings demonstrate that communication deficits in MCI emerge from a complex interplay of cognitive and linguistic changes. Standardized, ecologically valid assessment approaches are needed to clarify mechanisms and inform targeted interventions.