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

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 theScales 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 cognitivelyhealthy controls comparable in education. Cognitive-communicative functioning was assessed across SCCAN domains, includingorientation, 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 inmemory, attention, oral expression, and problem solving. These differences suggest reduced efficiency in tasks that requireintegrated cognitive-communicative processing. Reading comprehension and writing were largely preserved. Auditorycomprehension 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 impairmentalone. The SCCAN-BG captures early, functionally relevant vulnerability in everyday communication. This supports its usefor clinical monitoring and rehabilitation-oriented decision-making in populations at risk for Alzheimer’s disease–relatedcognitive decline.