Speech And Language Problems In Alzheimers Disease

February 5, 2008

The normal aging process does not create major deficits in the intelligibility or the appropriate organization of speech. However, those persons who are afflicted with Alzheimer’s disease are atypical because the undergo brain changes in areas that appear to be highly associated with memory and language. The mechanical components of speech production remain relatively unaffected by Alzheimer’s disease until the final stages of the disorder. It is disturbance in the meaningfulness of language that is most pronounced throughout the progression of the disease.

The major aspects of disrupted communication arising in Alzheimer’s disease are language problems that result from cognitive decline. One of. the first problems to occur involves the forgetting of appropriate words or the use of “pseudowords” in place of the forgotten item. For example. person might use the term pencicle to describe a ballpoint pen, or the term firebugs to describe matches. There is also difficulty naming objects, particularly specific names. The Alzheimer patient, for example, may be able to identify a picture as that of a dog, but not as that of a “collie,” which is a higher order name. The communication problem is not one of articulation but a deficit in generating the appropriate words with which to convey information on a symbolic level.

The Alzheimer patient is generally unaware of these communication problems; his/her speech is frequently characterized by an empty, aimless, quality. Much of this pointless vocalization is the result of verbal wandering characterized by repetitive speech with little comprehensible meaning. The spoken words are produced correctly and with appropriate fluency but with limited ability to communicate meaningfully .

As the disease progresses, problems will occur in generating words. naming objects, and recognizing meaningful relationships. For example - forks, knives, and spoons may no longer have a relationship to one another for a person experiencing the symptoms of Alzheimer’s disease. He or she may begin to engage in echolalia, repeating the same word or phrase over and over. These verbal repetitions will occur with little or no comprehension of what was said. Echolalia may progress to the point where vocalizing deteriorates to repetitious syllables that are unrecogniz able as language.

With Alzheimer’s disease there is also a decreased ability to recognize some of the pragmatic aspects of speech. Pragmatics involve the rules of speech and language as they apply to usage. Adjusting one’s rhetoric to suit the audience, not standing too close to the listener, and using body language to help convey intentions are all part of the pragmatics of communication. Other examples of pragmatics include asking questions by using the appropriate inflection, or greater emphasis being placed on certain statements by the way words are spaced and timed. Lacking awareness of the pragmatics of a certain situation, a person night not respond in the desired or appropriate manner.

In advanced stages of Alzheimer’s disease communication has progressed to such an extent that the individual is essentially mute. Spontaneous speech may all but cease, and echolalic behavior is quite common. At this point the patient may have difficulty even with the physical generation of speech sounds.

Posted in Alzheimer's Disease Disorder