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Functional communication in Alzheimer's disease.

D Fromm1, A Holland

  • 1University of Pittsburgh, PA.

The Journal of Speech and Hearing Disorders
|November 1, 1989
PubMed
Summary
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This study shows Alzheimer's disease (AD) significantly impairs functional communication, with moderate AD being more severe than mild AD. Elderly depression also affects communication but less than mild AD.

Area of Science:

  • Neurology
  • Psycholinguistics
  • Gerontology

Background:

  • Alzheimer's disease (AD) is a progressive neurodegenerative disorder.
  • Functional communication is crucial for daily living and quality of life.
  • Distinguishing communication deficits in AD from other conditions like depression and aphasia is clinically important.

Purpose of the Study:

  • To investigate and compare functional communication skills in individuals with mild and moderate Alzheimer's disease (AD).
  • To compare the communication performance of AD subjects with normal elderly controls, Wernicke's aphasic subjects, and elderly depressed subjects.
  • To identify specific patterns of communication impairment in different neurological and psychiatric conditions.

Main Methods:

  • The Communicative Abilities in Daily Living (CADL) test was administered to all participants.

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  • Participants included subjects with mild AD (n=26), moderate AD (n=22), normal elderly (n=26), Wernicke's aphasic (n=26), and elderly depressed (n=15).
  • Performance was analyzed based on total scores and across pragmatic categories and error types.

    • Main Results:

    • Subjects with mild and moderate AD demonstrated significant impairments on the CADL, with greater severity in the moderate AD group.
    • Elderly depressed subjects showed impaired functional language skills compared to normal elderly controls, but less impairment than mild AD subjects.
    • While moderate AD and Wernicke's aphasic subjects had similar total CADL scores, their specific pragmatic errors and response patterns differed significantly.
    • AD subjects exhibited irrelevant, vague, and rambling communication, distinct from the incomplete responses of depressed subjects.

    Conclusions:

    • Functional communication deficits are characteristic of Alzheimer's disease, worsening with disease severity.
    • Elderly depression impacts functional communication, but distinctively from AD.
    • Despite similar overall scores, Wernicke's aphasia and moderate AD present with different qualitative communication breakdowns.