Speech-Language Pathologist Interventions for Communication in Moderate-Severe Dementia: A Systematic Review

Area of Science:

• Neurology
• Speech-Language Pathology
• Gerontology

Background:

• Communication impairments are prevalent in moderate-severe dementia.
• Effective interventions are needed to support communication and well-being in this population.
• Current evidence for communication interventions requires systematic evaluation.

Purpose of the Study:

• To evaluate the evidence for direct and indirect communication interventions for people with moderate-severe dementia.
• To assess the impact of these interventions on communication function, participation, and well-being.
• To identify promising intervention approaches for clinical practice.

Main Methods:

• A systematic literature search was conducted across 8 electronic databases following PRISMA guidelines.
• Studies included direct or indirect interventions for moderate-severe dementia (Mini-Mental State Examination ≤ 15).
• Outcome measures focused on communication function, participation, and well-being; methodological quality was assessed using the McMaster critical appraisal tool.

Main Results:

• Eleven studies met inclusion criteria, with 10 focusing on direct interventions (e.g., cognitive stimulation, cognitive training, cognitive rehabilitation) and one on indirect intervention (conversation partner training).
• Due to study heterogeneity, a meta-analysis was not feasible.
• Descriptive synthesis indicated positive changes in communication and quality-of-life outcomes compared to baseline or control groups.

Conclusions:

• Preliminary evidence supports the efficacy of communication interventions for individuals with moderate-severe dementia.
• Group-based cognitive stimulation approaches show promise as direct intervention strategies.
• Findings have implications for speech-language pathologists and future research directions.