International Psychogeriatrics

Review Article

Aspects of communication in Alzheimer's disease: clinical features and treatment options

Michael Woodward 

Aged Care Service, Heidelberg Repatriation Hospital, Austin Health, Victoria, Australia

ABSTRACT

Background: During the course of Alzheimer's disease (AD), cognitive processes, including language and communication, become increasingly impaired. The aim of this review was to highlight the impact of communication deficits in AD, and discuss the need for effective treatments.

Method: PubMed was searched for studies relating to language and communication in AD. The publications identified were used as a basis for the commentary in this paper. Studies relating to the clinical effectiveness of pharmacological treatment for language and communication issues were identified systematically.

Results: Communication deficits are common in AD. From the earliest disease stage, the patient's capacity for communication declines as problems develop with the use of language and all aspects of functional communication. There is a loss of the ability to communicate thoughts and needs, and it becomes increasingly difficult to interact socially and sustain personal relationships with caregivers, family, and friends. It is unsurprising that patients become frustrated at their loss of self-expression, and studies have demonstrated that impaired communication is strongly linked with the development of significant behavioral concerns. Overall, poor communication contributes to caregiver strain, and adds notably to the burden of disease. Clinical data and post-hoc analyses provide preliminary indications that anti-AD therapies (memantine and the cholinesterase inhibitors, ChEIs) and non-pharmacological cognitive–linguistic stimulation techniques may be helpful in addressing communication difficulties.

Conclusions: The capacity to treat or slow the progression of communication deficits in AD would prolong patient independence, and have a profound impact on the quality of life of patients and caregivers. The use of pharmacological (anti-AD therapies) and non-pharmacological (cognitive–linguistic stimulation) treatments may be useful management methods and warrant further investigation.

(Received October 05 2012)

(Reviewed December 14 2012)

(Revised February 17 2013)

(Accepted February 18 2013)

(Online publication March 25 2013)

Key words:

  • cognition;
  • communication;
  • language;
  • functional communication;
  • Alzheimer's disease

Correspondence

Correspondence should be addressed to: Michael Woodward, Associate Professor, Aged Care Services, Heidelberg Repatriation Hospital, Austin Health, 300 Waterdale Road, Heidelberg West, Victoria 3081, Australia. Phone: +61-3-9496-2185; Fax: +61-3-9496-2613. Email: michael.woodward@austin.org.au.