Communication Disorders

Alzheimers Disease

What is it?
- A condition which results in a gradual and initially subtle deterioration of intellectual and eventually physical abilities including memory and perceptual deficits, change in personality, loss of reasoning capacity, difficulty in maintaining attention, orientation and learning and differential language loss
- Diagnosed by exclusion
Cause: primarily unknown
- Possible candidates include genetic factors, chromosonal abnormalities, slow acting viruses, accumulation of environmental toxins, individual psychology
Warning Signs
- Recent memory loss that affects job skills
- Difficulty performing familiar tasks
- Language problems
- Time and place disorientation
- Loss of judgement
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behaviour
- Changes in personality
- Loss of initiative

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Phonology
- Few problems until late stage of the disease
Morphology
- Few problems until late stage of the disease
Reading and writing
- Few problems until late stage of the disease
Syntax
- Few problems until late stage of the disease
- Well formed syntactic structure of what is said
- Most of the innapropriate and irrelevant utterances characteristic of the language used by Alzheimer's patients would not appear out of the ordinary in isolation
Up until the final stages of the disease, problems in communication are at a semantic and pragmatic level
Semantics
- Word finding difficulties
- Difficulty with interpretation of pronouns
- Difficulty with interpretation of indirectness: sarcasm and humour may be difficult to follow

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Early stage - mild
- Memory loss or other cognitive deficits are noticeable, yet the person can compensate for them and continue to function independently
Mild stage - moderate
- Mental abilities decline, personality changes, physical problems develop so that the person becomes more and more dependent on caregivers
Late stage - severe
- Complete deterioration of the personality and loss of control over bodily functions requires totaly dependence on others for even the most basic activities of daily living

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Drop in use of clarification requests; drop in ability to assess own comprehensive ability
Drop in excuses and justifications for forgretfulness and inability to do things
Drop in understanding of what the listener expects
Less initiation of conservations
Fewer attempts to prolong conversations
Slow response times
Discourse becomes increasingly disjointed until it is so disorganised that meaningful sequences cannot be produced

End state
- Echolalia is common, sufferer may be mute
- Comprehension is impaired
- Listener may glean part of message from intonation patterns and non verbal activities
- The sufferer will maintain eye contact, respond to handshakes, certain clarifications, responses to compliments

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Describe an object
- Perseverative
- Vague words
- Indefinite terms
Describe a picture
- Empty phrases
- Innapropriate use of anaphora
Tell a story
- Fewer propositions and words
- Errors in anaphora
- Shorter sentences
Participate in a conversation
- Fewer words per conversational turn
- More non verbal responses
- More unintelligible utterances
- Rapid change of topic, may be unrelated to previous topic, discourse lacks cohesion

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Stage 3
- Less active with number of words and questions used
- Questions in present time
- Can sometimes repair own mistakes; check own understanding
- Able to use attention - getting techniques, get action from others, state own wishes
- Word finding problems - neologism, empty word, unrelated word
- Inappropriate responses - no response
- No evidence of positive politness
Stage 4
- Passive, no lexical items, utterances are uhuh, mmm etc
- Can use these to seek clarification, take conversational turns, show recognition

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