Speech and orofacial apraxias in Alzheimer's disease

Background: Alzheimer's disease (AD) affects not only memory but also other cognitive functions, such as orientation, language, praxis, attention, visual perception, or executive function. Most studies on oral communication in AD focus on aphasia; however, speech and orofacial apraxias are also...

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Bibliographic Details
Authors: Cera, Maysa Luchesi [UNIFESP], Ortiz, Karin Zazo [UNIFESP], Bertolucci, Paulo Henrique Ferreira [UNIFESP], Minett, Thaís Soares Cianciarullo [UNIFESP]
Format: article
Status:Published version
Publication Date:2013
Country:Brasil
Institution:Universidade Federal de São Paulo (UNIFESP)
Repository:Repositório Institucional da UNIFESP
Language:English
OAI Identifier:oai:repositorio.unifesp.br:11600/36775
Online Access:http://dx.doi.org/10.1017/S1041610213000781
http://repositorio.unifesp.br/handle/11600/36775
Access Level:Open access
Keyword:apraxias
Alzheimer's disease
diagnosis
articulation disorders
Description
Summary:Background: Alzheimer's disease (AD) affects not only memory but also other cognitive functions, such as orientation, language, praxis, attention, visual perception, or executive function. Most studies on oral communication in AD focus on aphasia; however, speech and orofacial apraxias are also present in these patients. the aim of this study was to investigate the presence of speech and orofacial apraxias in patients with AD with the hypothesis that apraxia severity is strongly correlated with disease severity.Methods: Ninety participants in different stages of AD (mild, moderate, and severe) underwent the following assessments: Clinical Dementia Rating, Mini-Mental State Examination, Lawton Instrumental Activities of Daily Living, a specific speech and orofacial praxis assessment, and the oral agility subtest of the Boston diagnostic aphasia examination.Results: the mean age was 80.2 +/- 7.2 years and 73% were women. Patients with AD had significantly lower scores than normal controls for speech praxis (mean difference = -2.9, 95% confidence interval (CI) = -3.3 to -2.4) and orofacial praxis (mean difference = -4.9, 95% CI = -5.4 to -4.3). Dementia severity was significantly associated with orofacial apraxia severity (moderate AD: beta = -19.63, p = 0.011; and severe AD: beta = -51.68, p < 0.001) and speech apraxia severity (moderate AD: beta = 7.07, p = 0.001; and severe AD: beta = 8.16, p < 0.001).Conclusion: Speech and orofacial apraxias were evident in patients with AD and became more pronounced with disease progression.