Language and communication non-pharmacological interventions in patients with Alzheimer's disease: a systematic review. Communication intervention in Alzheimer

Abstract

Alzheimer's disease considerably compromises communication skills. Language changes become more prominent as the disease progresses. Deterioration of language and cognition reduces the ability of holding conversations, which has a negative impact on social interaction.OBJECTIVE:To conduct a systematic review of the literature for articles reporting interventions focused on the language and communication of people with Alzheimer's disease (AD) without use of medication.METHODS:We performed a search using the keywords Alzheimer's disease, language, communication, cognition, cognitive intervention, rehabilitation and therapy, and their corresponding Portuguese and Spanish terms, on the SciELO, LILACS, PubMed and PsychINFO databases. We analyzed intervention studies published from 1993 to 2016 that involved stimulation of language skills and/or communication with pre-and post-intervention quantitative results, and whose samples included at least 50% with a diagnosis of probable AD. Studies were analyzed and classified into four levels of evidence, according to the criteria described in the literature.RESULTS:Twenty-eight articles were included. The majority of the designs had medium-to-low scientific evidence. Most interventions showed benefits for at least one language or communicative skill. Eight types of interventions emerged from the analysis of the studies. Further research with higher levels of evidence is recommended in the investigation of interventions focused on language and communication skills of patients with dementia.CONCLUSION:Studies with high levels of evidence on the topic investigated are only being conducted on a small scale. Two intervention techniques seem potentially effective: lexical-semantic approaches and interventions that work with different cognitive skills (including language).

Comparison of the efficacy of gesture‐verbal treatment and doll therapy for managing neuropsychiatric symptoms in older patients with dementia

“…Importantly, although language disorders in PwD have been extensively studied, few studies have investigated the impact of language and communication interventions on NPS . Whereas communication generally worsens as dementia progresses, some aspects of communication are relatively preserved, including meaningful use of nonverbal communication .…”

“…26,27 Importantly, although language disorders in PwD have been extensively studied, few studies have investigated the impact of language and communication interventions on NPS. [28][29][30][31][32][33] Whereas communication generally worsens as dementia progresses, some aspects of communication are relatively preserved, including meaningful use of nonverbal communication. 34 There is evidence that the use of cospeech gestures could facilitate cognitive functions (eg, episodic memory; spatial working memory) [35][36][37] as well as speech production and comprehension of spoken language in PwD.…”

A Multimodal corpus to check on pragmatic competence for Mild Cognitive Impaired aging people

“…Clinicians have a duty to develop their professional practice through an evidence-based clinical approach whose main objective is to reconcile clinical practice with the best evidence from research (Dollaghan 2007). In the case of speech-language pathology, clinicians consider themselves very limited in this approach (Lof 2011;McCurtin 2011), especially for patients with Mild Cognitive Impairment (Mungas et al 2010;Hopper 2013;Morello 2017) and more specifically when it comes to assessing or supporting language functions (Cummings 2014).…”

“…However, clinical research on this topic is still marginal, especially regarding people suffering from dementia, while practitioners subjectively indicate (without any analytical grid or standardized tests) their observations on the pragmatic, interactive and particularly gestural skills of the patients they meet. Nunes da Cruz Morello et al (2017) conducted a systematic review of non-pharmacologic therapeutic interventions to maintain, assess or rehabilitate the language and communication skills of patients with ATD, and reveal this gap that significantly hinders guidance in evidence-based speech therapy and non-drug therapies. Most of the studies included in this systematic review show beneficial effects of speech therapy on the communication skills of MCI and ATD patients.…”

Review of AAC interventions in persons with dementia

“…Morello et al . () systematically reviewed studies on language and communication interventions for persons with Alzheimer's disease and found two studies that used memory cards in conversation. In two other systematic reviews on communication skills training programmes in dementia (Eggenberger et al .…”