Conversation Intervention with Alzheimer's Patients

Abstract

The effectiveness of conversation in improving verbal communication of nursing home residents with Alzheimer's disease was compared to exercise and a combination of both interventions. Fiftyfive participants were randomly assigned to treatment group and raters were blinded. Treatment was given three times weekly for 30 minutes, for 16 weeks. Although all groups evidenced decline in the total number of words used as a group, the conversation-only subjects' performance was significantly better in terms of the number of nonredundant units of information produced (p = .0433) and conciseness (p = .0101) using analysis of covariance controlling for baseline performance. Individual subjects' change in performance was also examined. Active engagement in structured one-on-one conversation may improve relevance of communication in this population. KeywordsAlzheimer's disease; dementia; conversation; exercise; communication; picture description One of the most tragic symptoms of Alzheimer's disease (AD) is the progressive loss of ability to communicate. This loss has obvious adverse consequences for the older individual and their loved ones. For the person with AD, sequelae include isolation, depression, disturbed behavior, and decreased quality of life (Zanetti, Frisoni, Bianchetti, Tamanza, Cigoli & Trabucchi, 1998;Lyketsos, Steele, Galik, Rosenblatt, Steinberg, Warren & Sheppard, 1999).Deterioration of verbal communication becomes evident in pauses, word substitutions and discourse that eventually becomes "circuitous and verbose, yet empty" (Appell, Kertesz & Fisman, 1982, p. 87). Vocabulary decreases and irrelevancies increase. Maintaining a topic becomes difficult (Ellis, 1996;Mentis, Briggs-Whittaker & Gramigna, 1995). Declines may be exaggerated due to the individual's awareness of the problem and resultant frustration, embarrassment, or anxiety, leading to further withdrawal (Cohen, 1991;Pepping & Roueche, 1991). The communicative difficulties also evoke discomfort in the caregivers, inhibiting their attempts to communicate and further reducing opportunities for meaningful interaction with others (Beck, 1996;Ekman, Norberg, Viitanen & Winblad, 1991;Pepping & Roueche, 1991;Hendryx-Bedalov, 2000).There is some evidence that the communication disability associated with AD can be reduced or ameliorated. A variety of interaction-based approaches have been used with cognitively impaired populations. For example, improvement in naming has been reported after exposure NIH Public Access (Huff, Spencer & Protetch, 1990), and simplified speech by the nonimpaired partner was found to improve communication with demented adults (Kemper, Anagnopulos, Lyons & Heberlein, 1994).Bourgeois (1991) reports that use of traditional language training does not generalize to other tasks but that training in conversation does. Use of a memory aid ("memory wallets") stimulated an increase in novel, relevant statements during conversation (Bourgeois, 1992). A family caregiver-led cognitive stimulation program, including both convers...

Treadmill training as an augmentation treatment for Alzheimer?s disease: a pilot randomized controlled study

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The development and evaluation of a training programme for nurses working with persons with communication disorders in a complex continuing care facility

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Atividade física sistematizada e desempenho cognitivo em idosos com demência de Alzheimer: uma revisão sistemática

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