Aged Care Service, Heidelberg Repatriation Hospital, Austin Health, Victoria, Australia.
Int Psychogeriatr. 2013 Jun;25(6):877-85. doi: 10.1017/S1041610213000318. Epub 2013 Mar 25.
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.
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.
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.
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.
在阿尔茨海默病（AD）的病程中，认知过程，包括语言和沟通，会逐渐受损。本综述旨在强调 AD 患者沟通障碍的影响，并讨论对有效治疗的需求。
在 PubMed 上搜索与 AD 中的语言和沟通相关的研究。将这些出版物作为本文评论的基础。系统地确定了与语言和沟通问题的药物治疗临床效果相关的研究。
沟通障碍在 AD 中很常见。从疾病的最早阶段开始，患者的沟通能力就会下降，语言的使用和所有功能沟通方面都会出现问题。他们会逐渐失去表达思想和需求的能力，与护理人员、家人和朋友进行社交互动和维持人际关系也会变得越来越困难。患者对自我表达的丧失感到沮丧，这并不奇怪，研究表明，沟通障碍与严重行为问题的发展密切相关。总的来说，沟通不畅会给护理人员带来压力，并显著增加疾病负担。临床数据和事后分析初步表明，抗 AD 疗法（美金刚和胆碱酯酶抑制剂，ChEIs）和非药物认知语言刺激技术可能有助于解决沟通困难。
治疗或减缓 AD 患者沟通障碍的进展能力将延长患者的独立性，并对患者和护理人员的生活质量产生深远影响。药物（抗 AD 疗法）和非药物（认知语言刺激）治疗的使用可能是有用的管理方法，值得进一步研究。
