Clark L W
Communication Sciences Program, School of Health Sciences, Hunter College of CUNY.
Geriatrics. 1994 Jun;49(6):51-5; quiz 56-7.
Communication impairments, with or without a swallowing disorder, are common among older adults. Aphasia, which is usually caused by a focal lesion, can affect spoken and written language, auditory comprehension, and reading ability but by itself does not affect intellectual and cognitive abilities. A cognitive-communicative impairment is related to underlying cognitive deficits in memory, attention, or visual perception and is seen with traumatic brain injury and nontreatable dementia. Voice and speech impairments such as dysarthria and apraxia of speech may lead to self-imposed social isolation and depression. Dysphagia may accompany a communication disorder or exist independently. As a primary care physician, your in-office workup can help diagnose a communication disorder and identify candidates for referral to an otolaryngologist and/or speech-language pathologist.
无论是否伴有吞咽障碍，沟通障碍在老年人中都很常见。失语症通常由局灶性病变引起，会影响口语和书面语言、听觉理解及阅读能力，但本身并不影响智力和认知能力。认知-沟通障碍与记忆、注意力或视觉感知方面潜在的认知缺陷有关，见于创伤性脑损伤和无法治疗的痴呆症。构音障碍和言语失用等嗓音和言语障碍可能导致自我施加的社会隔离和抑郁。吞咽困难可能伴随沟通障碍或独立存在。作为初级保健医生，你在办公室进行的检查有助于诊断沟通障碍，并确定转诊至耳鼻喉科医生和/或言语治疗师的合适人选。
