Speech and orofacial apraxias in Alzheimer's Disease

Abstract

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 subjects 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. AD patients 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). Orofacial (X²(2)= 38.9, p<0.001) and speech apraxia (X²(2)= 19.4, p<0.001) increased with disease progression. Conclusion: Speech and orofacial apraxias were evident in AD patients and became more pronounced with disease progression. (AU)