Language impairment in dementia: impact on symptoms and care needs in residential homes.
BACKGROUND
Impairment of language skills affects the level of functioning of an individual, interferes with effective communication and can result in development of disruptive behaviour. Social skills and capacity for self care may be compromised. Few studies have evaluated the impact of language problems on symptoms and socialization in people with dementia in care environments.


METHODS
315 elderly residents with dementia (29% living in nursing homes, 71% in social care facilities) were assessed using standardized psychiatric schedules including the Sheffield Screening Test for Acquired Language Disorders and Neuropsychiatric Inventory. Dementia Care Mapping was undertaken at random in at least 50% of residents in each facility.


RESULTS
Expressive language impairment was associated with the presence of delusions even when severity of dementia was controlled for (p=0.02) and showed a tendency of association with depression (p=0.06). Receptive language difficulties were strongly associated with presence of Aberrant Motor Behaviour, even controlling for severity of dementia (p=0.04). Decreased participation in social activities was correlated with both expressive (p=0.048) and receptive aspects of language (p<0.01) but social withdrawal was only correlated with receptive language difficulties (p=0.01).


CONCLUSIONS
Language disorders are associated with both behavioural and psychological symptoms of dementia even when severity of dementia is controlled for. Patients' needs in communication skills should be addressed earlier to help them maintain social interactions and reduce the impact on behavioural problems and patients' quality of life.
Potkins
Dawn
D
Wolfson Research Centre, Newcastle General Hospital, Newcastle, UK.
Myint
Pat
P
Bannister
Carol
C
Tadros
George
G
Chithramohan
Ramilgan
R
Swann
Alan
A
O'Brien
John
J
Fossey
Jane
J
George
Eugenie
E
Ballard
Clive
C
Margallo-Lana
Marisa
M
D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000451:nursing / Q000523:psychology*; D004739:England; D005260:Female; D006301:Health Services Needs and Demand; D006707:Homes for the Aged; D006801:Humans; D007398:Interpersonal Relations; D007806:Language Disorders / Q000209:etiology* / Q000523:psychology; D008297:Male; D009069:Movement Disorders / Q000209:etiology; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales; D012951:Socialization