7 - Language changes in healthy aging and dementia

Summary

The ultimate goal of the study of language in healthy and abnormal aging is the maximization of communication potential. Although it may seem tactful or humane, it is actually only destructive to deny the existence of difficulties or differences. Maximizing communication potential may involve teaching new strategies for talking and listening either to older and demented patients or to their younger or healthy relatives. In either case, these strategies should be based on the nature of the changes that characterize language in healthy aging and dementia.

This chapter contains two main sections covering language in dementia and in healthy aging. We first discuss language changes in dementia of the Alzheimer's type, looking especially at naming, comprehension, syntax, and discourse. We then present a view of the typical patterns of language deterioration found at different stages of Alzheimer's dementia. Language changes in other cortical dementias and in subcortical dementia are also addressed. In the section on language changes in healthy aging we contrast the relatively subtle changes that occur in the normal elderly with the more dramatic changes of Alzheimer's disease. Changes in naming, comprehension, and discourse are considered in the context of the sensory and neuropsychological changes associated with healthy aging. In a third short section, we address the question of changing neural organization for language with age.