[en] Abstract
Alzheimer’s disease is a prototypical neurodegenerative disease of ageing. Language disorders are part of the clinical picture of Alzheimer’s disease but are most often associated with other cognitive disorders that are responsible for the progressive reduction in activities, social interactions, and communicative autonomy. The aim of this chapter is to describe the language abilities of individuals with Alzheimer’s disease, their progression as the disease advances, and their consequences on patients’ daily lives. Furthermore, it intends to emphasize the adaptive behaviors that patients can put in place, and to examine how patients can be aided in sustaining some communicative skills. Overall, this chapter aims to connect different language domains—such as phonetics and semantics—to a broader discourse and communication setting. This will help clarify the context in which language deficits commonly occur, as well as the clinical and research challenges surrounding the study of discourse processing.
Disciplines :
Neurosciences & behavior
Author, co-author :
Pistono, Aurélie; Laboratoire Cognition, Langues, Langage, Ergonomie, Université Toulouse Jean Jaurès, Centre National de la Recherche Scientifique (CNRS)
Tran, Thi Mai; Independent scholar
Lefebvre, Laurent ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Education > Service de Psychologie cognitive et Neuropsychologie
Language :
English
Title :
Language in Alzheimer’s disease
Publication date :
22 October 2025
Main work title :
The Oxford Handbook of Communication Disorders in Neurodegenerative Diseases
Albert, M.S., S.T. DeKosky, D. Dickson, B. Dubois, H.H. Feldman, N.C. Fox, A. Gamst, et al. 2011. Te Diagnosis of Mild Cognitive Impairment Due to Alzheimer's Disease: Recommendations from the National Institute on Aging-Alzheimer's Association Workgroups on Diagnostic Guidelines for Alzheimer's Disease. Alzheimer's and Dementia 7 (3): pp. 270-279.
Alzheimer, A. 1907. über Eine Eigenartige Erkrankung Der Hirnrinde. Allgemeine Zeitschrif für Psychiatrie und Psychisch-gerichtliche Medizin 64: pp. 146-148.
American Psychiatric Association. 1994. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Washington, DC: American Psychiatric Publishing, Inc.
American Psychiatric Association. 2013. Diagnostic and Statistical Manual of Mental Disorders, Fifh Edition (DSM-5). Washington, DC: American Psychiatric Publishing, Inc.
Amieva, H., M. Le Gof, X. Millet, J.M. Orgogozo, K. Pérès, P. Barberger-Gateau, H. Jacqmin-Gadda, and J.F. Dartigues. 2008. Prodromal Alzheimer's Disease: Successive Emergence of the Clinical Symptoms. Annals of Neurology 64 (5): pp. 492-498.
Ash, S., P. Moore, L. Vesely, and M. Grossman. 2007. Te decline of narrative discourse in Alzheimer's disease. Brain and Language 103 (1-2): pp. 181-182.
Auriacombe, S., N. Lechevallier, H. Amieva, S. Harston, N. Raoux, and J.F. Dartigues. 2006. A Longitudinal Study of Quantitative and Qualitative Features of Category Verbal Fluency in Incident Alzheimer's Disease Subjects: Results from the PAQUID Study. Dementia and Geriatric Cognitive Disorders 21 (4): pp. 260-266.
Balthazar, M.L.F., F. Cendes, and B.P. Damasceno. 2008. Semantic Error Patterns on the Boston Naming Test in Normal Aging, Amnestic Mild Cognitive Impairment, and Mild Alzheimer's Disease: Is there Semantic Disruption?. Neuropsychology 22 (6): pp. 703-709.
Barbeau, E.J., M. Didic, S. Joubert, E. Guedj, L. Koric, O. Felician, J.P. Ranjeva, P. Cozzone, and M. Ceccaldi. 2012. Extent and Neural Basis of Semantic Memory Impairment in Mild Cognitive Impairment. Journal of Alzheimer's Disease 28 (4): pp. 823-837.
Basaglia-Pappas, S., M. Laterza, C. Borg, A. Richard-Mornas, E. Favre, and C. Tomas-Antérion. 2013. Exploration of Verbal and Non-Verbal Semantic Knowledge and Autobiographical Memories Starting from Popular Songs in Alzheimer's Disease. International Psychogeriatrics 25 (5): pp. 785-795.
Beales, A., A. Whitworth, J. Cartwright, P.K. Panegyres, and R.T. Kane. 2019. Profling Sentence Repetition Defcits in Primary Progressive Aphasia and Alzheimer's Disease: Error Patterns and Association with Digit Span. Brain and Language 194: pp. 1-11.
Belleville, S., S. Sylvain-Roy, C. de Boysson, and M.C. Ménard. 2008. Characterizing the Memory Changes in Persons with Mild Cognitive Impairment. Progress in Brain Research 169: pp. 365-375.
Berisha, V., S. Wang, A. LaCross, and J. Liss. 2015. Tracking Discourse Complexity Preceding Alzheimer's Disease Diagnosis: A Case Study Comparing the Press Conferences of Presidents Ronald Reagan and George Herbert Walker Bush. Journal of Alzheimer's Disease 45 (3): pp. 959-963.
Bézy, C., A. Renard, and J. Pariente. 2016. GREMOTS Batterie d'évaluation des Troubles du Langage dans les Maladies Neurodégénératives. De Boeck Supérieur.
Bliss, L.S., and A. McCabe. 2006. Comparison of Discourse Genres: Clinical Implications. Contemporary Issues in Communication Science and Disorders 33: pp. 126-137.
Bortfeld, H., S. Leon, J. Bloom, M. Schober, and S. Brennan. 2001. Disfuency Rates in Conversation: Efects of Age, Relationship, Topic, Role, and Gender. Language and Speech 44 (2): pp. 123-147.
Brandão, L., T.M. Lima, M.A.D.M.P. Parente, and J. Peña-Casanova. 2013. Discourse Coherence and Its Relation With Cognition in Alzheimer's Disease. Revista Psicologia em Pesquisa 7 (1).
Champagne, M., J.L. Seendy, and Y. Joanette. 2006. Efet du Vieillissement sur le Traitement du Langage Non-littéral. Canadian Journal on Aging: La Revue Canadienne du Vieillissement 25 (1): pp. 55-64.
Clark, L.J., M. Gatz, L. Zheng, Y.L. Chen, C. McCleary, and W.J. Mack. 2009. Longitudinal Verbal Fluency in Normal Aging, Preclinical, and Prevalent Alzheimer's Disease. American Journal of Alzheimer's Disease and Other Dementias 24 (6): pp. 461-468.
Croisile, B., B. Ska, M.J. Brabant, A. Duchene, Y. Lepage, et al. 1996. Comparative Study of Oral and Written Picture Description in Patients with Alzheimer's Disease. Brain and Language 53 (1): pp. 1-19.
Cuerva, A.G., L. Sabe, G. Kuzis, C. Tiberti, F. Dorrego, and S.E. Starkstein. 2001. Teory of Mind and Pragmatic Abilities in Dementia. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 14 (3): pp. 153-158.
de Lira, J.O., K.Z. Ortiz, A.C. Campanha, P.H.F. Bertolucci, and T.S.C. Minett. 2011. Microlinguistic Aspects of the Oral Narrative in Patients with Alzheimer's Disease. International Psychogeriatrics 23 (3): pp. 404-412.
De Looze, C., A. Dehsarvi, L. Crosby, A. Vourdanou, R. Coen, B. Lawlor, and R. Reilly. 2021. Cognitive and Structural Correlates of Conversational Speech Timing in Mild Cognitive Impairment and Mild-to-Moderate Alzheimer's Disease: Relevance for Early Detection Approaches. Frontiers in Aging Neuroscience 13: 637404.
Dijkstra, K., M. S. Bourgeois, R. S. Allen, and L. D. Burgio. 2004. Conversational Coherence: Discourse Analysis of Older Adults with and without Dementia. Journal of Neurolinguistics 17 (4): pp. 263-283.
Drummond, C., G. Coutinho, R.P. Fonseca, N. Assunção, A. Teldeschi, et al. 2015. Defcits in Narrative Discourse Elicited by Visual Stimuli Are Already Present in Patients with Mild Cognitive Impairment. Frontiers in Aging Neuroscience 7: 96.
Dubois, B., N. Villain, G. Frisoni, G. Rabinovici, M. Sabbagh, S. Cappa, A. Bejanin, et al. 2021. Clinical Diagnosis of Alzheimer's Disease: Recommendations of the International Working Group. Te Lancet Neurology 20 (6): pp. 484-496.
Fernández, G., F. Manes, N.P. Rotstein, O. Colombo, P. Mandolesi, L.E. Politi, and O. Agamennoni. 2014. Lack of Contextual-Word Predictability during Reading in Patients with Mild Alzheimer Disease. Neuropsychologia 62: pp. 143-151.
Filiou, R.P., N. Bier, A. Slegers, B. Houzé, P. Belchior, and S.M. Brambati. 2020. Connected Speech Assessment in the Early Detection of Alzheimer's Disease and Mild Cognitive Impairment: A Scoping Review. Aphasiology 34 (6): pp. 702-734.
Folstein, M.F., S.E. Folstein, and P.R. McHugh. 1975. "Mini-Mental State". A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research 12 (3): pp. 189-198.
Forbes, K.E., M.F. Shanks, and A. Venneri. 2004. Te Evolution of Dysgraphia in Alzheimer's Disease. Brain Research Bulletin 63 (1): pp. 19-24.
Forbes-McKay, K. E., and A. Venneri. 2005. Detecting Subtle Spontaneous Language Decline in Early Alzheimer's Disease with a Picture Description Task. Neurological Sciences 26 pp: 243-254.
Gayraud, F., H. R. Lee, and Barkat-Defradas, M. 2011. Syntactic and Lexical Context of Pauses and Hesitations in the Discourse of Alzheimer Patients and Healthy Elderly Subjects. Clinical Linguistics & Phonetics 25 (3): pp. 198-209.
Grossman, M., P. Koenig, G. Glosser, C. DeVita, P. Moore, J. Rhee, J. Detre, D. Alsop, J. Gee. 2003. Neural Basis for Semantic Memory Difculty in Alzheimer's Disease: An fMRI Study. Brain 126 (2): pp. 292-311.
Grossman, M., and J. Rhee. 2001. Cognitive Resources During Sentence Processing in Alzheimer's Disease. Neuropsychologia 39 (13): pp. 1419-1431.
Harnish, S.M., and J. Neils-Strunjas. 2008. In Search of Meaning: Reading and Writing in Alzheimer's Disease. Seminars in Speech and Language 29 (1): pp. 44-59.
Hodges, J.R., and K. Patterson. 1995. Is Semantic Memory Consistently Impaired Early in the Course of Alzheimer's Disease? Neuroanatomical and Diagnostic Implications. Neuropsychologia 33 (4): pp. 441-459.
Jack, C.R. Jr, M.S. Albert, D.S. Knopman, G.M. McKhann, R.A. Sperling, M.C. Carrillo, et al. 2011. Introduction to the Recommendations from the National Institute on Aging-Alzheimer's Association Workgroups on Diagnostic Guidelines for Alzheimer's Disease. Alzheimer's & Dementia 7 (3): pp. 257-262.
Joanette, Y., K. Kahlaoui, M. Champagne-Lavau, and B. Ska. 2006. 'Troubles du Langage et de la Communication dans la Maladie d'Alzheimer: Description Clinique et Prise en Charge.' In Actualités sur Les Démences: Aspects Cliniques et Neuropsychologiques, edited by C. Belin, A.M. Ergis, and O. Moreaud, pp. 223-245. Marseille, France: Solal éditeurs.
Joubert, S., S.M. Brambati, J. Ansado, E.J. Barbeau, O. Felician, M. Didic, J. Lacombe, R. Goldstein, C. Chayer, and M.J. Kergoat. 2010. Te Cognitive and Neural Expression of Semantic Memory Impairment in Mild Cognitive Impairment and Early Alzheimer's Disease. Neuropsychologia 48 (4): pp. 978-988.
Joubert, S., N. Gour, E. Guedj, M. Didic, C. Guériot, et al. 2016. Early-Onset and Late-Onset Alzheimer's Disease are Associated with Distinct Patterns of Memory Impairment. Cortex 74: pp. 217-232.
Kavé, G., and Goral, M. 2016. Word Retrieval in Picture Descriptions Produced by Individuals with Alzheimer's Disease. Journal of Clinical and Experimental Neuropsychology 38 (9): pp. 958-966.
Kindell, J., J. Keady, K. Sage, and R. Wilkinson. 2017. Everyday Conversation in Dementia: A Review of the Literature to Inform Research and Practice. International Journal of Language and Communication Disorders 52 (4): pp. 392-406.
Lambert, J., B. Gifard, F. Nore, V. de la Sayette, F. Pasquier, and F. Eustache. 2007. Central and Peripheral Agraphia in Alzheimer's Disease: From the Case of Auguste D. to a Cognitive Neuropsychology Approach. Cortex 43 (7): pp. 935-951.
Lambon Ralph, M.A., E. Jeferies, K. Patterson, and T.T. Rogers. 2017. Te Neural and Computational Bases of Semantic Cognition. Nature Reviews. Neuroscience 18 (1): pp. 42-55.
Lambon Ralph, M.A., K. Sage, and J. Roberts. 2000. Classical Anomia: A Neuropsychological Perspective on Speech Production. Neuropsychologia 38 (2): pp. 186-202.
Lefebvre, L., and R. Rinaldi. 2015. 'Langage et Mémoire de Travail dans la Maladie d'Alzheimer: Quelles Interrelations?' In Mémoire de Travail, edited by P. Gatignol and N. Joyeux, pp. 53-69. Isbergues: Ortho Edition.
Leyton, C.E., J.R. Hodges, O. Piguet, and K.J. Ballard. 2017. Common and Divergent Neural Correlates of Anomia in Amnestic and Logopenic Presentations of Alzheimer's Disease. Cortex 86: pp. 45-54.
Leyton, C.E., S. Hsieh, E. Mioshi, and J.R. Hodges. 2013. Cognitive Decline in Logopenic Aphasia: More Tan Losing Words. Neurology 80 (10): pp. 897-903.
Leyton, C.E., S. Savage, M. Irish, S. Schubert, O. Piguet, K.J. Ballard, and J.R. Hodges. 2014. Verbal Repetition in Primary Progressive Aphasia and Alzheimer's Disease. Journal of Alzheimer's Disease 41 (2): pp. 575-585.
Lukic, S., V. Borghesani, E. Weis, A. Welch, R. Bogley, J. Neuhaus, J. Deleon, Z.A. Miller, J.H. Kramer, B.L. Miller, N.F. Dronkers, and M.L. Gorno-Tempini. 2021. Dissociating Nouns and Verbs in Temporal and Perisylvian Networks: Evidence from Neurodegenerative Diseases. Cortex 142: pp. 47-61.
Luzzatti, C., M. Laiacona, and D. Agazzi. 2003. Multiple Patterns of Writing Disorders in Dementia of the Alzheimer Type and their Evolution. Neuropsychologia 41 (7): pp. 759-772.
Macoir, J., R. Laforce, L. Monetta, and M. Wilson. 2014. Les Troubles du Langage dans les Principales Formes de Démence et dans les Aphasies Primaires Progressives: Mise à Jour à la Lumière des Nouveaux Critères Diagnostiques. Geriatrie et Psychologie Neuropsychiatrie du Vieillissement 12 (2), pp. 199-208.
Martins, I.P., and L. Farrajota. 2007. Proper and Common Names: A Double Dissociation. Neuropsychologia 45 (8): pp. 1744-1756.
McKhann, G., D. Drachman, M. Folstein, R. Katzman, D. Rice, and E.M. Stadlan. 1984. Clinical Diagnosis of Alzheimer's Disease: Report of the NINCDS-ADRDA Work Group under the Auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 34 (7): pp. 939-944.
McKhann, G.M., D.S. Knopman, H. Chertkow, B.T. Hyman, C.R. Jack, et al. 2011. Te Diagnosis of Dementia due to Alzheimer's Disease: Recommendations from the National Institute on Aging-Alzheimer's Association Workgroups on Diagnostic Guidelines for Alzheimer's Disease. Alzheimer's & Dementia 7 (3): pp. 263-269.
Mestach, M., R.J. Hartsuiker, and A. Pistono. 2024. Can We Track the Progression of Alzheimer's Disease via Lexical-Semantic Variables in Connected Speech?. Journal of Neurolinguistics 70: 101189.
Montembeault, M., S.M. Brambati, M.L. Gorno-Tempini, and R. Migliaccio. 2018. Clinical, Anatomical, and Pathological Features in the Tree Variants of Primary Progressive Aphasia: A Review. Frontiers in Neurology 9: 692.
Moro, V., V. Valbusa, N. Corsi, A. Bonazzi, M.T. Condoleo, E. Broggio, and G. Gambina. 2020. Comprehension of Written Texts for the Assessment of Clinical Competence and Decision Making in People with Mild to Moderate Alzheimer Disease. Neurological Sciences 41 (5): pp. 1225-1231.
Mueller, K.D., R.L. Koscik, L.S. Turkstra, S.K. Riedeman, A. LaRue, L.R. Clark, B. Hermann, M.A. Sager, and S.C. Johnson. 2016. Connected Language in Late Middle-Aged Adults at Risk for Alzheimer's Disease. Journal of Alzheimer's Disease 54 (4): pp. 1539-1550.
Neils-Strunjas, J., K. Groves-Wright, P. Mashima, and S. Harnish. 2006. Dysgraphia in Alzheimer's Disease: A Review for Clinical and Research Purposes. Journal of Speech, Language, and Hearing Research 49 (6): pp. 1313-1330.
Orimaye, S.O., J.S.-M. Wong, and K.J. Golden. 2014. 'Learning Predictive Linguistic Features for Alzheimer's Disease and Related Dementias Using Verbal Utterances.' In Proceedings of the Workshop on Computational Linguistics and Clinical Psychology: From Linguistic Signal to Clinical Reality, edited by P. Resnik, R. Resnik, and M. Mitchell, pp. 78-87. Baltimore, Maryland: Association for Computational Linguistics.
Oviatt, S. 1995. Predicting Spoken Disfuencies During Human-Computer Interaction. Computer Speech and Language 9 (1): pp. 19-35.
Parris, B., and B. Weekes. 2001. Action Naming in Dementia. Neurocase 7 (6): pp. 459-471.
Pistono, A., M. Jucla, E.J. Barbeau, L. Saint-Aubert, B. Lemesle, et al. 2016. Pauses During Autobiographical Discourse Refect Episodic Memory Processes in Early Alzheimer's Disease. Journal of Alzheimer's Disease 50 (3): pp. 687-698.
Pistono, A., J. Pariente, C. Bézy, B. Lemesle, J. Le Men, and M. Jucla. 2019a. What Happens When Nothing Happens? An Investigation of Pauses as a Compensatory Mechanism in Early Alzheimer's Disease. Neuropsychologia 124: pp. 133-143.
Pistono, A., M. Jucla, C. Bézy, B. Lemesle, J. Le Men, and J. Pariente. 2019b. Discourse Macrolinguistic Impairment as a Marker of Linguistic and Extralinguistic Functions Decline in Early Alzheimer's Disease. International Journal of Language and Communication Disorders 54 (3): pp. 390-400.
Pistono, A., M. Senoussi, L. Guerrier, M. Rafq, M. Giméno, P. Péran, M. Jucla, and J. Pariente. 2021. Language Network Connectivity Increases in Early Alzheimer's Disease. Journal of Alzheimer's Disease 82 (1): pp. 447-460.
Ramkissoon, I., P.A. Dagenais, K.J. Evans, T.J. Camp, and N.N. Ferguson. 2013. Efects of Ethnically Diverse Photographic Stimuli on Preference and Discourse Tasks in African American and Caucasian American Adults. Communication Disorders Quarterly 34 (2): pp. 97-105.
Reuter-Lorenz, P.A., and D.C. Park. 2014. How Does it STAC Up? Revisiting the Scafolding Teory of Aging and Cognition. Neuropsychology Review 24 (3): pp. 355-370.
Sajjadi, S.A., K. Patterson, M. Tomek, and P.J. Nestor. 2012. Abnormalities of Connected Speech in Semantic Dementia vs Alzheimer's Disease. Aphasiology 26 (6): pp. 847-866.
Salehi, M., M. Reisi, and L. Ghasisin. 2017. Lexical Retrieval or Semantic Knowledge? Which One Causes Naming Errors in Patients with Mild and Moderate Alzheimer's Disease?. Dementia and Geriatric Cognitive Disorders 7 (3): pp. 419-429.
Sandoz, M., K. Iglesias, A.M. Achim, J.F. Démonet, and M. Fossard. 2020. Referential Adjustment During Discourse Production in Alzheimer's Disease, Journal of Clinical and Experimental Neuropsychology 42 (7): pp. 710-724.
Sharma, P., A. Sharma, F. Fayaz, S. Wakode, and F.H. Pottoo. 2020. Biological Signatures of Alzheimer Disease. Current Topics in Medicinal Chemistry 20 (9): pp. 770-781.
Silveri, M.C., B.L. Salvigni, A. Cappa, C. Della Vedova, and M. Puopolo. 2003. Impairment of Verb Processing in Frontal Variant-Frontotemporal Dementia: A Dysexecutive Symptom. Dementia and Geriatric Cognitive Disorders 16 (4): pp. 296-300.
Simoes Loureiro, I., and L. Lefebvre. 2015. Le QCS: Questionnaire de Connaissances Sémantiques pour Déterminer le Stade de Détérioration Sémantique Chez les Patients Atteints de la Maladie d'Alzheimer. Geriatrie et Psychologie Neuropsychiatrie du Vieillissement 13 (2): pp. 225-233.
Snowdon, D.A., S. Kemper, J. Mortimer, L. Greiner, D. Wekstein, and W. Markesbery. 1996. Linguistic Ability in Early Life and Cognitive Function and Alzheimer's Disease in Late Life. Findings from the Nun Study. JAMA 275 (7): pp. 528-532.
Stern, Y. 2002. What is Cognitive Reserve? Teory and Research Application of the Reserve Concept. Journal of the International Neuropsychological Society 8 (3): pp. 448-460.
Taler, V., and N. Phillips. 2008. Language Performance in Alzheimer's Disease and Mild Cognitive Impairment: A Comparative Review. Journal of Clinical and Experimental Neuropsychology 30 (5): pp. 501-556.
Teichmann, M., A. Kas, C. Boutet, S. Ferrieux, M. Nogues, D. Samri, C. Rogan, D. Dormont, B. Dubois, and R. Migliaccio. 2013. Deciphering Logopenic Primary Progressive Aphasia: A Clinical, Imaging and Biomarker Investigation. Brain 136 (11): pp. 3474-3488.
Tran, T.M., P. Dasse, L. Letellier, C. Lubjinkowic, J. Tery, and M.A. Mackowiak. 2012. Les Troubles du Langage Inauguraux et Démence: étude des Troubles Lexicaux Auprès de 28 Patients au Stade Débutant de la Maladie d'Alzheimer. SHS Web of Conferences (1): pp. 1659-1672.
World Health Organization. 2015. European Health Report 2015: Targets and Beyond-Reaching New Frontiers in Evidence. Geneva: World Health Organization. Regional Ofce for Europe.
Wray, A. 2013. Formulaic Language. Language Teaching 46 (3): pp. 316-334.
