Language and communication disorders in dementia with Lewy bodies versus Alzheimer's disease: Objective screening and subjective perspectives of patients, their caregivers and clinicians

BackgroundLanguage and communication disorders in dementia with Lewy bodies (DLB) remain understudied and have rarely been explored from the caregiver's perspective. Comparative studies with Alzheimer's disease (AD) are also limited.ObjectiveTo provide an initial overview of language and communication profiles in DLB, compared to AD and healthy elderly controls (HC); to assess subjective complaints reported by patients, caregivers and healthcare professionals; and to explore their relationships with rapid language screening. A further aim was to aid non-specialist professionals in identifying patients needing speech therapy referral.MethodsSeventeen DLB patients, 15 AD patients, and 11 HC completed the Diagnostic Tool for Language Assessment and the alpha version of the Communication Support Needs Assessment Tool for Dementia (CoSNAT-D), alongside a semi-directed interview (SDI). Proxy-ratings were also collected from caregivers and healthcare professionals (HP) for the CoSNAT-D and SDI.ResultsCompared to HC, DLB patients showed significantly poorer performance in repetition, verbal working memory, sentence comprehension and dictation, and reported more communication difficulties. Compared to AD patients, DLB patients had greater impairments in phonemic fluency, and more frequent reports of discomfort, vocal changes, and difficulties with writing and handwriting execution. Perceptions of communicative difficulties and their functional impact varied across patients, caregivers, and HP.ConclusionsThis study has identified distinct language and communication deficits in DLB versus AD and HC. Discrepancies between patient and caregiver perceptions were frequent in both groups and may contribute to increased caregiver burden. Findings highlight the potential value of rapid screening tools to better support patients and their caregivers.