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Impaired affective prosody in AD

Relationship to aphasic deficits and emotional behaviors

From the Departments of Psychiatry and Behavioral Sciences (Drs. Testa and Beatty), Communication Sciences and Disorders (D.M. Orbelo), and Neurology (D.M. Orbelo and Dr. Ross), University of Oklahoma Health Sciences Center, Oklahoma City; and the Department of Psychology (A.C. Gleason), University of Houston, TX.

Address correspondence and reprint requests to Dr. Testa, University of Oklahoma Health Sciences Center, Veterans Administration Medical Center, Center for Alzheimer’s and Neurodegenerative Disorders, 921 N.E. 13th Street, 11-AZ, Oklahoma City, OK 73190; e-mail: julietesta{at}hotmail.com

Objective: — To assess the ability of patients with AD to produce, repeat, and comprehend affective prosody in relationship to severity of dementia, aphasic deficits, and changes in emotional behaviors.

Methods: — An Aprosodia Battery was used to assess affective-prosodic performance and to identify patterns of deficits in affective communication. In addition, the presence and severity of aberrant behaviors, depression, and aphasia were assessed using standardized assessment tools.

Results: — Patients with AD had significant impairments in their ability to repeat, comprehend, and discriminate affective aspects of speech, but maintained normal spontaneous affective-prosodic performances. As dementia severity increased, performance on the comprehension tasks and, to a lesser degree, on the repetition tasks became more impaired; spontaneous affective prosody remained normal. In the current study, affective-prosodic comprehension impairments were present in patients with all stages of AD; comparable aphasic deficits were not observed until patients were severely demented. The majority of aphasic deficits involved anomia without loss of comprehension. Patients with AD with sensory aprosodia had increased frequency and severity of behavioral changes whereas patients with AD with normal affective-prosodic performance were significantly less demented, had normal linguistic ability, and displayed fewer aberrant psychiatric behaviors.

Conclusion:— Patients with mild AD are at considerable risk for affective-prosodic comprehension deficits. As patients become more demented and develop sensory aprosodia, they are at greater risk for disturbances in behavior and mood.

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