The assessment of language and communication in Dementia: A synthesis of evidence

Objective: Without the current option of a dementia cure, there is an existing need to focus on rehabilitation intervention. This includes interventions that address language and communication impairment (LCI), found to be present early in most types of dementia. Assessment of LCI can occur in many contexts (e.g., speech pathology, neuropsychology, occupational therapy) and is a vital initial step in providing adequate support to people living with dementia and their families. However, no previous research has compared the psychometric properties and utility of currently available and suitable tools for this purpose. Methods: Eighteen tools with the potential to assess language and communication in dementia were identified through a two-stage process, and a synthesis of evidence is provided. Results: Three tools satisfied all selection criteria: the Arizona Battery for Communication Disorders of Dementia, the Sydney Language Battery, and the Addenbrooke's Cognitive Examination III. Main limitations of the 18 tools reviewed concern a lack of standardization, normative data, and criterion validity, as well as poor evidence of reliability of tools originally developed for non-neurodegenerative LCI (e.g., aphasia in the context of cerebrovascular accidents). Furthermore, no tool considers the perspectives of people with dementia regarding the impact of LCI on their daily lives. Conclusion: Further research is needed to improve reliability and validity of currently available tools for the linguistic assessment of people living with dementia. Importantly, a tool to assess early identification of language and communication difficulties and associated needs among people with dementia is warranted to facilitate timely management and support.