People with Alzheimer’s disease have many problems communicating with others. Although these communication problems involve some deficits in their speech and language, it is not possible to discuss speech or hearing problems as they relate to communication without also examining the relationship between speech/hearing and language.

Physiologically, speech can be considered the result of the appropriate use of the lips, tongue, teeth, and vocal cords to produce sounds. The pure mechanics of speech (making speech sounds) can be accomplished without imparting any information to the listener, especially if the speech sounds have no meaning. Choosing the desired words and ordering them in a fashion that will accomplish the intended meaning involves language.The symbols that are used during oral communication are words. Even if of the words of a sentence are produced clearly and concisely, no meaning can be derived if the sentence is not organized in a logical fashion with words that conform to the speaker’s intended mental image.

In much the same way, hearing involves not only the basic reception of sounds but also the processing of these acoustical items in a fashion .that matches the perceptions with meaningful information in the brain. It , quite possible for a person to hear everything that is spoken on a pure awareness or sensory basis but not derive any meaning or symbol association from these sounds. Therefore, the comprehension and understanding of a spoken message is equally dependent on not only the awareness of all of the acoustical elements of what was spoken, but also the mental organization of the speech sounds and the brain’s association of these sounds with meaningful linguistic symbols. For example, a person might hear every component of a message that is being presented in Chinese but be unable to understand what is said. The person’s hearing acuity is adequate to perceive all of the components of the message, but no association can be made between the auditory perception and any meaningful information.

Effective communication must involve both a speaker’s articulation and the hearing of the listener. The speaker must produce the words correctly and organize them in an appropriate fashion. The listener must be able to hear all of the components of the spoken message and be able. associate meaning with what is heard.

Most individuals will experience some type of communication problem during the aging process. As a person ages, a number of natural of natural changes occur that reduce sensory acuity. This gives rise to less precise communication. After the age of sixty, individuals generally see and hear less than in their youth. Sensory decline is expected with age and not considered abnormal unless such deficits are major. For example, while a certain amount of hearing loss is considered normal as one grows older, acquired deafness is not considered a normal factor accompanying old age. Also it is not unusual to wear glasses (or require bifocals) as one ages, but total loss of sight is abnormal.

Hearing Impairment

One of the expected changes that occur during normal aging is a decrease in hearing acuity. The term used for hearing loss associated with the aging process is presbycusis. This impairment is the product of many factors heaving to do with what the individual’s condition and the environment to which he or she has been exposed. Some contributing factors include noise exposure, toxic substances, hypertension, vascular insufficiency, and anatomical changes in the hearing system. In reality, presbycusis relates to numerous disorders under the category of hearing loss resulting from the aging process.

The average person affected by Alzheimer’s disease will also experience presbycusis. Therefore, it is to be expected that the individual will develop some high-frequency hearing difficulty and problems in understanding speech. Those with high-frequency hearing loss will have numerous problems understanding when in noisy situations. Therefore, when talking to a person who has Alzheimer’s disease it is always wise to select a quiet environment and reduce the rate of speaking to allow greater time for the patient to understand what is spoken.

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