PROSODY IMPAIRMENT AND ASSOCIATED AFFECTIVE AND BEHAVIORAL DISTURBANCES IN ALZHEIMERS-DISEASE

We examined the ability to produce, repeat, and comprehend emotional p rosody in 20 patients with Alzheimer's disease (AD) and in 11 elderly normal control subjects. In addition, caregivers of AD patients comple ted affective and behavioral measures with reference to the patient. R elative to control subjects, comprehension of emotional prosody was ma rginally impaired in mildly demented AD patients, whereas production, comprehension, and repetition of emotional prosody were significantly impaired in moderately demented AD patients. The moderately demented p atients performed significantly poorer than the mildly demented patien ts on the production and repetition tasks. In contrast, there was no s ignificance difference between the two groups on the prosody comprehen sion task. Additional analyses revealed an inverse relationship betwee n the ability to correctly produce and repeat emotional prosody and th e frequency of agitated behaviors and depressive symptomatology in mod erately demented patients. This latter finding suggests that the inabi lity to communicate emotional messages is associated with disturbances in mood and behavior in AD patients. Implications for the management of disruptive behavior in agitated and aprosodic AD patients include t he development of caregiver sensitivity to unexpressed emotion and car egiver assistance with emotional expression.