Impaired affective prosody in AD - Relationship to aphasic deficits and emotional behaviors

Objective: To assess the ability of patients with AD to produce, repeat, an d comprehend affective prosody in relationship to severity of dementia, aph asic deficits, and changes in emotional behaviors. Methods: An Aprosodia Ba ttery was used to assess affective-prosodic performance and to identify pat terns of deficits in affective communication. In addition, the presence and severity of aberrant behaviors, depression, and aphasia were assessed usin g standardized assessment tools. Results: Patients with AD had significant impairments in their ability to repeat, comprehend, and discriminate affect ive aspects of speech, but maintained normal spontaneous affective-prosodic performances. As dementia severity increased, performance on the comprehen sion tasks and, to a lesser degree, on the repetition tasks became more imp aired; 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 pati ents were severely demented. The majority of aphasic deficits involved anom ia without loss of comprehension. Patients with AD with sensory aprosodia h ad 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 psych iatric behaviors. Conclusion,: Patients with mild AD are at considerable ri sk for affective-prosodic comprehension deficits. As patients become more d emented and develop sensory aprosodia, they are at greater risk for disturb ances in behavior and mood.