Alzheimer’s Disease

  • Nicole Rogus-PuliaEmail author
  • Anne L. Foundas
  • Kimberly D. Mueller


Dementia is associated with pathological changes in the brain structure and function that lead to cognitive decline, functional deficits, memory loss, and behavioral problems. While there are various subtypes of dementia, we focus our discussion on the effects of Alzheimer’s disease (AD), the most common subtype, on communication and swallowing. Effective communication requires multiple cognitive and biologic processes, including intact semantic and episodic memory, executive function, speech, voice, and language. Given that AD is a neurodegenerative disease, all patients will experience one or more impairments in the areas necessary for communication as the disease progresses. Specific communication deficits experienced by persons with AD include difficulties with language functions (e.g., word retrieval issues), sound substitutions and decreased speech fluency, and abnormal voicing (dysphonia). Additionally, persons with AD often experience challenges with the eating process, involving issues with both self-feeding and swallowing (dysphagia). Adverse health consequences of feeding and swallow impairments include malnutrition, dehydration, decreased quality of life, and aspiration pneumonia. Various evidence-based treatment approaches available to address both communication and eating impairments in persons with AD are described. Early intervention by a speech–language pathologist as part of an interdisciplinary team is critical for the maintenance of communication and swallowing function into disease progression.


Dementia Language Memory Voice Self-feeding Swallowing Dysphagia Communication 



This research was supported by NIH grants 1K23AG057805-01A1 (NRP) and the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS), grant UL1TR002373 (NRP). The manuscript was partially prepared at William S. Middleton Veteran Affairs Hospital in Madison, WI, GRECC manuscript #003-2020. The views and content expressed in this chapter are solely the responsibility of the authors and do not necessarily reflect the position, policy, or official views of the Department of Veterans Affairs, the US government, or the NIH.


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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Nicole Rogus-Pulia
    • 1
    • 2
    • 3
    Email author
  • Anne L. Foundas
    • 4
  • Kimberly D. Mueller
    • 5
  1. 1.Division of Otolaryngology–Head and Neck Surgery, Department of Surgery & Department of MedicineUniversity of Wisconsin–MadisonMadisonUSA
  2. 2.Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans HospitalMadisonUSA
  3. 3.Department of Communication Sciences and DisordersUniversity of Wisconsin–MadisonMadisonUSA
  4. 4.Brain Institute of LouisianaMetairieUSA
  5. 5.Department of Communication Sciences and DisordersUniversity of Wisconsin–MadisonMadisonUSA

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