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Language Disorders - Complications In Diagnosing Language Disorders In Older Adults

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During the aging process, changes in bodily systems such as vision, hearing, or motor control for speech may cause changes in everyday language activities, such as reading the newspaper, following a conversation, or speaking clearly on the telephone. But as implied in the discussion of aphasia, one must be careful to account for or rule out difficulties of this sort before diagnosing a language (or other cognitive) disorder. Depression, while not a normative condition in older adults, is worth noting here as well, because it can reduce performance in testing situations and thus, without careful assessment, masquerade as a language or other cognitive disorder.

Education, and potentially related factors like literacy and language practice or use over the lifespan, also may complicate assessment and diagnosis of language disorders. Performance on aphasia tests, for example, shows a clear relationship to education. As such, unless an examiner is appropriately cautious, traditional assessments may overdiagnose difficulties in people with little formal education or language proficiency. On the other side of the coin, many measures may not be sufficiently sensitive to detect definite changes in highly educated or literate individuals.

CONNIE A. TOMPKINS MARGARET T. LEHMAN-BLAKE

See also BRAIN; DEMENTIA; SPEECH; STROKE.

BIBLIOGRAPHY

BAYLES, K. A. "Management of Neurogenic Communication Disorders Associated with Dementia." In Language Intervention Strategies in Adult Aphasia, 3d ed. Edited by R. Chapey. Baltimore: Williams & Wilkins, 1994. Pages 535–545.

BAYLES, K. A., and KASZNIAK, A. W. Communication and Cognition in Normal Aging and Dementia. Boston: College-Hill, 1987.

FROMKIN, V., and RODMAN, R. An Introduction to Language, 4th ed. New York: Holt, Rinehart and Winston, 1988.

GRODZINSKY, Y. "The Neurology of Syntax: Language Use Without Broca's Area." Behavioral and Brain Sciences 23 (2000): 1–71.

MELVOLD, J. L.; AU, R.; OBLER, L. K.; and ALBERT, M. L. "Language During Aging and Dementia." In Clinical Neurology of Aging, 2d ed. Edited by M. L. Albert and J. E. Knoefel. New York: Oxford University Press, 1994. Pages 329–346.

MESULAM, M.-M. Principles of Behavioral and Cognitive Neurology, 2d ed. Oxford: Oxford University Press, 2000.

TOMPKINS, C. A. Right Hemisphere Communication Disorders: Theory and Management. San Diego: Singular, 1995.

WERTZ, R. T. "Neuropathologies of Speech and Language: An Introduction to Patient Management." In Clinical Management of Neurogenic Communicative Disorders, 2d ed. Edited by D. F. Johns. Boston: Little, Brown and Company, 1985. Pages 1–96.

WINGFIELD, A., and STINE-MORROW, E. A. L. "Language and Speech." In The Handbook of Aging and Cognition. Edited by F. I. M. Craik and T. A. Salthouse. Mahwah, NJ: Erlbaum, 2000. Pages 359–416.

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