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Language disintegration in dementia: effects of etiology and severity
Hier DB, Hagenlocker K, Shindler AG.. Brain and language, 1985-05-01
Topic: Risk, prevention and care in population studies
The speech characteristics on a standardized picture description task of 26 subjects with presumed senile dementia of the Alzheimer type (SDAT) and 13 subjects with stroke-related dementia (SRD) were compared to 15 normal subjects over age 59 years. Compared to the normal subjects, the dementia subjects used fewer total words, fewer unique words, fewer prepositional phrases, fewer subordinate clauses, and more incomplete sentence fragments. Lexical deficits tended to be more severe than syntactic ones, confirming prior suggestions that lexicon is more vulnerable to disruption in dementia than syntax. Greater dementia severity among the SDAT subjects was associated with marked difficulties in accessing the mental lexicon (increased use of empty words, indefinite anaphora, and pronouns). Greater dementia severity in the SRD subjects was associated with laconic speech that was syntactially less complex. Diffuse brain injury (as typified by SDAT) appears to disproportionately affect lexicon whereas multifocal injury (as typified by SRD) has a disproportionate effect on syntax (assuming that focal lesions of the posterior language zone have been excluded). The speech characteristics of the mild SDAT subjects showed similarities to those of anomic or semantic aphasia whereas the speech of the more advanced SDAT subjects showed similarities to Wernicke aphasia or transcortical sensory aphasia. The speech of the subjects with more severe SRD showed some similarities to Broca aphasia. The most important nonlinguistic deficit in both the SRD and the SDAT groups was a failure to make relevant observations during the picture description task. Perseverations were present in the speech of both the SRD and SDAT subjects, whereas aposiopesis, logorrhea, and palilalia were more typical of the SDAT subjects. Laconic speech was more characteristic of the SRD subjects.
Key findings
- The speech characteristics on a standardized picture description task of 26 subjects with presumed senile dementia of the Alzheimer type (SDAT) and 13 subjects with stroke-related dementia (SRD) were compared to 15 normal subjects over age 59 years.
- Compared to the normal subjects, the dementia subjects used fewer total words, fewer unique words, fewer prepositional phrases, fewer subordinate clauses, and more incomplete sentence fragments.
- Lexical deficits tended to be more severe than syntactic ones, confirming prior suggestions that lexicon is more vulnerable to disruption in dementia than syntax.
- Greater dementia severity among the SDAT subjects was associated with marked difficulties in accessing the mental lexicon (increased use of empty words, indefinite anaphora, and pronouns).
- Greater dementia severity in the SRD subjects was associated with laconic speech that was syntactially less complex.
Why it matters
This small study compared speech in people with Alzheimer's-type dementia and stroke-related dementia and found word-finding problems were worse than grammar problems. It describes language symptoms only and does not test any treatment, cure or prevention.
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Study details
- Participants26
- Evidence strengthLow
How this study scored 43/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 42 of the 97 points we could judge it on, which is 43 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Brain and language) |
| Journal's citation record | 2 / 4 | Brain and Language: journal h-index 214 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1985 — older than 20 years, still counted |
| Sample size | 1 / 4 | 26 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 279 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.5 citations a year over 43 year(s) since 1985 |
| Impact for its field and year | 3 / 6 | Cited 5.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 7 other studies in this library |
| Still being cited | 2 / 4 | Cited 24 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Andrea Gellin Shindler: h-index 5 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 2411334) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 42 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 42 of the 97 points we could judge it on is 43 out of 100. |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Hier, D. B., Hagenlocker, K., & Shindler, A. G. (1985). Language disintegration in dementia: effects of etiology and severity. Brain and language. https://doi.org/10.1016/0093-934x(85)90124-5
Vancouver
Hier DB, Hagenlocker K, Shindler AG. Language disintegration in dementia: effects of etiology and severity. Brain and language. 1985. doi:10.1016/0093-934x(85)90124-5. PMID: 2411334.
BibTeX
@article{hier1985-2411334,
author = {Hier, D. B. and Hagenlocker, K. and Shindler, A. G.},
title = {{Language disintegration in dementia: effects of etiology and severity}},
journal = {Brain and language},
year = {1985},
doi = {10.1016/0093-934x(85)90124-5},
pmid = {2411334},
url = {https://doi.org/10.1016/0093-934x(85)90124-5}
}
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