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Alzheimer's Disease and Word-Finding Difficulties

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Updated November 05, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

What Are Word-Finding Difficulties?

If you or a loved one has been diagnosed with Alzheimer's or a related dementia, one of the areas that was probably assessed, in addition to memory, judgment, and general cognitive functioning, is the ability to communicate.

Just as the phrase sounds, word-finding difficulties means that a person has difficulty choosing or recalling the right word to adequately express a thought.

Word-finding difficulties are a common symptom of early-stage Alzheimer's, but there are many other possible causes. Some decline in the ability to find the correct word is considered normal as people age, especially in low-frequency words: those that aren't used as often as others. An assessment by a physician is important if continued difficulties are noted.

Word-finding difficulty may also be described as:

  • Tip of the tongue experiences
  • Difficulty finding the right words
  • Speech fluency problems
  • Difficulty naming objects

Examples of Word-Finding Difficulties

Word-finding difficulties may be demonstrated in several different ways. The person may hesitate at length before speaking, and when eventually she tries, she may use an incorrect word that perhaps starts with the same letters of the desired word ("floor" instead of "flower" or "sack" instead of "sand"), or give a description of what the word means ("You know, the thing on the wall with the numbers and the time").

How Are Word-Finding Difficulties Assessed?

There are many formal and informal ways to evaluate word-finding ability. Some practitioners use tests such as the Verbal Fluency Test or the Boston Naming Test. Others may simply note the person's communication abilities throughout a conversation, and ask family members for their observations.

You can also expect that a physician may ask: if the individual previously had difficulties with finding the right words, or if this is a new concern; when the problems occur; if the individual is bilingual, and if so, what his primary language is (as this can affect word-retrieval); what his level of education is; and if there are any other related problems.

What Causes Word-Finding Difficulties?

There are many causes of word-finding difficulty, including stroke, delirium, major depression, anxiety, head injuries and aging.

In dementia, impairment of the semantic memory (the memory for understanding and recognizing words) appears to be a significant contributor to word-finding difficulties.

What Are Helpful Ways to Respond to Word-Finding Difficulties?

If you're certain which word the person with dementia is searching for, go ahead and say it. If you're not sure, don't offer guesses of multiple words, as that has the potential to further frustrate and overwhelm the person.

Ask for clarification. If the person says that her "fig" hurts, for example, ask her if her finger hurts, and point to it.

Be patient. Rushing the person will almost certainly not facilitate communication, but rather increase anxiety and frustration—and possibly cause the person to exhibit challenging behaviors.

Sources:

American Medical Association. Differentiating Normal Aging and Dementia. Accessed October 30, 2012.

Australian Psychologist Volume 32, Issue 2, pages 114–119, July 1997. http://onlinelibrary.wiley.com/doi/10.1080/00050069708257363/abstract

Brain. 2008 January; 131(Pt 1): 8–38. Word-finding difficulty: a clinical analysis of the progressive aphasias. Accessed October 29, 2012. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2373641/

Strategic Promotion of Ageing Research Capacity. Where’s that Word? Word finding problems in older age. Accessed October 29, 2012.

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