Aphasia and dementia: Steps towards a new era in neuropsychology

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Abstract
Once the victim of comparative neglect, the study of language in patients with dementia is beginning to flourish. It is important for both practical and theoretical reasons. Language dysfunction can be prominent in patients with dementia and indeed may be the presenting symptom (e.g. Pogacar and Williams 1984, Wechsler, Verity, Rosenschein, Fried and Scheibel 1982). The presence or absence of language impairment has come to occupy a key role in relation to a number of nosological and nosographic issues. These include the controversial classification of the dementias into cortical and subcortical types and the distinction between so-called early- and late-onset types of Alzheimer's disease, the most common cause of dementia. Furthermore, it has been suggested that impairment of language in patients with dementia may be a useful index of severity and can have prognostic implications (Bayles and Boone 1982, Kaszniak, Fox, Gandell, Garron, Huckman and Ramsay 1978, Skelton-Robinson and Jones 1984). Impaired communicative abilities undoubtedly contribute to the burden of caring which falls largely upon the shoulders of relatives (Gilleard, Boyd and Watt 1982).

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