March 17, 2016
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| Immunohistochemistry for alpha-synuclein showing positive staining (brown) of an intraneural Lewy-body in the Substantia nigra in Parkinson's disease. Credit: Wikipedia |
Cognitive impairment could affect the conversational ability of people with Parkinson's more than physical speech problems - according to research from the University of East Anglia (UEA) and the University of Aberdeen.
A new study published today is the first to
assess the extent to which a patient's ability to think quickly forms a barrier
to communication - rather than experiencing physical speech problems.
The research team found that physical speech
problems are often less of a problem for patients
than having the cognitive ability to keep up with conversations.
Parkinson's disease is a common
neurodegenerative condition which affects around 1.5 per cent of people over 65
in Europe. The condition was originally characterised largely in terms of its
motor features, however more recent research has revealed a wide range of
non-motor symptoms including cognitive impairment in over a quarter of
patients.
The research was carried out at UEA's School
of Health Sciences and led by Dr Maxwell Barnish, who is now at the University
of Aberdeen.
Dr Barnish said: "Around 70 per cent of
people with Parkinson's have problems with speech and communication, which can
really impact their quality of life.
"Researchers and clinicians have in the
past focused on the physical problems patients have with making their speech
clear. But patients themselves say the problems are more complex and are more
to do with cognitive impairment - for example not being able to think
quickly enough to keep up with conversations or not being able to find the
right words.
"They say that this that this has the
biggest impact on their ability to communicate in everyday life.
"We wanted to really prioritise the
problems that patients experience - and to find out whether it is clarity of
speech, or these more cognitive issues, that have the most impact on everyday
communication."
The research team undertook the first systematic
review to look at whether cognitive issues or physical speech
problems create the biggest barriers to communication. They sifted through
nearly 5,000 studies in search of helpful data, and found 12 relevant studies
involving 222 patients.
They found that both cognitive status
and physical speech problems are associated with everyday communication
problems among people with Parkinson's. However patients who had greater
cognitive difficulties, had more problems communicating.And while patients with
less clear speech also had trouble communicating, this factor had less of an
impact on everyday communication.
Dr Katherine Deane, from UEA's school of
Health Sciences, said: "What this research tells us is that speech and
language therapists need to assess the cognitive problems of people with
Parkinson's as well as their speech clarity when trying to improve everyday
communication. It may be that patients who are struggling with thinking quickly
need different communication strategies to help them in everyday life.
"Before embarking on this research, we
listened to the needs of patients, and found that much of the research to date
had not prioritised what was really important to people with Parkinson's, their
families, and their carers.
"Due to global ageing populations,
Parkinson's should be considered a major healthcare challenge of the future,
and it will become increasingly important to prioritise the needs of patients
in research."
'Roles of cognitive status and
intelligibility in everyday communication in people with Parkinson's disease: A
systematic review' is published in the Journal of Parkinson's Disease on
Friday, March 18, 2016.
http://medicalxpress.com/news/2016-03-conversation-stopper-people-parkinson.html?
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