Abstract
Classification of individuals with Alzheimer's disease (AD) based on their communication deficits was performed and communication support for each type of deficit was investigated. The relationship between the daily clinical activities of speech and hearing therapists and the provision of evidence based medicine (EBM) for individuals with AD is discussed. When cluster analysis of the communication deficits of individuals with probable AD was done by Ward's method, five types were identified ; 1) general high, 2) hearing difficulty, 3) cognitive difficulty, 4) speech difficulty, and 5) general low. After comprehensive cognitive group therapy was provided for the cognitive difficulty type, the Mini Mental State Examination score of individuals with probable AD exceeded the scores obtained in several previous clinical trials assessing the efficacy of donepezil hydrochloride. When displaying mouth movements during listening to words was investigated for the hearing difficulty type, probable AD patients with moderate or severe hearing loss showed significant improvement of aural comprehension compared to their comprehension without showing mouth movements. We should try to obtain high-level evidence for communication therapy such as by performing a randomized controlled trial. In addition, it is particularly important for the self-evaluation of EBM for individuals with dementia to develop investigations during daily clinical activities, such as analysis of the effect on each type of dementia or grade of severity and comparison with the effects of medication, in order to generate and verify hypotheses.
