Ideomotor apraxia in Alzheimer's disease: Intervention using an unaided augmentative and alternative communication system

Objectives: The potential value of gestures needs to be evaluated as an unaided alternative and augmentative communication (AAC) method to improve the naming ability of persons with Alzheimer's disease (AD). Considering the possible effect of ideomotor apraxia (IMA) in AD patients, the current study aimed to investigate the difference between AD groups and a control group in an IMA task and a verb naming task focusing on transitive movements. Methods: Ten patients with questionable AD, 15 with mild AD, 10 with moderate AD, and 12 healthy seniors participated in the study. Task accuracy and error types were analyzed by using non-parametric statistical methods. Results: The mild and the moderate AD groups showed significantly lower accuracy in the IMA task than the control group. When the body-part-as-object (BPO), delayed, and occurrence errors were considered as acceptable responses, no significant difference was observed between the control and the mild AD groups, whereas significant differences exited between the control group and three patient groups in the verb naming task. Verb naming scores were significantly lower than IMA task scores in the questionable and the mild AD groups. Conclusion: These results suggest that the gesture can be used as an effective unaided AAC system to supplement verb naming deficit for persons with questionable AD and mild AD regardless of the presence of IMA. Meanwhile, an increase of non-acceptable gestures (e.g., external configuration orientation errors) in the moderate AD requires therapists to consider other alternative approaches to aid their verbal naming.