PANTOMIME RECOGNITION AND PANTOMIME EXPRESSION IN PERSONS WITH ALZHEIMER'S DISEASE.

Abstract

There are few, yet contradictory, reports in the literature regarding whether persons with Alzheimer's disease demonstrate a disturbance of nonverbal communication or pantomime. While some researchers ascribe all disturbances of gestural behavior to apraxic phenomena, others have viewed a disturbance of pantomime as the consequence of language disorder or general intellectual deterioration. This investigation was conducted (1) to determine whether persons with Alzheimer's disease demonstrate a disturbance of pantomime recognition, pantomime expression, or both, compared to healthy, aged controls; (2) to determine the relation of performance on measures of pantomime recognition and pantomime expression to performance on measures of cognition/intelligence, language, and praxis in Alzheimer subjects; (3) to determine whether Alzheimer subjects improve pantomimic expressive performance on imitation of the examiner; and (4) to determine whether a statistically significant difference in pantomimic expressive performance between Alzheimer and control subjects is also a clinically obvious difference. Forty-five subjects (30 subjects with Alzheimer's disease and 15 healthy, aged controls) were administered measures of pantomime recognition, pantomime expression, cognition/intelligence, language, and praxis. In addition, 13 graduate students in speech-language pathology viewed and judged as being "normal" or "abnormal" 15 expressive pantomimes performed by 10 Alzheimer and 5 control subjects. Results indicated that there was a significant difference between groups in performance on both pantomime measures; the Alzheimer subjects performed less well than controls. The performance of Alzheimer subjects on both pantomime measures was also more closely related to performance on measures of language and cognition/intelligence than to praxis. Alzheimer subjects improved pantomimic expressive performance on imitation of the examiner, to the extent that between groups performance no longer differed significantly. Finally, graduate student judges rated the pantomimic expressive performance of Alzheimer subjects as being "abnormal" significantly more often than the pantomimic expressive performance of controls. Because the pantomime variables were related to both the language and cognition/intelligence variables, and the language and cognition/intelligence variables were related to one another, it was concluded that these variables were functionally interdependent, and therefore, these results for this sample conformed with central mechanism explanations for a disturbance of pantomime.