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Sentence comprehension in Alzheimer's disease: effects of grammatical complexity, speech rate, and repetition.

Caregivers of patients diagnosed with Alzheimer's disease (AD) are often advised to modify their speech to facilitate the patients' sentence comprehension. Three common recommendations are to (a) speak in simple sentences, (b) speak slowly, and (c) repeat one's utterance, using the same words. These three speech modifications were experimentally manipulated in order to investigate their individual and combined effects on sentence comprehension in AD. Fifteen patients with mild to moderate AD and 20 healthy older persons were tested on a sentence comprehension task with sentences varying in terms of (a) degree of grammatical complexity, (b) rate of presentation (normal vs. slow), and (c) form of repetition (verbatim vs. paraphrase). The results indicated a significant decline in sentence comprehension for the AD group. Sentence comprehension improved, however, after the sentence was repeated in either verbatim or parapharsed form. However, the patients' comprehension did not improve for sentences presented at the slow speech rate. This pattern of results is explained via-à-vis the patients' working memory loss. The findings challenge the appropriateness of several clinical recommendations.