Apraxia in Dementia



Alzheimer’s disease is associated with problems in brain networks that store the memories of how to use and manipulate tools. This problem can impact how these individuals eat and swallow. More research needs to be done to improve functional independence in people with a diagnosis of Alzheimer’s disease.


Summary: Dementia is defined as a decline from a prior level of cognitive and behavioral function and is commonly associated with deficits in learned skilled movements or apraxia. Apraxia comprises a wide spectrum of higher-order motor disorders that result from brain injury. Patients with apraxia are thought to have deficits in the control or programming of the spatial organization, sequencing, or timing of goal-directed movements. Specifically, patients with Alzheimer’s disease, the most common form of degenerative dementia, develop problems with manipulating and using tools, such as using a fork to eat a meal. Progressive difficulty manipulating and using tools can make it difficult for these patients to eat a meal without assistance. With disease progression, these patients can have difficulty with oral intake, including problems with swallowing.


The real-world effects of apraxia in degenerative dementias have not been extensively studied. Apraxia is common in dementia. Apraxia increases caregiver burden, and impacts day-to-day functioning as patient have more difficulty grooming and with mealtime behavior. As the population ages and dementias become even more prevalent, a better understanding of the nature, management, and treatment of apraxia is warranted. It is also important to determine how cognitive motor systems impact oral intake and swallowing in patients with dementia and in healthy brain aging.


Our researchers are working with colleagues to learn more about apraxia, eating problems, and swallowing in Alzheimer’s disease and other dementias. Our goal is to help patients and family members understand challenges including strategies to improve functional independence.


AUTHORS: Anne L. Foundas, MD, and Jessica A. Shields, MD, PhD


REFERENCE: Foundas AL, Shields J (2012) Apraxia in Dementia: Impact on Oral Intake. ASHA Special Interest Division 13: Perspectives on Swallowing and Swallowing Disorders (Ed. Donna Edwards MA).