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Verbal repetition in people with mild-moderate Alzheimer's Disease: a descriptive analysis from the VISTA clinical trial

“It’s the time that we’re leaving that is always the problem to her.

‘What time is it we’re leaving?’ so I say you know ‘ quarter to ten’…then after before she’ll go up stairs she’ll say ‘what time is it we’re leaving again ?’

... and once in a while she’ll say ‘oh you told me that before,’ once in awhile…but now this morning again she’ll say ‘ what time is it we’re going?’” [carer-housemate]

 

Verbal repetition is a common symptom and target for treatment in Alzheimer’s disease (AD), yet little is know about how it manifests itself in the daily lives of patients.

To address this, we performed  a qualitative, secondary analysisof videorecorded interviews with 130 community dwelling patients with mild/moderate AD and their carers enrolled in the Video Imaging Synthesis of Treating Alzheimer’s disease (VISTA) clinical trial.  Descriptions of verbal repetition were captured, coded, and analysed for what type of repetition (questions, stories, talk around one topic, single words, etc) and within these categories we attempted to tease out what the repetition were about (e.g. questions about what recently happened or about what  is upcoming?). We also analysed any mentions of the frequency of a given repetition (e.g. if the personrepeats, will do it be more than ten times before it stops), and the consistency of the problem (e.g. the person repeats every day versus only repeating on occasion).

Results

  • Verbal repetition was reported in 100/130 (77%) patients
    • 57 of whom identified less repetition as a desired outcome of treatment
  • 76% of patients repeated questions (usually about upcoming events)
  • 32% of patients repeated statements/stories (usually about recent events)
  • 65% of repetitions occurred within a two hour interval
  • For 52% of patients the problem was consistent (e.g., occurred everyday)
  • There were no differences for interval between repetitions by dementia severity; however 88% of those who repeated statements/stories were mild.

From this, we understand that  verbal repetition is a common problem, and appears especially to be provoked by upcoming events and the more frequent the patient’s repetition, the more likely that lessening of this was to be set as a goal for treatment.

This secondary analysis of verbal repetition contributes greatly to our understanding of how this problem manifests itself in the daily lives of patients and their carers.  It also suggests the need for further work in making clearer the links between such daily manifestations and the classifications of this problem as captured by clinical tests.

Further Reading

P2-259: Verbal repetition in people with mild to moderate Alzheimer's disease: A descriptive analysis from the video-imaging synthesis of treating Alzheimer's disease Clinical Trial. Sherri Fay, Cheryl Cook, Kenneth Rockwood. Alzheimer's & Dementia: The Journal of the Alzheimer's Association - July 2008 (Vol. 4, Issue 4, Page T447, DOI: 10.1016/j.jalz.2008.05.1335)

 
   
 
 
Dalhousie University Faculty of Medicine