Words, concepts and learning in dementia

Jamie Reilly, Ph.D.

As Alzheimer’s disease and other forms of dementia progress, most patients lose the fundamental ability to recognize and name common objects and people they have known for a lifetime. Jamie Reilly, Ph.D., is developing treatments that may help patients with progressive language impairments preserve language as the disease advances, helping patients to remember the name of a favorite place or loved one longer.

“Language problems are among the first to emerge in dementia. As the disease gets worse you see patients have problems negotiating the meaning of fundamental objects in the world,” said Reilly, an assistant professor in the department of speech, language and hearing sciences and the primary speech pathologist for UF’s Memory Disorders Clinic. “For example, if you were to put an apple into the hands of someone with dementia they often have a vague familiarity that they once knew what it was. A patient can be almost certain that they’ve seen this object before, that they’ve known what it is for a long time, but now they have no idea what it does, what it’s used for, really, what it is anymore.”

This language loss gradually results in profound social isolation and compromised functional independence, Reilly said.

Reilly directs the Cognition and Language Laboratory where he and his research team are studying how the brain assembles different pieces of information about objects and how neurodegenerative conditions like Alzheimer’s disease affect object knowledge. The team also performs functional brain imaging on healthy young adults to see how the brain organizes newly-learned concepts. One of the primary goals of the lab is to determine the best ways to rehabilitate or retrain forgotten concepts in Alzheimer’s disease and other forms of dementia.

Supported by a grant from the National Institute on Deafness and Other Communication Disorders, Reilly is leading a study to help people with dementia retain words. The research team works with each participant and his or her caregiver to develop a communication board of images representing 80 to 100 words that the participant would like to hang on to over time. The participants choose words in categories like hygiene, places, foods and clothes, as well as the names of about 20 important people in their lives. The researchers then go to the participant’s home to take photographs of the participant’s own things so, for example, participants learn and remember the attributes of their toothbrush, not just a toothbrush.

“We take a multi-modal approach for the treatment,” Reilly said. “It’s not just having the patient repeat naming of each thing, we also tell the person a little bit about each thing so they’re learning different semantic features of what it looks like, what it’s used for and a couple of other aspects. The idea is that the training gives the person the ability to communicate a little bit better with a functional vocabulary that can resist some of the neurodegenerative changes that are happening.”