Neurodegenerative Conditions and Communication

Written by: Kendra Wormald / Medical Rehabilitation / March 22, 2023 / 8 minutes read

This introduction piece serves as a brief overview of neurodegenerative conditions. It is part of a series that will investigate specific neurodegenerative conditions in greater detail. 

A neurodegenerative (ND) condition is defined as,

“A type of disease in which cells of the central nervous system stop working. Neurodegenerative disorders usually get worse over time and have no cure” (NIH, 2023).

Conditions

Two of the most common neurodegenerative conditions are Parkinson’s Disease and Alzheimer’s Disease. Notably, Alzheimer’s is also the leading cause for dementia, which is not a specific disease itself but used as an umbrella term to describe symptoms caused by physical disorders that affect the brain (Alzheimer Society, 2023). Alzheimer’s Disease is defined as the progressive mental deterioration due to generalized degeneration of the brain (Alzheimer Society, 2023). Parkinson’s Disease is a progressive condition that affects the nervous system and parts of the body that are controlled by nerves. Huntington’s Disease is a hereditary disease that causes degeneration of brain cells (Alzheimer’s Association, 2023). Brain cancer is defined by growth of abnormal cells in the tissues of the brain. These can be either benign (not cancer) or malignant (cancerous). Similarly, oral or throat cancer have abnormal tissue growth within their respective areas (National Cancer Institute, 2023). ALS (Amyotrophic Lateral Sclerosis also coined Lou Gehrig’s Disease) is a progressive disease of gradual deterioration of nerve cells and the spinal cord (ALS, 2023).

Causes

There is a combination of factors at play that can increase the risk of developing neurodegenerative conditions. For example, someone may have a specific gene that increases their likelihood of developing Parkinson’s disease but their environmental exposure can impact the severity, when, and how the disease is experienced. 

Often, ND conditions are rooted in a combination of genes, and environmental impact. Further investigation into specific causes for individual conditions will be explored within the series. 

The Statistics

There are more than 100,000 Canadians living with Parkinson's Disease and 30 more are diagnosed every day (Parkinson Canada, 2023). The number of people in Canada living with dementia in 2020 was 597,000.  The number of people in Canada projected to be living with dementia in 2030 is 955,900 (Alzheimer Society, 2023). For Huntington’s, 1 in 7000 people in Canada have the disease and approximately 1 in 5500 are at-risk of inheriting the disease (Huntington Society of Canada, 2022). 55,000 Canadians are living with 1 of 120 brain tumors, which makes treatment very complicated. Within one year, around 23.5 new brain tumor cases per 100,000 Canadians occur (Brain Tumor Foundation, 2023). According to the Canadian Society of Otolaryngology, more than 4,300 Canadians will develop head or neck cancer within a year (2023). There are an estimated 3,000 Canadians who live with ALS and each year 1,000 Candians will succumb to the disease (ALS Society of Canada, 2023).

Two of the most common neurodegenerative conditions are Parkinson’s Disease and Alzheimer’s Disease. 

Impact on Communication

Below are some neurodegenerative diseases and symptomatology as it relates to communication: 

• Parkinson’s Disease: Tremor, slowness and stiffness, rigidity of muscles

  • Impact: Soft speech, monotone, reduced emotion within speech, hoarse or breathy voice, slurred speech, mumbling, trailing off at ends of sentences and reduced enunciation and reduced oral muscle control 
    More information here

• Alzheimer’s Disease: Memory challenges, disorientation to time and place, impaired judgment, difficulty with abstract thinking and reasoning, reduced initiative 

  • Impact:  Difficulty finding a word, creating new words for ones that are forgotten, repeating a word or phrase (perseveration), using words that don’t fit the context, difficulty organizing words into logical sentences, cursing or using other offensive and inappropriate language, reverting to their first learned language and talking less than usual.
    More information here 

• Huntington’s Disease: Changes in memory and judgment, challenges with learning new things and concentration, forgetting facts, trouble making decisions, slow movements, rigidity and tremors

  • Impact: Difficulty with starting a conversation, putting thoughts into words, perseveration on one topic, social withdrawal related to depression and anxiety which will decrease communication use, and muscle control for articulation will be more challenging.
    More information here 

• Brain Tumors: Headaches, hearing and vision problems, weakness of face muscles, memory challenges, reduced tolerance and judgment, facial asymmetry, muscle weakness. 

  • Impact: Word finding difficulties which impacts the forward flow of communication, saying things not situationally appropriate, fatigue of muscles while speaking or coordination of articulators may be disrupted which impacts clarity and accuracy of speech. You may also experience Aphasia, a language impairment that affects the production and comprehension of speech either oral or written, making it difficult to participate in conversation.
    More information here   

• Multiple Sclerosis: Fatigue, vision problems, muscle spasms, challenges with learning, planning and thinking, reduced processing speed, reduced ability to multitask, word finding challenges, reduced ability to comprehend and process visual information, difficulty with problem solving. You may also experience Dysarthria, a difficulty speaking due to speech muscle weakness

  • Impact: Slurred speech and lack of control of oral and/or throat muscles may reduce clarity of speech, difficulty with the volume of your voice, voice changes which may be more nasal, strained or monotone. Also, hesitations in speech are present along with short bursts of communication
    More information here

• Oral and Throat Cancer: Persistent unhealed lip or mouth sore(s), loose teeth, growths within the oral cavity, mouth pain, ear pain, trouble moving the tongue or jaw, a sore throat, and changes in voice quality

  • Impact: Huskier, quieter voice or total voice loss, at times can sound as though you have a persistent cold, reduced articulation accuracy impacting the clarity of speech making it difficult to be understood
    More information here 

• ALS (Lou Gehrig’s Disease): Muscle weakness stiffness or paralysis, decreased muscle tone, reduced breath control, muscle fatigue 

  • Impact: Slurred, nasalized or ‘thick’ sounding speech, fatigue of speech muscles including the lungs, abdomen, diaphragm and rib cage muscles, reduced volume and trailing off at the ends of sentences, slow effortful speech and breathy or hoarse voice. To learn more about Breathing for Communication, see our Masterclass. In general, the individual will present with speech characteristics of dysarthria
    More information here

Neurodegenerative conditions are often progressive and debilitating, causing problems with how people think, speak, move, feel and behave. Not only do neurodegenerative conditions impact the individual but those around them as well, such as close family and friends. For more information on each condition and how a Speech-Language Pathologist can help, check-in with this link over the next few months. 

To speak with a psychotherapist or one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.