Alzheimer’s disease often shows up in subtle ways, especially in the early stages, and changes in speech or communication can be one of the first signs. If you’ve noticed speech and language changes in yourself or someone you love, here’s what you need to know.

Speech Changes and Cognitive Decline

Speech and language changes can fall into different categories, often linked to various types of cognitive decline, like Alzheimer’s disease. These changes might include struggling to find the right words or following conversations. Paying attention to these signs can help identify potential issues early on.

Conversation Changes

Some people who are later diagnosed with Alzheimer’s disease have trouble with various aspects of conversing. This may look like:

• Trouble joining a conversation
• Difficulty tracking what goes on in a conversation
• Repetitive conversation
• Stopping in the middle of what they’re saying and not knowing how to continue

Caregivers on myALZteam report experiencing this in various ways. One member shared, “It is fun to have something we both enjoy, otherwise he really cannot hold a conversation.” Another said, “Conversation is not very successful as she loses her train of thought, forgets vocabulary, and cannot respond coherently to questions.”

Vocabulary Changes

Changes in vocabulary can look different depending on the person. Some may forget words entirely and point to get what they want, while others try to describe an object instead of naming it. Often, struggling to name familiar or everyday objects is one of the first signs that something may be wrong.

Caregivers on myALZteam have observed these issues, too. “I have noticed D., who had quite an extensive vocabulary, is now not able to finish his sentences because he doesn’t know the word,” one member explained. Another added, “I see her vocabulary leaving fast now.” Yet another said, “He gives things the wrong name or simply points.”

Some difficulties in conversation may be because of struggles with vocabulary, although it's difficult to know how or when this is true. It makes sense that people might pause when they can’t find a word or have trouble tracking if they don’t understand everything being said.

Jumbled Speech Changes

People living with Alzheimer’s disease may speak in ways that are hard, if not impossible, to understand, although this is more likely to be a symptom of later stages of Alzheimer’s. People experiencing this issue might make up words or put their words in the wrong order.

“For some reason, he started speaking in unintelligible words, something that sounded made-up,” one member wrote. Another added, “Most of her statements are illogical, and it’s also very hard for her to find words.”

Speech Timing, Tone, and Volume Changes

Many changes in speech may be difficult to hear unless you’re a trained professional. You might notice that something seems off about the way you or your loved one is speaking but be unable to pinpoint the exact changes taking place.

One study in 2022 showed that changes to how fast a person speaks, how much they pause, and how long those pauses are can be an early indication of Alzheimer’s disease. The researchers noted, however, that the specifics of which changes indicate Alzheimer’s versus other types of dementia were unknown.

Another study, in 2021, aimed to help figure this out. The researchers observed that people experiencing cognitive decline showed changes in the variation of their speech tones and the force with which they spoke. However, because this was a small study, more research is needed to confirm the findings and make any firm conclusions.

In 2022, neuroscience researchers looked at several aspects of speech. These included the frequency at which a person spoke, their rhythm of speech, and how fluently they communicated. Researchers drew some correlations between certain patterns and different types of cognitive decline. However, this kind of research is still in the early stages. More is needed to figure out exactly how speech and dementia go together.

Researchers in 2023 used computers to analyze the speech of both cognitively impaired and unimpaired people. They found that struggling with words and meaning correlated with Alzheimer’s disease. As new research develops, artificial intelligence could help detect early signs of Alzheimer’s just by listening to how people speak.

When Is It Just Aging Versus Alzheimer’s Disease?

It can be really hard to know if changes in a person’s speech are occurring because they’re aging or if there’s something else going on. They may also be experiencing dementia, Alzheimer’s disease, mild cognitive impairment, or some other type of decline.

It’s normal, for instance, to feel like you can’t quite find the right word that you need, even though it’s a word you know well. In general, symptoms of dementia and/or Alzheimer’s are more severe than they are in normal aging. For instance, occasionally not finding the right word is attributed to aging, but when it interferes with your communication regularly, it might be dementia.

Occasionally not finding the right word is attributed to aging, but when it interferes with your communication regularly, it might be dementia.

In addition, if speech-related symptoms are getting worse or you’re noticing more of them, it might be more likely to be dementia. Similarly, if speech problems are new and come alongside other warning signs of dementia, like memory loss, it’s likely time to see a health care provider.

It can be harder to distinguish between normal aging and mild cognitive impairment. Many people living with mild cognitive impairment can handle themselves in normal, daily life activities.

What To Do if You Notice Speech Changes

If you notice new or worsening speech issues, it’s important to talk to your doctor. Your primary care provider can assess the situation and, if necessary, refer you to a neurologist. A specialist can help you get the appropriate tests to understand what’s going on. If it’s just normal aging, they can offer reassurance and ease your concerns.

If it’s something more serious, they can guide you toward the right treatment and support, helping you maintain your quality of life. Your doctor will ensure you get the care you need, whether that means working with them or a neurologist with more expertise.

Talk With Others Who Understand

On myALZteam, the social network for people with Alzheimer’s and their loved ones, more than 86,000 members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s.

Did you notice changes in speech before you or your loved one was diagnosed with Alzheimer’s disease? Share your experience in the comments below, or start a conversation by posting on your Activities page.