Maxwell Barnish, Ph.D.

Having the cognitive ability to keep up with conversations often is more of an issue for those with Parkinson’s disease than are physical speech problems, according to research to be published March 18 in the Journal of Parkinson’s Disease.

“What this research tells us is that speech and language therapists need to assess the cognitive problems of people with Parkinson’s as well as their speech clarity when trying to improve everyday communication,” said Katherine Deane, Ph.D., from University of East Anglia in England. “It may be that patients who are struggling with thinking quickly need different communication strategies to help them in everyday life.”

The research team undertook what it said is the first systematic review to look at whether cognitive issues or physical speech problems create the biggest barriers to communication. They sifted through nearly 5,000 pieces of research and found 12 relevant studies involving 222 people with Parkinson’s disease.

Although through the review they learned that both cognitive status and physical speech problems are associated with everyday communication problems among people with Parkinson’s, it was the people who had greater cognitive difficulties who had more problems communicating. Also, although people with less clear speech also had trouble communicating, this factor had less of an effect on everyday communication.

“Around 70% of people with Parkinson’s have problems with speech and communication, which can really impact their quality of life,” said Maxwell Barnish, Ph.D., who led the study while he was at the UEA and is now at the University of Aberdeen in Scotland. “Researchers and clinicians have in the past focused on the physical problems patients have with making their speech clear. But patients themselves say the problems are more complex and are more to do with cognitive impairment — for example, not being able to think quickly enough to keep up with conversations or not being able to find the right words. They say that this that this has the biggest impact on their ability to communicate in everyday life.”