When Should Your Worry about Word-Finding Difficulty and Alzheimer's?

If you or a loved one has been diagnosed with Alzheimer's or a related dementia, one of the areas that was probably assessed, in addition to memory, judgment, and general cognitive functioning, is word-finding difficulty. Just as the phrase sounds, word-finding difficulties means that a person has difficulty choosing or recalling the right word to adequately express a thought.

Word-finding difficulties are a common symptom of early-stage Alzheimer's, but there are many other possible causes. An assessment by a physician is important if continued difficulties are noted.

Word-finding difficulty may also be described as:

• Tip of the tongue experiences
• Difficulty finding the right words
• Speech fluency problems
• Difficulty naming objects

Word-finding difficulties may be demonstrated in several different ways. The person may hesitate at length before speaking, and when eventually she tries, she may use an incorrect word that perhaps starts with the same letters of the desired word ("floor" instead of "flower" or "sack" instead of "sand"), or give a description of what the word means ("You know, the thing on the wall with the numbers and the time").

There are many formal and informal ways to evaluate word-finding ability. Some practitioners use tests such as the Verbal Fluency Test or the Boston Naming Test. Others may simply note the person's communication abilities throughout a conversation, and ask family members for their observations.

You can also expect that a physician may ask: if the individual previously had difficulties with finding the right words, or if this is a new concern; when the problems occur; if the individual is bilingual, and if so, what his primary language is (as this can affect word-retrieval); what his level of education is; and if there are any other related problems.

There are many causes of word-finding difficulty, including stroke, delirium, major depression, anxiety, head injuries and aging.

In dementia, impairment of the semantic memory (the memory for understanding and recognizing words) appears to be a significant contributor to word-finding difficulties.

If you're certain which word the person with dementia is searching for, go ahead and say it. If you're not sure, don't offer guesses of multiple words, as that has the potential to further frustrate and overwhelm the person.

Ask for verbal and non-verbal clarification. If the person says that her "fig" hurts, for example, ask her if her finger hurts, and point to it.

Be patient. Rushing the person will almost certainly not facilitate communication, but rather increase anxiety and frustration—and possibly cause the person to exhibit challenging behaviors.

If you've been noticing some difficulty lately with finding the right words, pay attention to when, and how often, this occurs. Does this happen when you're tired and multi-tasking, or is it truly interfering with your ability to communicate effectively? 

It can also be helpful to ask a family member or close friend if they've noticed any changes in your word-finding ability. This can help you sort out if you're just not finding the perfect word to describe a specific situation or if you're having trouble on a regular basis.

You can also take an online, at-home dementia test called the SAGE test. The results of this test should be reported to your doctor who can conduct a thorough exam and test for any reversible causes of word-finding difficulty, as well as work towards an appropriate diagnosis and treatment if your word-finding ability is related to the early stages of dementia.

Keep in mind that some decline in the ability to find the correct word can be considered normal as people age, especially in low-frequency words: those that aren't used as often as others. You may find it helpful to keep your mind active by reading a book from a different genre than usual, or spending some time working on a crossword puzzle.