One of the most devastating secondary effects of Alzheimer's disease is the progressive deterioration in the ability to communicate. The broad, long-term objective of this research is to assist the individual in the middle and later stages of Alzheimer's disease to improve his or her ability to communicate through the use of non-pharmacological interventions. To move toward accomplishment of this objective, the specific aims of this study are to: 1 . Test the effect of planned walking on the communication performance of individuals with Alzheimer's disease. 2. Test the effect of conversation treatment on the communication performance of individuals with Alzheimer's disease. 3. Test the effect of combining planned walking and conversation treatment on the communication performance of individuals with Alzheimer's disease. 4. Test the direct and indirect effects of the constructs of mental status, physical performance and mood on communication performance before and after institution of treatments. The purpose of this study is to test two distinctly different approaches to improving communication, performance, planned walking and conversation treatment, alone and in combination, in a three-group experimental design with random selection and random assignment. Seventy-two subjects with a confirmed diagnosis of probable Alzheimer's disease and ability to stand and walk 25 feet with the assistance of one person will be randomly selected from the long-term care population of a large nursing home and randomly assigned to one of the three treatment groups. Thirty-minute individual treatment sessions will be conducted three times a week for 16 weeks. Data on each subject's mental status, mood state, physical performance and communication ability will be collected at six points: baseline two months before treatment is initiated, immediately before treatment, at the midpoint of treatment, at the end of treatment and at follow-up two and four months post-treatment. Data analysis will include repeated measures ANOVA of each outcome measure, Growth curve analysis of change over the six testing points and causal analysis of the direct and indirect effects of physical performance, mental status and mood on communication before and after treatment will also be done.
