Abstract
Patients with severe aphasia and possible dementia cannot be adequately assessed for want of normative data. We describe four patients with global aphasia without hemiparesis who were referred for evaluation of dementia without the knowledge that they had previously suffered a stroke. All four had no neurological deficits except for language dysfunction. The study looked at the utility of the commonly-used dementia scales in patients with severe aphasia and possible dementia. The findings indicated the limitations of verbal, non-verbal cognitive tests and the reliance on informant reports. Appropriate weighting of these may help in arriving at a more accurate diagnosis. Until guidelines for a reliable criteria are established, the clinician should assess the patient in a global way and not just in one aspect of the patient's symptomatology. Dementia in the severely aphasic remains a diagnostic challenge and merits further study.