Overview

Alexia and neurodegenerative diseases affect the brain in a variety of often permanent ways. Such as with short-term memory in the cases of Alzheimer's. This can often lead to difficulties in tasks such as reading or writing.

What is Alexia?

Alexia is defined as the brain's inability to understand written language, typically caused by a focal brain injury in the brain's temporal lobe.¹ It can range from partial to total ‘word blindness’ in those affected.

The specific type of Alexia depends entirely on which part of the brain was damaged during either a stroke or lesion causing trauma. 

Neurodegenerative diseases

Neurodegenerative diseases are chronic conditions which, over time, permanently damage or destroy parts of the body's nervous system - including the brain.² Although incurable, modern medical advancements have allowed some symptoms to be treatable. 

As an umbrella term that applies to many conditions, the most common neurodegenerative diseases include Alzheimer’s, Parkinsons' and Prion diseases. The majority of these conditions are strongly connected to age with the most at risk being those over the age of 65. 

Alexia - types and symptoms

Alexia is the inability to understand handwritten or printed language as a direct result of a brain injury. It is sometimes interchangeably used to describe dyslexia but they are completely different disorders. Dyslexia refers to the innate inability to learn to read whereas Alexia is a reading disorder directly caused by injury. 

Alexia itself is an umbrella term and can be separated into three more specific types:

• Literal Alexia refers to the inability to recognize individual letters
• Verbal Alexia is where the letters are recognised but the words are not
• And, pure Alexia is a reading disorder but not a writing disorder (agraphia)

The type of Alexia completely depends on which area of the left hemisphere has been damaged.³

Common symptoms include:

• Difficulty recognising words 
• Slower reading pace
• Errors when reading 

Symptoms of neurodegenerative diseases

The symptoms vary drastically depending on the type of disease, generally, the following symptoms are observed:

• Dementia-type diseases - confusion, memory loss and trouble concentrating
• Demyelinating diseases - muscle spasms, weakness and other muscle pain
• Parkinson's-type diseases - shaking and tremors, issues balancing, hunched posture
• Motor-neuron diseases - affect muscle control by affecting the nervous system, resulting in weakness and eventual paralysis

The symptoms vary as no two brains are the same. 

Alexia and neurodegenerative diseases

Both Alexia and neurodegenerative diseases majorly affect the brain in a variety of ways. 

Alzheimer's and reading

Alzheimer's is a brain disorder that gets progressively worse over time due to it causing the brain to shrink and the brain cells to die.

For example, in those suffering with Alzheimer's reading may prove incredibly difficult. This is mainly because reading requires a reliable short-term memory which in Alzheimer's patients is significantly impacted. 

In early stage Alzheimers the reading skills are not much affected but some difficulty may be experienced in unfamiliar material. In middle-stage Alzheimer’s, most can read but due to the breakdown in comprehension skills, there may be some difficulty in remembering what was read previously. In late-stage Alzheimer’s, it's often found that sufferers have lost interest in reading but in the cases where they still do, large-type reading materials can be used to assist.⁴

This may lead to issues retaining and interpreting information they may have just read. However since Alzheimer's affects every patient differently it's likely not every patient will have difficulties reading, some who regularly enjoyed reading prior to the diagnosis may find they can continue after too. ⁴

Parkinson's and reading 

Parkinson's is a progressive disorder which damages the body's nervous system over time. The first symptom can be a small noticeable tremor in just one hand. 

It's common for those living with Parkinson's to develop vision-related changes ranging from, blurry vision, trouble following a line of sight and trouble voluntarily opening the eyes (apraxia). This means some have found reading to become more and more difficult as the eye movements needed to follow lines are slowed and less easy to control.⁵

Management and strategies to help reading 

It is no surprise that those found to develop difficulties in reading as a result of these neurological conditions, it often cause a lot of emotional distress. Although no direct cure is available for any of these conditions, modern medical advancements mean their symptoms can be alleviated.

Therapeutic management 

Working with a speech-language therapist or an occupational therapist can assess individual situations and provide specific rehabilitation plans.

For Alexia specifically simple strategies have been shown to have some benefits:⁶

• Repetition to help the brain rewire itself - engaging in repetitive behaviours can help those with pure Alexia restore some function
• Working with a skilled therapist 
• Using speech therapy apps - therapy appointments can sometimes be expensive so free apps can help you stay engaged for free in between sessions
• Sounding out letters - this is an example of a speech therapy exercise which helps you gradually build whole words
• Reading out loud - speech-language therapists recommend reading any text out loud for 30 minutes a day
• Tactile treatment - using the touch sense to help recognise letters by their shapes
• Visual field therapy programs - helps the patient notice words via visual scanning training helping the brain make eye movements across an entire text
• Adaptive technology - online text-to-speech converters can help practice reading skills

A lot of these methods have also been used by in those struggling to read due to their neurodegenerative disease. 

Caregiver support

When a person suffers from either a neurodegenerative disease or Alexia, it's likely they will rely on those around them for more support, especially in reading. 

It's important the caregiver understands the condition and can not only provide assistance when needed but also encourage the patient to stick with any therapies they may be doing or just to provide emotional support. 

Providing emotional support and positive reinforcement have been shown to be essential in the treatment of those with neurodegenerative diseases and Alexia by encouraging them to stick with the therapies and improving their resilience.

In many circumstances, it has been shown that obtaining reading material in large/giant print or using audiobooks can help, especially in those living with Alzheimer's. Sometimes, therapists recommend caregivers read aloud to patients in order to keep morale high and motivation strong.

FAQs

What is Agraphia?

Agraphia is the loss of the ability to create written language, it can occur in isolation or in conjunction with other neurological diseases. 

Who is most at risk of neurodegenerative diseases?

Lifestyle choices such as diet, amount of physical activity, sleep patterns and stress levels can influence the risk of developing some neurodegenerative diseases. Those over the age of 65 are most likely to develop a neurodegenerative disease. 

How is Alexia caused?

Alexia is caused by an infarction to the left hemisphere of the brain typically as a result of a stroke or traumatic brain injury. 

Can you prevent Alexia?

As alexia occurs as a direct result of brain damage, usually a stroke or a traumatic injury, there is nothing you can do to specifically prevent alexia. However, you can reduce your risk of traumatic injury by avoiding unnecessary risks which could cause such injuries. For example, always wear appropriate protective headgear when riding motorbikes or normal bikes. 

You can also reduce your risk of a stroke by maintaining your physical health and ensuring you are living a healthy and well-balanced lifestyle. 

Can you prevent neurodegenerative diseases?

No, they cannot be specifically avoided as they are often caused by a combination of factors such as genetic, environmental or external triggers. However, you can reduce your risk of developing one by maintaining a healthy and balanced lifestyle. 

Can you completely cure Alexia?

Alexia is caused by an injury to the brain's left hemisphere by either a stroke or a traumatic injury. There is no cure currently, however, there are treatment options which can help significantly - such as tactile-kinesthetic training and therapies. 

Summary 

Alexia is defined as an inability to understand the written language typically caused by a stroke or brain injury. Neurodegenerative diseases differ by permanently damaging or destroying parts of the body's nervous system over time and are caused by a variety of unavoidable factors. 

Both cause either directly or indirectly create difficulties in reading which is often a source of emotional distress in patients. Although no cure is yet available, there are a multitude of therapies and treatment options available to patients. In worse cases, it's often caregivers that find reading to the patients is the only option but this has been shown to help boost morale and help cope.