We hypothesized that patients with delirium would produce fewer words and more errors in language production. Therefore, the present study aimed to investigate language production and comprehension in delirium in more detail. It is evident from the small literature base, which has mostly focused on dysgraphia, that language impairments in delirium are poorly defined, in particular regarding speech and comprehension. Tate and colleagues explored the communication of symptoms between critically ill patients and nurses, finding that patients with delirium were less likely to initiate symptom communication compared with non-delirious patients. Dysgraphia was almost always present in delirium, typically involving motor and spatial aspects of writing, and spelling and punctuation errors.

Chedru and Geschwind compared writing abilities of hospitalized patients with and without delirium. Additionally, the production of jagged and angular segments of letters was found to be specifically impaired in delirium compared with non-delirious psychiatric inpatients. Another study analyzed writing disturbance (dysgraphia), reporting that signature writing was impaired in delirium. Delirious patients produced more perseverations and semantically unrelated misnamings compared to the dementia group. Wallesch and Hundsalz compared the performance on single word naming and comprehension tasks between patients with delirium and those with AlzheimerРІР‚в„ўs dementia. Fundamental domains of language such as speech production in delirium have remained largely unexplored despite one study reporting language impairments in over half of patients with delirium. Yet very few studies have investigated the nature of language abnormalities in delirium. Studies on communication difficulties in delirious patients have reported significant issues when conveying information, as reported by patients, their relatives and nursing staff. Language disturbances in delirium diagnostic tools. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Р”В¬ompeting interests: The authors have declared that no competing interests exist. AMJM and ZT are members of the University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology which was funded by the BBSRC and MRC as part of the LLHW (MR/K026992/1)РІР‚Сњ. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Р”Вata Availability: All relevant data are available within the paper and its Supporting Information files.Р”Р‡unding: ZT, LMR, EN, CC, ND and AMJM were funded by the Medical Research Council through a Developmental Pathway Funding Scheme, reference MR/L023210/1 (PI: AMJM). Received: JAccepted: NovemPublished: November 26, 2018Р”В¬opyright: Р’В© 2018 Green et al. PLoS ONE 13(11):Р”В®ditor: Enrico Mossello, University of Florence, ITALY (2018) Investigating speech and language impairments in delirium: A preliminary case-control study. Citation: Green S, Reivonen S, Rutter L-M, Nouzova E, Duncan N, Clarke C, et al.

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