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2023 Advancing Research on Care and Outcome Measurements (ARCOM)

Assessing Meaningful Engagement in Advanced Dementia (MEAD)

How can we measure engagement for individuals with dementia who can no longer speak?

Arlene Astell, Ph.D.
University Health Network
Toronto, Canada


Studies have shown that Alzheimer’s and other dementia may impact the region of the brain responsible for speech and language, leading to symptoms including losing the ability to speak or comprehend speech. This can often result in isolation for individuals living with dementia as caregivers struggle to communicate with them. A new way of communication called adaptive interaction may provide a nonverbal way for individuals with dementia to connect by using sounds, movements, and facial expressions.

Research Plan

For this study, Arlene Astell and colleagues plan to implement adaptive interaction in long-term care settings, including hospital and home settings, to enhance communication for individuals living with dementia who have lost the ability to speak. They will do this by developing a training program that teaches caregivers nonverbal measures of communication and engagement technique to use to communicate with their care recipient living with dementia who is unable to speak.


This project could shed new light on how nonverbal tools could improve communication for individuals with dementia who have lost the ability to speak. It could also lead to improved quality of life for individuals living with dementia.

The ARCOM Grant Program was developed jointly with Leveraging an Interdisciplinary Consortium to Improve Care and Outcomes for Persons Living With Alzheimer’s and Dementia (LINC-AD). The funding partners for this initiative are the Brain Canada Foundation through the Canada Brain Research Fund, an innovative partnership between the government of Canada (through Health Canada) and Brain Canada and the Alzheimer’s Association.

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