Brain and Language 75, 277–309 (2000) doi:10.1006/brln.2000.2357, available online at http://www.idealibrary.com on Phonological and Articulatory Impairment in Alzheimer’s Disease: A Case Series Karen Croot,* ,1 John R. Hodges,* , ² John Xuereb,‡ and Karalyn Patterson* *Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom; ²University of Cambridge Neurology Unit, Addenbrooke’s Hospital, Cambridge, United Kingdom; and ‡University Department of Pathology, Addenbrooke’s Hospital, Cambridge, United Kingdom We demonstrate that phonological and articulatory impairments may occur at presentation or early in the course of Alzheimer’s disease, contrary to claims that these aspects of language production are relatively preserved until the final stages of this disease. Six patients with pathologically confirmed Alzheimer’s disease (AD) and four patients with clinically diagnosed dementia of the Alzheimer’s type (DAT) presented with one of five different clinical profiles: nonfluent progressive aphasia, mixed progressive aphasia, progressive aphasia diagnosed as DAT from neuropsy- chological assessment, initial amnestic syndrome with prominent phonological er- rors, and biparietal syndrome. Analysis of their conversational speech, single-word production, and performance of highly familiar series speech tasks such as counting revealed false start errors, phonological paraphasias, and/or articulatory difficulty. Neuropathological changes were located in left perisylvian regions consistent with speech and language impairment but atypical for Alzheimer’s disease.  2000 Aca- demic Press Key Words: Alzheimer’s disease; dementia; language; phonology; articulation; progressive aphasia. This work was supported in part by a research grant from the Medical Research Council, UK, to J.R.H., and a Packer Australia Scholarship from the Cambridge Commonwealth Trust to K.C. We thank Hilary Baddeley for assistance in testing control subjects, Naida Graham, Elaine Giles, Lindsay Stuart-Green, and Sarah Mackenzie Ross for the neuropsychological assessment of the patients, and most of all we thank the patients and their families for their participation and interest in this study. A preliminary report of some data in this study was presented at the American Speech-Language-Hearing Association Annual Convention, San Antonio, 1998. Address correspondence and reprint requests to John R. Hodges, Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 2EF, United Kingdom. Fax: (01223) 359062. E-mail: john.hodges@mrc-cbu.cam.ac.uk. 1 Karen Croot is now at the School of Communication Sciences and Disorders, The Univer- sity of Sydney, Sydney, Australia. 277 0093-934X/00 $35.00 Copyright  2000 by Academic Press All rights of reproduction in any form reserved.