Verbal repetition in people with mild-to-moderate Alzheimer disease: A descriptive analysis from the VISTA clinical trial

BACKGROUND: Verbal repetition is a common symptom and target for treatment in Alzheimer disease (AD), yet little is known of its manifestations in the daily lives of patients. Here we characterized the nature of verbal repetition and its correlates. METHODS: This is a qualitative, secondary analysis of video-recorded interviews with 130 community dwelling mild-to-moderate patients with Alzheimer disease and their carers, enrolled in the Video Imaging Synthesis of Treating Alzheimer's disease clinical trial. Narratives about verbal repetition were characterized using a qualitative framework analysis approach. RESULTS: Verbal repetition was reported in 100/130 patients, 57 of whom identified diminished repetition as a desired outcome of treatment. Most patients (76/100) repeated questions (usually about upcoming events); fewer (32/100) patients repeated statements/stories (usually about recent events). Most repetitions occurred within a 2-hour interval (65/100), and for 52/100 patients the problem was consistent (eg, occurred everyday). There were no differences for interval between repetitions by dementia severity, but most patients who repeated statements/stories were mild (27/32). CONCLUSIONS: Verbal repetition is a common problem, and seems especially to be provoked by upcoming events. More frequent repetitions (shorter intervals between each repetition) were associated with goal setting around this problem.