Dementia patients struggle to read and write primarily because dementia affects the brain areas responsible for language, memory, attention, and visual processing. These cognitive functions are essential for understanding written words, forming sentences, recalling vocabulary, and coordinating the physical act of writing.
Reading requires multiple complex brain processes: recognizing letters and words (visual processing), accessing their meanings (language comprehension), remembering what was read earlier (working memory), and integrating all this information to understand sentences or stories. Dementia often damages regions like the hippocampus and temporal lobes that handle memory and language comprehension. This damage leads to difficulties in recognizing words or understanding their meaning even if the person can still see them clearly. For example, some dementia patients develop a condition called alexia—an acquired reading disorder where they lose the ability to read despite retaining other language skills such as speaking or writing. Different types of alexia affect reading in various ways: some cannot sound out unfamiliar words; others confuse similar-sounding words or lose word meanings altogether[2].
Writing is equally challenging because it demands not only language skills but also fine motor coordination, planning, concentration, and working memory. Dementia impairs these abilities by affecting frontal brain regions involved in executive function—the mental processes that help plan actions—and parietal areas important for spatial awareness needed when forming letters correctly on a page[1]. Patients may forget how to spell common words or have trouble organizing thoughts into coherent sentences. They might also struggle with physically controlling a pen due to impaired motor coordination.
Additionally, dementia can cause problems with attention span and fatigue easily sets in during mentally demanding tasks like reading long texts or writing extensively[3]. This makes sustained focus difficult; patients may lose track of storylines quickly or feel overwhelmed by complex material.
Emotional changes caused by dementia—such as apathy or frustration—can further reduce motivation to engage with reading or writing activities[4]. However, engaging in tailored cognitive exercises involving reading short stories aloud together or practicing calligraphy has shown benefits by stimulating brain networks related to attention and visuospatial skills while providing emotional comfort through creative expression[1][3].
In summary:
– **Memory loss** disrupts recalling word meanings and plot details.
– **Language impairments** hinder decoding written text into meaningful content.
– **Visual-spatial deficits** interfere with letter recognition and handwriting.
– **Executive dysfunction** affects planning coherent writing.
– **Motor control issues** make physically writing difficult.
– **Attention fatigue** reduces ability to sustain reading/writing sessions.
– Emotional symptoms lower engagement motivation.
These combined effects explain why many people living with dementia find it increasingly hard over time both to read fluently for comprehension and express themselves clearly through writing. Yet carefully adapted support strategies focusing on simpler materials, social interaction during reading/writing tasks, frequent breaks for restfulness alongside creative therapies can help maintain these vital communication skills longer than might otherwise be expected.
