Mutism in the Older Adult

Nages Nagaratnam, MD, FRCP, FRACP, FRCPA, FACC; Gowrie Pavan, MBBS, FRAGP


Geriatrics and Aging. 2005;8(8):61-68. 

In This Article


Mutism is a neuropsychological disorder and is not uncommon in older adults. It is often mistaken for locked-in syndrome, severe depression, or persistent vegetative state. Mutism is both a symptom and a syndrome. It is often associated with such diverse conditions as advanced Alzheimer's disease, frontotemporal dementias, and certain other psychiatric and psychological disorders. When akinesia occurs concomitantly, the term akinetic mutism is used. Akinetic mutism has a number of causal factors with varied pathology. All of its manifestations can be explained by focal or diffuse brain lesions causing damage to the frontal lobe and/or interruption of the complex frontal subcortical circuits and frontal diencephalic brain stem system. A trial with dopaminergic therapy is justifiable in patients with AM associated with vascular lesions. Communicator devices are available to augment communication in patients with anarthria or severe dysarthria.


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