In comparing Alzheimer-type dementia with aphasia from a CVA, a key difference is that

• A. Repetition is more severely impaired in dementia
• B. Dementia shows greater dysfluency
• C. Dementia patients are more aware of disruptions in communication
• D. Aphasia patients more readily comment on recent events

Answer: (B)

The key idea is that fluency of spontaneous speech tends to be more disrupted in Alzheimer-type dementia than in aphasia from a stroke. In dementia, widespread cognitive decline—affecting memory, retrieval, planning, and sequencing—produces frequent pauses, hesitations, self-corrections, and word-finding disruptions. This leads to noticeable dysfluency in everyday conversation as the person struggles to keep thoughts and words flowing. By contrast, aphasia after a CVA is a focal language disorder: the specific linguistic deficits (such as naming, repetition, or comprehension problems) show up, but the overall flow of speech is not necessarily more dysfluent than normal, except in certain aphasia types that are characterized by halting speech. So the pattern that best differentiates the two is the greater dysfluency seen in dementia.

As for the other options, repetition impairment and awareness of disruptions are not as consistently distinguishing: repetition can be variably affected depending on aphasia type, and awareness of communication problems can be reduced in dementia, not reliably increased, while memory-related comments about recent events depend on multiple factors beyond the core language-dysfluency difference.