Alzheimer’s Disease (AD) is a neurodegenerative illness with frequency of occurrence increasing with old age [1] [2] [3] [4] [5] . If memory loss setting progressively in is here an element associated upfront, other neuro-psycho-cognitive troubles are also associated, as, for example, language impairment which can degenerate into aphasia [6] - [13] . Such disorders are not necessarily pronounced and do not necessarily kill the desire to communicate (“relational communicability”) but they can occasionally be disabilitating in certain atypical forms known as logopenic. The disease from that point on is accompanied by deterioration of comprehension, speech, writing and reading [14] . Language dysfunction is one of the most significant symptoms in terms of incidence on textuality in AD [15] [16] . In the earliest stages, it is slight but it increases in time through foreseeable phases [17] [18] [19] [20] . Memory dysfunction also interferes with language possibilities [21] . Knowing the importance of both these components could help to prepare as well as possible for the consequences on the patient’s social life [22] [23] [24] .

Studies carried out on the language of the demented show at least relative and temporary conservation of language structure [25] [26] [27] . Emphasis is often placed on language conservation (phonology, syntax…) rather than “demented speech performance” [28] [29] [30] . The premises of approach of modern speech semiotics were already established as was the study of the mental thesaurus reflecting semantic competences, whether of the words used or the verbal symbols manipulated. However, if semantic studies have often been carried out, there are, to our knowledge, only a few on texts [25] [31] [32] , other than those made to validate the Barbizet test used for this paper [33] [34] . The inability for a patient to express his or her own suffering [35] faced by a world that escapes his or her consciousness is a source of suffering both for the patient and his family [36] [37] [38] . Understanding language mechanisms is thus contingent to understanding the meaning of symptoms expressed by the patient’s behaviour [22] [37] [39] . Language dysfunction, communication distortion, and mutual incomprehension are part of the hidden causes that sometimes lead formal or informal (family) care-givers into painful situations [40] [41] : psychological or psychiatric difficulties in the families, unspoken discord, financial problems arising from errors made by the aging patient as well, unfortunately, as the tactlessness or unscrupulousness of some people… What is at stake here is important as usual [42] , and consequently we have tried, in this monocentric prospective observation and study to evaluate semantic and textual dysfunction in AD.

The cohort studied were old demented patients living at home with AD followed since at least 3 months by gerontopsychiatrics for cognitive, behavioural and memory dysfunction. During a gerontopschiatric interview, patients and accompanying family were informed completely and loyally and in understandable language how the study would be carried out. With the agreement of the patient and assistant, the results of the neuropsychological tests were computer recorded anonymously. The study protocol was ethically reviewed and approved by Hospital of Brest ethics committee. Computing procedures for data capture and processing followed the recommendations of the French National Commission on Computer Technology and Freedom.

Criteria were determined for inclusion based from AD patients, (MMSE > 10) [43] , having given written consent together with their family assistants, to take part in this study validated by the Hospital of Brest ethics committee. Only those patients still capable of understanding the instructions for the Barbizet’s test, showing symptoms of Alzheimer dementia, i.e. without massive memory impairment and capable of asserting their consent and assent during the test and fit and able in the eyes of the Law, were included. Patients inability to understand information relating to the study, their inability to choose whether or not to take part, or the possible opposition of their family accompanying person as a criterion were decisive for non-inclusion of such patients. Population number reflects the demented persons follow-up during the period of one year of this study.

Semantic memory is the memory necessary for language manipulation and not over vulnerable to amnesia [44] . To evaluate semantic and textual disorders in a cohort of AD patients, tests were routinely recorded with memory consultation, and from a few sociodemographic data (sex, age, cultural level estimated by the number years of schooling: 1 = illiterate; 2 = can read and write; 3 = six years schooling; 4 = 11 years schooling; 5 = more than 11 years schooling). The following are the tests customarily carried out under consultation: Folstein Test (MMSE) [43] , Dubois’s 5-word test (D5WT) [45] , formal fluency (Number of animals mentioned in one minute), semantic lexical fluency (number of words beginning with L named in one minute) [45] , DFB (Dubois’s Frontal Battery) [46] , Cornell’s scale (Depression) [47] , Barbizet’s test [33] or “The lion’s tale”.

The “Lion’s tale” (presented Table 1) must be read by the examiner slowly. The subject must be informed that it is a long story, the point of which is to evaluate his memory capacity. He must be told it is not a matter of repeating the story word for word but just recalling its main lines and as many details as possible. Barbizet recommended an immediate application, an immediate recall, then a delayed recall. In practice, in the present framework, the text was read out at the beginning of the consultation, followed by an immediate recall and then a delayed recall towards the end of the consultation, that is, about one hour later.