<![CDATA[Anomic aphasia is a language disorder resulting from brain damage, characterized by difficulty accessing lexical items, particularly in the elderly population post-injury. Although previous research has described language deficits in various types of aphasia, a deep understanding of the manifestations of anomic aphasia in older adults and the compensatory strategies they use is still limited. This study aims to comprehensively describe language disorders and identify compensatory communication strategies used by elderly subjects with anomic aphasia post-brain injury. Qualitative research with a case study approach was conducted on a 59-year-old female subject with a history of brain injury who exhibited symptoms of verbal/semantic paraphasia. Data were collected through semi-structured interviews in two sessions (30 minutes each), then analyzed using linguistic analysis (paraphasia classification, Mean Length of Utterance/MLU) and thematic analysis. Data source triangulation was conducted with the caregivers to ensure the validity of the findings. Frequency analysis shows a dominance of lexical-semantic errors (verbal/semantic paraphasia = 95.24%) compared to phonemic errors (4.76%), confirming the diagnosis of fluent (anomic) aphasia. A very high MLU (71.0 words/utterance) and intact intonation and prosody rule out speech motor disorders. The deficit centers on the failure of lexical access from long-term memory (self-name substitution, procedural memory loss) and short-term memory (tip-of-the-tongue phenomenon, inconsistency of quantitative information). Thematically, lexical deficits trigger high self-monitoring and extreme cognitive load, manifested in significant silent pauses (4–6 seconds). Subjects adopted three main compensatory strategies: circumlocution as a linguistic/cognitive strategy, gestures as nonverbal compensation, and self-acknowledgment leading to adaptive introversion. The manifestations of anomic aphasia in elderly subjects are multidimensional, involving not only linguistic deficits but also cognitive load management impairments due to high metacognitive awareness. Clinical management requires a holistic approach that includes lexical rehabilitation interventions, support for working memory function, and communication anxiety reduction strategies.]]>
