This study explores how the identity is constructed of elders who have Dementia of the Alzheimer Type (DAT) by examining the communicative disorder in daily interactions with other interlocutors. Specifically, this paper evaluates a conversation between one Chinese elder with early-stage DAT and the interviewer. It analyzes the identity construction processes in the discourse in depth, using the age-identity taxonomy, self-identity representation theory, and the pragmatic emergentist model. Based on the case study, this paper confirms the five dimensions of age-identity taxonomy provided by Coupland as: (1) disclosure of chronological age, (2) age-related categories/role reference, (3) age-identity concerning health, decrement, and death, (4) adding time-past perspective, and (5) self-association with the past. Meanwhile, two more approaches to the age-identity taxonomy were developed, i.e., address behavior and cross-generational contrast. Self-identity to realize interactional goals is typically constructed at the individual level, although rarely at the relational level. The DAT elder conducts compensation in the interaction by adopting verbal and non-verbal strategies to bridge cognitive disorders such as memory loss, word-finding difficulty, or meeting the desire to enhance the pragmatic effects of their identity. This shows that the self-identity construction also facilitates the DAT elders in generating a discourse strategy when encountering pragmatic impairment.

This paper explores how older adults with different cognitive abilities perform the refusal speech act in the cognitive assessment in the setting of memory clinics. The refusal speech act and its corresponding illocutionary force produced by nine Chinese older adults in the Montreal Cognitive Assessment-Basic was annotated and analyzed from a multimodal perspective. Overall, regardless of the older adults’ cognitive ability, the most common discursive device to refuse is the demonstration of their inability to carry out or continue the cognitive task. Individuals with lower cognitive ability were found to perform the refusal illocutionary force (hereafter RIF) with higher frequency and degree. Additionally, under the pragmatic compensation mechanism, which is influenced by cognitive ability, multiple expression devices (including prosodic features and non-verbal acts) interact dynamically and synergistically to help older adults carry out the refusal behavior and to unfold older adults’ intentional state and emotion as well. The findings indicate that both the degree and the frequency of performing the refusal speech act in the cognitive assessment are related to the cognitive ability of older adults.