Cognitive impairment and pragmatics

Abstract

BackgroundOne of the most important ingredients of felicitous conversation exchanges is the adequate expression of illocutionary force and the achievement of perlocutionary effects, which can be considered essential to the functioning of pragmatic competence.FindingsThe breakdown of illocutionary and perlocutionary functions is one of the most prominent external features of cognitive impairment in Alzheimer’s Disease, with devastating psychological and social consequences for patients, their family and caregivers.ConclusionsThe study of pragmatic functions is essential for a proper understanding of the linguistic and communicative aspects of Alzheimer’s disease.

Intranasal Insulin in Alzheimer’s Disease: A Pragmatic Account

“…More broadly, pragmatic functions (of the illocutionary or perlocutionary type) refer to the set of inferential processes, strategies, arrangements, and constraints regulating illocutionary force and perlocutionary effects for speakers [7]. These types of pragmatic functions can be partly understood as belonging to executive-function mechanisms in general.…”

“…This suggests that improvements in pragmatic competence can occur with extended intra-nasal insulin treatment even if other linguistic and cognitive capacities (e.g., some aspects of inferential reasoning, word finding, word interpretation) deteriorate. 7 Preservation of pragmatic functions and pragmatic inference generation under targeted treatment also appears strongly associated with the slowing of the pronounced rates of executive function in terms of attention span and visuo-spatial deterioration [5], typically those cognitive dimensions in AD that decline annually most rapidly *50+. This is consistent with the frontal lobes' pathway of intra-nasal insulin, as the left lobe is a key site for pragmatics and the same region functions for motivation, working memory and executive functions [69].…”

“…Future work is required to determine the specific, additional functional impacts of nose-to-brain pathways of intra-nasal insulin transport and aspects of improved pragmatic competence in MCI & AD. 7 For example, AR deteriorated by year five and a half after AD diagnoses and year five of intra-nasal insulin treatment in orientation to place, time, and had confusion about family members and their correct roles. Nevertheless, even at that point (6/18) he was still always able to ask valid questions of events transpiring around him, e.g.…”

“…Employing a model of pragmatic competence [6], we show the ability of a late-stage AD patient under long-term, targeted treatment to use selfdeprecatory humor, sarcasm and metaphor in multiple inter-personal settings. We claim that the ability to recognize and tell jokes requires continued pragmatic competence because the speaker needs to assess the reaction of the addressee and to understand the meaning underlying the relevant discourse utterances to be then able to flout the conversational maxims to make a joke [7]. The pragmatic capacity to relate emotionally to others in conversation with humor that can cause laughter reduces the social isolation of AD patients from other speakers.…”

“…Hamidovic [4] for a contrary view in abstinent smokers). Improved pragmatic function in patients with Mild Cognitive Impairment (MCI) and early to moderate Alzheimer's Disease (AD) after targeted therapy has been the subject of several studies [5][6][7]. Accumulating evidence suggests the capacity of the short-term administration of intra-nasal insulin to improve verbal fluency and to slow cognitive decline in the areas of immediate recall and list learning recall in adults with MCI and early AD [8,9].…”