Discourse Topic Management in Senile Dementia of the Alzheimer's Type

Abstract

The purpose of the study was to provide a detailed evaluation of the topic management abilities of a group of subjects with senile dementia of the Alzheimer’s type (SDAT) and to compare their patterns of topic management to that of a normal elderly (NE) subject group. Twenty-four subjects participated in the study: 12 SDAT subjects and 12 NE subjects matched along the variables of age, sex, and education. The evaluation of topic management was based on a 20-minute casual conversational interaction between the subject and a speech-language pathologist that was videotaped and later transcribed orthographically. Topic management was analyzed in terms of a modified version of the multidimensional topic coherence analysis developed by Mentis and Prutting (1991). The results indicated significant differences between the SDAT and NE subjects along a number of parameters of topic introduction and maintenance. The topic management profiles of the SDAT subjects were characterized by a reduced ability to change topics while preserving the discourse flow, difficulty in actively contributing to the propositional development of the topic, and a failure to consistently maintain topic in a clear and coherent manner. These problems appeared to be related to underlying problems across the discourse-pragmatic, linguistic, and cognitive domains; they highlight the need to more fully explore the interactions among deficits in SDAT and their effects on conversational discourse.

A Tutorial on Multiblock Discriminant Correspondence Analysis (MUDICA): A New Method for Analyzing Discourse Data From Clinical Populations

“…In the early stage, DAT dyads had more difficulty with subtopic and social unit boundaries after a topic transition. This suggests a reduction in the cognitive flexibility required to shift and/or change topics and confirms the findings of Mentis et al (1995) and Joanette (1994, 1997). In middle-stage DAT, dyads began to show cognitive trouble sources when a topic or subtopic was reintroduced.…”

“…Typically, they have difficulty introducing, changing, elaborating on, and maintaining the topic of conversation as compared with their conversational partners (Mentis, Briggs-Whittaker, & Gramingna, 1995). Consequently, DAT participants introduce and unexpectedly shift topics more frequently (Garcia & Joanette, 1994, 1997.…”

“…Four raters recoded a random 16% of the conversational samples (as per Mentis et al, 1995). For trouble-source repair sequences at topic boundaries, percentage agreement with the original rater was 75%.…”

“…We coded topic information using a modified version of the taxonomies described by Joanette (1994, 1997) and Mentis et al (1995).…”

Conversation Intervention with Alzheimer's Patients

“…Vocabulary decreases and irrelevancies increase. Maintaining a topic becomes difficult (Ellis, 1996;Mentis, Briggs-Whittaker & Gramigna, 1995). Declines may be exaggerated due to the individual's awareness of the problem and resultant frustration, embarrassment, or anxiety, leading to further withdrawal (Cohen, 1991;Pepping & Roueche, 1991).…”