Proverb interpretation in fluent aphasia and Alzheimer's disease: Implications beyond abstract thinking

Abstract

This study compared proverb processing across three groups, i.e. patients with fluent aphasia (APH), patients with Alzheimer's Disease (AD), and normal control subjects (NC). Proverb stimuli were used to examine the effects of group membership and proverb familiarity in two presentation formats (i.e. spontaneous versus multiple-choice) on performance. The sensitivity of linguistic and cognitive measures as predictors of ability to interpret proverbs was also investigated. In relation to NC subjects, patients with fluent APH exhibited significant difficulty formulating responses for familiar and unfamiliar spontaneous proverbs, whereas patients with AD demonstrated lower performance only on the unfamiliar proverbs. On the multiple-choice paradigm, however, patients with APH exhibited minimal difficulty. Conversely, the patients with AD manifested significant problems selecting the correct abstract response for familiar proverbs. With regard to predictors, language was relevant to familiar proverb interpretations and to proverbs presented in the spontaneous format. Cognition was a sensitive predictor for unfamiliar proverb interpretations and to the multiple-choice format. Deficits on the proverb tasks are discussed with reference to the potential breakdown of underlying linguistic and cognitive processes. The present data support the diagnostic value of proverbs in elucidating brain-behaviour relationships.

Effects of four years of exercise, language, and social interventions on Alzheimer discourse

“…Given the sensitivity of a PI task to declines in abstract verbal reasoning (Van Lancker, 1990) and figurative language processing, we elected to use a proverb interpretation task as one of our discourse outcome measures. Chapman et al (1997) compared persons with fluent aphasia, persons with AD and healthy elders on their ability to interpret familiar and unfamiliar proverbs. They found that persons with AD performed well on interpretation of familiar proverbs but had difficulty with unfamiliar proverbs.…”

“…The highest possible score on the test was 30 (5 items  6 points). To ensure reliability of scoring, baseline and first year postintervention transcripts were scored by Chapman and colleagues, using their guidelines (Chapman et al, 1997). At the end of the first year, the second author scored all patient responses, following Chapman's guidelines and consulting with her on questionable responses.…”

“…Proverb interpretation scoring system used by Chapman et al (1997). Modified from Delis et al (1984) POOR PUPPY A cocker spaniel puppy that is usually kept in the basement got into the living room when the owner was at work.…”

“…Participant responses were scored along a seven-point concretenessabstractness continuum (Chapman et al, 1997-Appendix B) with 6 being a complete abstract response and 0 being an incorrect or no response. The highest possible score on the test was 30 (5 items  6 points).…”

Lexical Substitution and Paraphasia in Advanced Dementia of the Alzheimer Type

“…AD patients failed to correspond the meaning of the idiomatic phrase with a relevant picture or a one-word description; they understood the phraseme literally / by semantic associations to words from the idiom without processing sentential meaning (Rassiga, Lucchelli, Crippa, & Papagno, 2009, p. 409). The patients also manifested significant problems selecting the correct abstract word to explain even familiar proverbs (Chapman, Ulatowska, Franklin, Shobe, Thompson, & McIntire, 1997). Since AD damages the cortex, the patients are impaired in different cognitive domains; they lose the ability to grasp the idiom holistically on the ground of their own communicative and cognitive experience when they performed the tests.…”