Discourse and conversation impairments in patients with dementia

TL;DR

This paper reviews how dementia affects discourse and conversation, highlighting language, cognitive, and social impairments, and advocates for clinical discourse analysis as a comprehensive assessment tool.

Contribution

It synthesizes findings on language and communication deficits in dementia and emphasizes clinical discourse analysis for diagnosis and treatment evaluation.

Findings

Dementia impairs discourse production and perception.

Communication deficits involve emotions, empathy, and theory-of-mind.

Clinical discourse analysis complements neurolinguistic assessments.

Abstract

Neurodegeneration characterizes individuals with different dementia subtypes (e.g., individuals with Alzheimer's Disease, Primary Progressive Aphasia, and Parkinson's Disease), leading to progressive decline in cognitive, linguistic, and social functioning. Speech and language impairments are early symptoms in individuals with focal forms of neurodegenerative conditions, coupled with deficits in cognitive, social, and behavioral domains. This paper reviews the findings on language and communication deficits and identifies the effects of dementia on the production and perception of discourse. It discusses findings concerning (i) language function, cognitive representation, and impairment, (ii) communicative competence, emotions, empathy, and theory-of-mind, and (iii) speech-in-interaction. It argues that clinical discourse analysis can provide a comprehensive assessment of language and communication skills in individuals, which complements the existing neurolinguistic evaluation for (differential) diagnosis, prognosis, and treatment efficacy evaluation.