Discourse Comprehension Test Performance of Elders With Dementia of the Alzheimer Type Spoken language comprehension, including comprehension for inferential material in narrative discourse, is diminished in dementia of the Alzheimer type (DAT). There are, however, no empirical data concerning comprehension by adults with DAT of main ideas versus details in narratives. Evidence from other groups with and without brain damage has shown ... Research Article
Research Article  |   December 01, 2002
Discourse Comprehension Test Performance of Elders With Dementia of the Alzheimer Type
 
Author Affiliations & Notes
  • Richard J. Welland, PhD
    Brock University St. Catharines, Ontario, Canada
  • Rosemary Lubinski
    State University of New York at Buffalo
  • D. Jeffery Higginbotham
    State University of New York at Buffalo
  • Contact author: Richard J. Welland, PhD, Department of Applied Language Studies, Brock University, St. Catharines, Ontario, Canada L2S 3A1. E-mail: rwelland@spartan.ac.brocku.ca
Article Information
Special Populations / Older Adults & Aging / Attention, Memory & Executive Functions / Language / Research Articles
Research Article   |   December 01, 2002
Discourse Comprehension Test Performance of Elders With Dementia of the Alzheimer Type
Journal of Speech, Language, and Hearing Research, December 2002, Vol. 45, 1175-1187. doi:10.1044/1092-4388(2002/095)
History: Received April 6, 2002 , Accepted June 19, 2002
 
Journal of Speech, Language, and Hearing Research, December 2002, Vol. 45, 1175-1187. doi:10.1044/1092-4388(2002/095)
History: Received April 6, 2002; Accepted June 19, 2002
Web of Science® Times Cited: 21

Spoken language comprehension, including comprehension for inferential material in narrative discourse, is diminished in dementia of the Alzheimer type (DAT). There are, however, no empirical data concerning comprehension by adults with DAT of main ideas versus details in narratives. Evidence from other groups with and without brain damage has shown that comprehension for main ideas is relatively better than for details and that comprehension for stated material is relatively better than comprehension for inferential material. Participants in the present investigation were 24 older adults, 8 with early-stage DAT (EDAT), 8 with middle-stage DAT (MDAT), and 8 with no brain damage (NBD). Selected narratives and associated sets of yes-no questions from the Discourse Comprehension Test (DCT) (Brookshire and Nicholas, 1993) were presented on videotape. Participants with EDAT and MDAT had significantly poorer overall comprehension of DCT narratives than did those in the NBD group (p<.0001), but they did not differ significantly from each other. Responses to DCT narratives by participants in the NBD, EDAT, and MDAT groups followed the same pattern of relatively better comprehension for main ideas than for details and relatively better comprehension for stated than for implied information. Working memory and episodic memory were shown to be significantly associated with DCT overall scores. Together, these findings suggest that although overall narrative comprehension is diminished in those with DAT, individuals appear to retain a mental representation for narratives that facilitates better comprehension of main ideas than of details as well as better comprehension of stated information than of implied information. This interpretation is consistent with schema-based accounts of narrative comprehension.

Acknowledgments
This research is based in part on the first author's doctoral dissertation, completed at the State University of New York at Buffalo. Portions of this research were presented at the 1999 Annual Convention of the American Speech-Language-Hearing Association and at the 2000 Tri-Joint Congress (Canadian Association of Speech-Language Pathologists and Audiologists). Research funding was provided to the first author by the Mark Diamond Memorial Research Fund (S-96-45), State University of New York at Buffalo and by the R. Samuel McLaughlin Centre for Gerontological Health Research, McMaster University, Hamilton, Ontario, Canada.
Special thanks are given to the following individuals for their assistance with the study: Mr. Kenneth Johnson; Dr. Mikael D. Z. Kimelman; Mr. Jeffrey Lear; Ms. Judy Lever; Ms. Janine Misiak; Dr. William Molloy; Dr. J. B. Orange; Dr. Christopher Patterson; Dr. Eric Roy; and Dr. David Streiner.
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