N. Gawron, A. Pluta, M. Sobanska, E. Lojek Narrative Discourse in Individuals with Subcortical Ischaemic Vascular Dementia (SIVD) INS Mid-year Meeting Jerusalem 2014

1. Narrative Discourse in Individuals with
Subcortical Ischaemic Vascular Dementia
(SIVD)
N. Gawron, A. Pluta, M. Sobanska, E. Lojek
Faculty of Psychology, University of Warsaw, ngawron@gmail.com
Conclusions
SIVD patients may experience problems with discourse
production mainly at the level of macrostructure.
The discourse impairments are related to neurocognitive
shortcomings in this group.
References
Arbuckle T Y, & Gold D P (1993). Aging, inhibition, and verbosity. Off topic speech is found in normal elderly. Journal of Gerontology: Psychological Sciences, 48, P225-P232.
Bestgen, Y. (1998). Segmentation markers as trace and signal of discourse structure. Journal of Pragmatics, 29, 753-763.
Gawron N, Łojek E, Kijanowska-Haładyna B, Nestorowicz J, Harasim A, Pluta A & Sobańska M (2013). Cognitive patterns of normal elderly sbjects are consistent with
frontal cortico-subcortical and fronto-parietal neuropsychological models of brain aging, Applied Neuropsychology: Adult, DOI: 10.1080/09084282.2013.789965
Kintsch W, van Dijk T A (1978). Toward a model of text comprehension and production. Psychological Review, 85, 363-393.
Łojek-Osiejuk E (1996). Knowledge of scripts reflected in discourse of aphasics and right-brain-damaged patients. Brain and Language, 53, 58-80.
Vuorinen E, Laine M, & Rinne J (2000). Common pattern of language impairment in vascular dementia and in Alzheimer disease. Alzheimer Disease and Associated
Disorders, 14(2):81-86.
Aim of the study
The study aimed at investigating discourse features as well as the relationships between
discourse and other cognitive functions in SIVD.
Method
Fourteen patients with mild SIVD, 14 patients with mild Alzheimer’s disease (AD), and 14
healthy controls (HC) matched in age, gender, and education took part in the study (full
description of groups and neuropsychological data is in Gawron et.al., 2013).
Table 1. Means (Mean ± Standard Deviation) and Differences in Demographics, Mental Status,
and Mood for Groups
Discourse was elicited with two tasks of story retelling. The utterances were transcribed
verbatim and analyzed at the levels of discourse organization (Kintsch, Van Dijk, 1978):
Microstructure – ratio of paraphasias, omitted words, repeated words, and conjunctions.
Macrostructure – number of propositions recalled, number of pronominal references, ratio of
comments, ratio of pragmatic words and expressions (eg. well, you know, lets’s say), accurate
topic of the story, accurate moral of the tale.
Superstructure – at least one proposition from introduction, action, and ending.
Ratios of paraphasias, omissions, repetitions, conjunctions, comments, and pragmatic words
were calculated for the two retellings altogether and adjusted for utterance length.
Sets of model propositions for story retelling
Results
SIVD group produced
• less correct propositions (p < .05),
• less correct morals (p < .001),
• more irrelevant off-topic comments (p < .058) than HC.
AD patients produced
• less correct propositions (p < .05),
• less correct topics (p < .05),
• less correct morals (p < .001),
• more pragmatic expressions (eg. you know) (p < .05) than HC.
SIVD patients recalled more correct propositions (p < .002) than AD patients.
In the SIVD group comments were more frequent in individuals with lower memory
performance (rs = - .538; p < .05). Pragmatic expressions were more frequent in
individuals with problems of executive functioning (rs = -.542; p < .05).
Discussion
SIVD and AD groups differed only in the amount of propositions recalled from the stories.
More detailed recall in the SIVD group could be related with their slighlty better cognitive
status (MMSE). However, the clinical groups showed basically a similar pattern of
language difficulties which is in line with previous evidence (Vuorinen et al., 2000).
The SIVD group showed difficulties only at the level of discourse macrostructure.
The SIVD group added the most redundant off - topic information. Redundant statements
may be related with inhibition deficits (Arbuckle at al., 1993) and frontal dysfunction, but
have been found in diverse brain diseases as well as in neurologically normal elderly.
Adding irrelevant information and frequent use of pragmatic expressions indicated
production difficulties and was associated with cognitive decline (Bestgen, 1998).
SIVD N = 14 AD N = 14 HC N = 14 F/ χ2 p Value
Age (years) 77.6 ± 4.4 75.1 ± 5.3 72.9 ± 5.5 ns
Education
(years)
13.8 ± 3.1 13.6 ± 3.5 15.1 ± 2.8 ns
MMSE 26.4 ± 2.4 23.1 ± 2.7 28.4 ± 1.8 < .001
BDI-II 8.7 ± 7.2 5.8 ± 4.1 7.4 ± 4.1 ns
10.1080/09084282.2013.789965
DOI:
10.1080/09084282.2013.789965
DOI:
10.1080/09084282.2013.789965
DOI:
10.1080/09084282.2013.789965
0
0,02
0,04
0,06
0,08
0,1
0,12
0,14
0,16
SIVD AD HC
Ratio of comments
Ratio of pragmatic words