Wardlow Liane, Ivanova Iva, Gollan Tamar H
University of California, San Diego, Department of Psychology, 9500 Gilman Drive, La Jolla, CA 92093-0109, USA.
University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive, La Jolla, CA 92093-0948, USA.
Neuropsychologia. 2014 Apr;56:184-95. doi: 10.1016/j.neuropsychologia.2014.01.013. Epub 2014 Jan 24.
Successful communication requires speakers to consider their listeners׳ perspectives. Little is known about how this ability changes in Alzheimer׳s Disease (AD) although such knowledge could reveal the cognitive mechanisms fundamental to perspective-taking ability, and reveal which cognitive deficits are fundamental to communication disorders in AD. Patients with mild to moderate AD and age and education matched controls were tested in a communicative perspective-taking task, and on measures of executive control, general cognitive functioning, and lexical retrieval. Patients׳ ability to perform the perspective-taking task was significantly correlated with performance on measures of general cognitive functioning, visual scanning and construction, response conflict and attention. Measures of lexical retrieval tended not to be correlated with performance on the communication task with one exception: semantic but not letter fluency predicted a derived score of perspective-taking ability. These findings broaden our understanding of the cognitive mechanisms underlying perspective taking, and suggest that impairments in perspective taking in AD occur during utterance planning, and at a relatively early processing stage which involves rapid visual scanning and problem solving, rather than during retrieval of lexical items needed to speak. More broadly, these data reveal executive function and semantic deficits, but not problems with lexical retrieval, as more fundamental to the basis of cognitive changes associated with AD.
成功的沟通要求说话者考虑听众的观点。尽管了解这种能力在阿尔茨海默病（AD）中的变化情况有助于揭示换位思考能力背后的认知机制，并揭示哪些认知缺陷是AD沟通障碍的根本原因，但目前对此知之甚少。对轻度至中度AD患者以及年龄和教育程度相匹配的对照组进行了一项沟通换位思考任务测试，并对执行控制、一般认知功能和词汇检索进行了测量。患者执行换位思考任务的能力与一般认知功能、视觉扫描与构建、反应冲突和注意力测量的表现显著相关。词汇检索测量结果往往与沟通任务的表现无关，但有一个例外：语义流畅性而非字母流畅性预测了换位思考能力的派生分数。这些发现拓宽了我们对换位思考背后认知机制的理解，并表明AD患者在话语规划过程中以及在涉及快速视觉扫描和问题解决的相对早期处理阶段出现换位思考障碍，而不是在说话所需词汇检索过程中出现障碍。更广泛地说，这些数据揭示了执行功能和语义缺陷，而不是词汇检索问题，是与AD相关的认知变化基础中更根本的因素。
