Institut des Sciences Logopédiques, Université de Neuchâtel , Neuchâtel, Switzerland.
Haute Ecole de Santé, HES-SO Haute Ecole Spécialisée de Suisse Occidentale , Fribourg, Switzerland.
J Clin Exp Neuropsychol. 2020 Sep;42(7):710-724. doi: 10.1080/13803395.2020.1798883. Epub 2020 Aug 11.
Several studies have shown that people with Alzheimer's disease (AD) tend to use more pronouns than healthy aged adults when referring to entities during discourse. This referential behavior has been associated with the decrease of cognitive abilities, such as lexical retrieval difficulties or reduced abilities in working memory. However, the influence of certain important discourse factors on the referential choices made by people with AD has yet to be established. This study examines referential choices made at three discourse stages during narrative discourse (the introduction of a referent, the maintaining of the referent in focus, and the shift from one referent in focus to another). These referential choices are examined in increasingly complex referential contexts. In addition, this study investigates the relationships between referential choices and various cognitive abilities. To do so, the narrative discourses of 21 people with AD and 21 healthy adults were elicited using a newly developed storytelling in sequence task. The analyses focused on the production of three major referential expressions (indefinite expressions, definite expressions and pronouns) which are expected to vary according to discourse stage and the referential complexity of the stories. The results show that AD participants produce significantly fewer of the referential expressions expected at the introduction and shift stages than healthy aged adults produce. Nevertheless, the variation in the categories of referential expressions produced by the AD participants between the discourse stages is similar to that produced by the healthy aged adults, suggesting a preserved sensitivity to the factors manipulated in the task (i.e., discourse stages and referential complexity). This study also highlights the fact that different cognitive competences, especially executive abilities, are greatly involved in referential choices. The results add further evidence that referential choices rely on a variety of cognitive skills, depending on the discourse context in which they are made.
几项研究表明，在进行话语交流时，阿尔茨海默病（AD）患者在指代实体时往往比健康老年人使用更多的代词。这种指代行为与认知能力下降有关，如词汇检索困难或工作记忆能力下降。然而，某些重要话语因素对 AD 患者做出的指代选择的影响尚未确定。本研究考察了叙事话语中三个话语阶段的指代选择（参照语的引入、参照语的保持焦点和从一个焦点参照语到另一个参照语的转移）。这些指代选择是在越来越复杂的指代语境中进行考察的。此外，本研究还调查了指代选择与各种认知能力之间的关系。为此，使用新开发的序列故事讲述任务引出了 21 名 AD 患者和 21 名健康成年人的叙事话语。分析重点是三种主要指代表达（不定代词、定代词和代词）的产生，这些表达预计会根据话语阶段和故事的指代复杂性而有所不同。结果表明，AD 参与者在引入和转移阶段产生的预期指代表达明显少于健康老年人。然而，AD 参与者在话语阶段之间产生的指代表达类别的变化与健康老年人产生的变化相似，这表明他们对任务中操纵的因素（即话语阶段和指代复杂性）保持敏感。本研究还强调了这样一个事实，即不同的认知能力，特别是执行能力，在指代选择中起着重要作用。研究结果进一步证明，指代选择依赖于各种认知技能，具体取决于做出指代选择的话语语境。
