Ripich D N, Terrell B Y
Department of Communication Sciences, Case Western Reserve University, Cleveland, OH 44106.
J Speech Hear Disord. 1988 Feb;53(1):8-15. doi: 10.1044/jshd.5301.08.
Patterns of discourse--as reflected in the use of propositions, cohesion devices, and in judgments of coherence--in the speech of 6 well elderly and 6 patients with senile dementia of the Alzheimer type (SDAT) during topic-centered interviews were compared. Compared to the well elderly, SDAT patients used significantly more words and conversational turns. The interviewer also used more words and turns when interviewing SDAT patients, making those interviews more lengthy and more interactive than those of the elderly comparison group. Although significant differences in propositional form and cohesion devices were not found, a pattern of cohesion disruptions in SDAT patients was identified that appears consistent with previously noted patterns of language dissolution. Coherence judgements by four listeners showed significant differences between the two groups. The breakdowns in coherence were related to one subtype of cohesion disruption, missing element. This suggests that incoherence may result in part from a loss of the ability to take the listener's perspective in developing thematic structure during conversation. It is argued that SDAT results not only in the impairment of linguistic abilities but also in the impairment of discourse abilities that contribute to Alzheimer patients' incoherent speech.
对6名健康老年人和6名阿尔茨海默病型老年痴呆症（SDAT）患者在以主题为中心的访谈中的话语模式进行了比较，这些模式体现在命题的使用、衔接手段以及连贯性判断上。与健康老年人相比，SDAT患者使用的单词和对话轮次明显更多。访谈者在采访SDAT患者时也使用了更多的单词和轮次，使得这些访谈比老年对照组的访谈更长且更具互动性。虽然在命题形式和衔接手段上未发现显著差异，但已识别出SDAT患者中存在一种衔接中断模式，这似乎与先前指出的语言解体模式一致。四名听众的连贯性判断显示两组之间存在显著差异。连贯性的破坏与衔接中断的一种亚型即缺失元素有关。这表明不连贯可能部分是由于在对话中构建主题结构时失去了从听众角度出发的能力。有人认为，SDAT不仅导致语言能力受损，还导致话语能力受损，这导致了阿尔茨海默病患者言语不连贯。
