Task demands and sentence comprehension in patients with dementia of the Alzheimer's type.

Patients with dementia of the Alzheimer's type (DAT) and matched normal controls were given three tests of syntactic comprehension in which nonlinguistic visual and memory task demands were varied. In all tasks, subjects were presented spoken semantically reversible sentences with a variety of syntactic structures and required to match the sentence to a picture. In the first experiment, subjects matched the spoken sentence to one of two pictures that appeared either before or immediately following the presentation of the sentence. The target picture depicted the spoken sentence correctly and the foil depicted the reversed thematic roles to those in the sentence (i.e., it was a syntactic foil). The second experiment employed a sentence video-verification task in which subjects were required to determine if the spoken sentence matched a videotaped depiction of the action in the sentence or a syntactic foil. In the third experiment, in different conditions, subjects were required to determine whether the spoken sentence matched a single picture or to choose the picture that matched the sentence from an array of two or three pictures. In this experiment, both lexical and syntactic foils were used. In all tasks, DAT patients were affected by the number of propositions in the presented sentence, but not by the syntactic complexity of the sentence. Control subjects also were unaffected by the syntactic complexity of the sentence; the number-of-proposition effect was present in some experiments in the control population. Comparison of performance across the one-, two-, and three-picture versions of the task showed that the magnitude of the effect of number of propositions increased as the number of pictures in the array increased. In addition, analysis of the data from each of the tasks separately showed that the effect of number of propositions only occurred when subjects were attempting to match the target to a syntactic foil (one-picture version) or to choose between the target and a syntactic foil (two- and three-picture versions). The results support the view that patients with DAT do not have disturbances affecting syntactic processing. In addition, they suggest that the effect of number of propositions arises at a stage of analysis that is partially separate from assigning sentence meaning, such as in holding a representation of the sentence in memory until the pictures can be analyzed and encoded and/or in comparing the results of the picture analysis with a stored representation of the sentence meaning.