Discourse and conversation impairments in patients with dementia

Dementia is the progressive deterioration of cognitive, linguistic, and social functioning that affects the quality of life, including the physical, social, and economic conditions of individuals, their families, and society (2-5). Although there is no treatment for dementia, early-stage identification, and assessment of individuals with dementia are of utmost importance to enable interventions that can delay the progression of dementia and support family planning. The neurocognitive assessment aims to evaluate individuals' condition and provide early diagnosis, prognosis, and quantify intervention efficacy. Speech, language, and communication impairments are early symptoms in individuals with dementia (6-8). For example, earlier studies have shown that discourse narratives in the autobiographies of Catholic sisters of the School Sisters of Notre Dame congregation can be an exceedingly early predictor of dementia (9). In addition, studies of the speeches of the US president Ronald Reagan (10, 11) and the comparative analysis of the British novelists Iris Murdoch and Agatha Christie works showed that narratives could provide an early prognosis of dementia development (12). Clinical Discourse Analysis (CDA) examines speech, language, and communication impairments in individuals with dementia and elicits language and communication measures. These measures can provide an early, stressless, and comprehensive assessment of individuals' language and neurocognitive functioning (e.g., memory, attention, social interaction) and inform treatment approaches (13, 14). CDA involves the characterization of texts produced by individuals through language, cooperation, and social interaction in communicative settings such as conversations, semi-structured interviews (15-17), role-plays, and monologues (18).