Conversational cohesion patterns in men and women with Alzheimer's disease: a longitudinal study

The use of cohesion devices in conversations was examined in 60 individuals (31 women, 29 men) with early to midstage Alzheimer's disease (AD) and 47 non-demented elderly (NE) (27 women, 20 men). AD individuals produced more referent errors than NE, although AD and NE subjects otherwise demonstrated similar use of cohesion devices. AD women showed more frequent use of two elliptical devices (clause omission and word omission) compared with AD men and NE men and women. A subset of 23 AD subjects (13 women, 10 men) who completed four data collections (entry, 6, 12 and 18 months) was followed longitudinally. They demonstrated a significant decline in the number of ellipses and conjunctions at 18 months post-entry. As AD subjects produced fewer and shorter utterances across time, their use of all cohesive devices declined. No gender differences were found over time. Although referencing errors differentiated early to midstage AD from NE, conversational discourse tasks alone may have limited clinical value to assess and monitor communication competence.