Assessment of strategic processing during narrative comprehension in individuals with mild cognitive impairment

A think-aloud protocol was used to examine the strategies used by individuals with mild cognitive impairment (MCI) during text comprehension. Twenty-three participants with MCI and 23 cognitively healthy older adults (OA) read narratives, pausing to verbalize their thoughts after each sentence. The verbal protocol analysis developed by Trabasso and Magliano (1996) was then used to code participants' utterances into inferential and non-inferential statements; inferential statements were further coded to identify the memory operation used in their generation. Compared with OA controls, the MCI participants showed poorer story comprehension and produced fewer inferences. The MCI participants were also less skilled at providing explanations of story events and in using prior text information to support inference generation. Poorer text comprehension was associated with poorer verbal memory abilities and poorer use of prior text events when producing inferential statements. The results suggest that the memory difficulties of the MCI group may be an important cognitive factor interfering with their ability to integrate narrative events through the use of inferences and to form a global coherence to support text comprehension.