Discourse Production of Alzheimer’s disease patients: Sociolinguistic and cultural preservation

Renné P. Alegria ¹,², Cássio M. C. Bottino², Maria Inês Nogueira ¹, ¹Neuroscience and Behavior. Institute of Psychology of the University of Sao Paulo, ²PROTER- Old Age Program, Institute of Psychiatry of the School of Medicine of the University of São Paulo

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Conflict of Interest DisclosureRenné Alegria (PhD)

Has no real or apparent conflicts of interest to report

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Introduction

-Language comprehension between Alzheimer’s patients and their caregivers has to be efficient in order to have better understanding.

-It is very important to research the lexical items that are more preserved in the discourse of the patients.

- Few studies of language comprehension of Alzheimer’s disease patients have stressed the importance to manage adequate communication with sociolinguistic, cultural and ideological lexicon in the oral interaction.

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-For this study, we used Stablex - a program for lexical textual and discursive analysis for the patients and controls productions.

-Therefore, it is necessary to research the sociolinguistic, ideological cultural underpinnings to avoid more stressful situations with patients and caregivers.

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Objective

To verify if Alzheimer’s disease patients have preserved lexical items with historical, ideological and cultural meanings in order to create a guide of oral communication between patients and caregivers.

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Methods Participants

- Eight Alzheimer’s disease patients from PROTER- Old Age program – Ambulatory Care, Institute of Psychiatry, Hospital das Clinicas, School of Medicine of the University of Sao Paulo.

- Patients were four male and four female aged 80 to 86

- Six healthy elderly controls aged 75 to 86,

- Three male and three female, their relatives or caregivers of the patients.

-All native Portuguese speakers 6

- Patients and controls had 4 to 11 years of education

-MMSE- Mini-Mental State Exams 13 to 30.

-All patients had clinical exams, neuroimages, CAMGOG- Cambridge Cognitive Test, NPI- Neuropsychiatry Inventory and several neuropsychological tests.

- Besides MMSE, the controls answered to the SRQ-20 Self Reporting questionnarie.

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Patients Controls Statistical tests and p values

Age 7 =801= 86

1=75 2=782= 791= 86

Mann-Whitney= 0,002p = 0,022

Sex M = 4F = 4

M= 3F = 3

Χ² (1) =0P =1

Education 1 basic 32 high school 5

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Χ² (1) = 0,2187P =1

Work activity YesNo

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X² (1) =1,6593P = 0,2854

MMSE 1=131=171=182=191=231=241= 25

1=271=281=293=30

Mann-Whitney= 0,002P= 0,002

Table 1. Demographic and clinical data

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Material - STABLEX- method of lexical, textual and discursive analysis, developed by André Camlong from the University of Toulouse, Le Mirail- France.

-The method permits the construction of lexicon, tables, graphics and specific vocabularies.

-It is based on mathematical-statistical-computer assisted program.

- Stablex mainly distinguishes and separate the results of preferential, basic and differential vocabularies.

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Procedure

We talked with all the patients and controls during 15 minutes, free conversation with the themes: Education, familiy, health, food and religion. They were after transcribed and thereafter analysed by Stablex.

Data analysis

The results of the frecuencies of the preferential , basic and differential vocabularies of the patients and controls correlated by Chi- square.

Demographic data of sex, profession and education were also analyzed and did not significat values.

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Results

There was a significant statistical correlation with the preferential words used by the patients.

The patients expressed more preferential words because they have more lexical items preserved with historical, ideological, cultural and sociolinguistic items.

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Frecuency Preferential Basic Differential total

Patient 738 1047 28 1813

Control 426 1673 35 2134

Total 1164 2720 63 3947

% Preferential Basic Differential total

Patient 40,7060 57,746 1,5444 100

Control 19,9625 78,3974 1,6401 100

Table 2 Comparison of vocabularies of patients and controls

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Frecuency Preferential Basic Differential total

Patient 535 1294 29 1813

Control 629,33 1470,605523 34,062 2134

Total 77,327 32,78670188 0,0304 110,144

65,695 27,85486903 0,0258 93,57597

203,72

Table 3 Specific Values

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Chi-square 114,3052

P 0,0004998

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Word Oc T1 Value(z)

family 20 17 4,606

Everythin’ 48 31 4,183

truth 11 10 3,825

God37 24 3,708

other 7 7 3,553

daughter 154 76 3,545

sons61 35 3,540

much 59 34 3,522

field 6 6 3,290

coffee 6 6 3,290

money 8 7 3,061

time 15 11 3,046

Word Oc T2 Value(z)

Catarina 4 4 5,484

Mine 4 4 5,484

saint 4 4 5,484

pray 6 5 5,448

is 21 10 5,108

husband 3 3 4,749

daughter 3 3 4,749

son 3 3 4,749

Mark 3 3 4,749

river 3 3 4,749

south 3 3 4,749

cold 27 10 4,083

Germany 2 2 3,877

there 2 2 3,877

Table 4. Preferential lexicon of patients T1 and T2

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Words Oc T1 Value(z)

no 41 30 4,907

much 45 31 4,544

know 19 16 4,341

go 10 9 3,530

son 30 20 3,457

is 9 8 3,280

all 6 6 3,244

that 105 53 3,017

other 5 5 2,961

you 5 5 2,961

true 5 5 2,961

she 27 17 2,879

fdaughter 4 4 2,648

city 4 4 2,648

Word Oc T3 Value (z)

tmother 11 8 6,111

Barretos 5 5 5,978

two 5 5 5,978

years 27 13 5,681

with 34 15 5,659

sons 10 7 5,564

number 3 3 4,631

father 3 3 4,631

Pirassununga 3 3 4,631

fiofteen 5 4 4,615

came 10 6 4,600

Paulo 13 7 4,568

five 2 2 3,781

Table 5. Preferential lexicon of controlsT1 and T3

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Conclusions/ Discussion-This study suggests that the word choice done by the people is not by guessing or randomized, It just does not show the character of the basic idea how the discurse is formed, but it also shows the used resources that are capable of determine the ideological, historical and cultural characteristics.

- The study also showed that besides Alzheimer’s disease patients have progressive lexical lose, their preferential lexicon is still preserved and the oral communication with caregivers and relatives may be possible and rehabilitated until they reach a severe stage.

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Thank you very much

Renné : realegrias@usp.br