華語無失智年長者與阿茲海默失智年長者言談特徵研究

Discourse Features of Chinese-Speaking Seniors with and without Alzheimer’s Disease

阿茲海默氏症失智年長者言談實證研究發現：隨著病程惡化，患者適當情境語言使用能力與溝通能力亦日趨受損。儘管相關研究日益增多，目前仍有待解問題，例如：鮮少有研究言談特徵於阿茲海默氏症失智程度之預測力與解釋力，再者，華語母語阿茲海默氏症失智年長者之言談特徵尚乏人問津。本研究意旨描述二十位華語母語阿茲海默氏症失智年長者與二十位無失智年長者之言談特徵，言談特徵細分為：言談助益特徵與言談阻礙特徵，並進一步討論語義與語用範疇之口語修正特徵。結果發現：與無失智年長者相較之下，華語母語阿茲海默氏症失智年長者口語表達呈現顯著較少言談助益特徵，但顯著較多言談阻礙特徵；其次，與言談助益變數相較，言談阻礙變數較能有效解釋阿茲海默氏症失智程度，尤其以修正和無整體連貫兩特徵與阿茲海默氏症失智程度顯著相關。

Empirical studies on the discourse of persons with Alzheimer’s disease (AD) have revealed that appropriate language usage in context becomes more impaired and the communicative ability gradually deteriorates over the course of the disease. Despite the growing research interest in AD discourse patterns, there are still open questions. Up to the present time, few studies have addressed the predictive power of discourse features for the severity of Alzheimer’s dementia. Also, little attention has been drawn to the linguistic features in Mandarin Chinese-speaking persons with AD’s discourse. This study intends to describe discourse patterns produced by 20 AD participants and 20 healthy elderly controls in a Chinese-speaking society. Forty transcripts of interview style conversations were analyzed. Discourse patterns were examined in light of discourse-building features and discourse-impairing features. Semantic and pragmatic aspects in oral revisions are also discussed. Results indicate that fewer discourse-building features but more discourse-impairing features were found in conversations of the elderly with AD compared to the healthy controls. Discourse-impairing variables correlate significantly more with the degrees of dementia than with the discourse-building variables. Especially, revisions and no global coherence were significantly associated with the severity of Alzheimer’s dementia for the Chinesespeaking population in Taiwan.