Conversational coherence: discourse analysis of older adults with and without dementia

The purpose of this study was to compare the discourse profiles of 30 nursing home residents with dementia and of 30 healthy older adults. A total of 60 transcripts of interview style conversations were analyzed using a discourse analysis schema. The results revealed a higher frequency of discourse building features, such as coherence and cohesion, for healthy adults compared to adults with dementia. Conversely, discourse-impairing features, such as disruptive topic shifts and empty phrases, were found more often in conversations of adults with dementia compared to healthy adults. Conversational partners deviated from their conversation protocol when talking to adults with dementia by including facilitative strategies in the conversation. Discourse features in interview style conversations in adults with dementia reflect declines in their memory. (C) 2003 Elsevier Ltd. All rights reserved.