Dementia Discourse Research Articles

Social health in dementia. Towards a positive dementia discourse

ABSTRACTA shift in focus from symptoms and disability towards the capacity and potential of the person with dementia is urgently needed to create a more balanced view of dementia and a more dementia-friendly society, which enables people and their families to adapt to the changes dementia brings in their lives. The new concept of social health suggested by Huber and colleagues seems helpful to make such a shift. In this dedicated special issue, a consensus-based operationalization of the concept of social health in dementia is proposed and several aspects of social health and related dementia care are addressed within the framework of European collaborative projects of the INTERDEM network.

Alzheimer's Disease Metaphors as Mirror and Lens to the Stigma of Dementia.

This essay gives an overview of the metaphors that patients in comparison to caregivers employ to conceptualize their experience with the chronic degenerative, cognitive, and incurable aspects of Alzheimer's disease. It explores how the images (such as the journey, darkness, the death sentence, and torture) relate to the narration of cognitive decline and memory loss, and how these personal accounts negotiate with the culturally dominant dementia narrative that centers on the patient's passivity and dependence and is, usually, found in caregiver stories. This analysis, based on English, French, and German language texts, argues that the metaphors of this mainstream dementia narrative are, first, grounded in medico-scientific dementia discourse and, second, encapsulated in "Alzheimer's disease" as metaphor itself.

치매환자 담화분석의 최근 연구동향 : 과제, 전사 및 측정요인

담화분석은 치매환자의 발화특성을 알아보거나, 환자군을 변별하는 데 있어서 그 효용성이 입증되었다. 그러나 기존의 담화연구들에서 활용된 과제, 전사법, 측정요인들이 서로 상이하므로, 체계적이고 일관적인 분석이 이루어지지 않아 해석을 도출하는데 어려움이 있다. 본 연구는 치매환자의 담화과제, 전사법, 측정요인들을 조사하여 향후 담화분석에 도움이 되고자 하는 목적으로 수행되었다. 이에, 스코퍼스(Scopus) 데이터베이스를 통해 2005년부터 2014년도까지 치매 환자의 담화를 분석한 연구들이 조사되었다. 그 결과, 첫째, 치매환자를 대상으로 가장 많이 쓰인 담화과제는 '주제에 대해 이야기하기'이었다. 둘째, 전사과정에서 일관된 전사규약(transcription conventions)을 적용하는 경우, 좀 더 신뢰성 있는 전사자료를 얻을 수 있었다. 셋째, 담화측정요인들은 담화처리모델에 따라 통일성, 응집성, 생산성, 명제 통사 사전분석, 유창성의 영역들로 범주화되며, 각 범주는 담화처리단계(즉, 개념형성단계, 명제처리단계, 자연언어단계)에 속하였다. 결론적으로, 향후의 담화연구는 치매유형 및 특징에 따라 담화과제를 선정하고, 분석의 신뢰성을 위해 일관된 전사규약을 적용해야 할 것이다. 또한, 담화처리이론에 바탕을 둔 측정을 통해, 담화연구의 해석이 체계적으로 이루어지는 것이 바람직하다고 할 수 있다. Discourse analysis is useful for examining discourse characteristics of dementia patients and differentiating them from normal adults. However, inconsistent tasks, transcription methods and measures have been utilized, thus analyses were inevitably unsystematic. The purpose of this study was to investigate tasks, transcription methods and measures of discourse studies in dementia. Studies on dementia discourses written in English were collected via Scopus database containing abstracts and citations from 2005 to 2014, and were analyzed in detail. From the results, the most frequently used task was 'storytelling-topic'. It was observed that use of consistent transcription conventions rendered more reliable transcription data. Measures could be categorized into coherence, cohesion, productivity, propositional syntactic lexical analysis, and fluency, and each category belonged to discourse processing levels (i.e., processing of conceptual networks, propositions, and natural language units). In conclusion, future research warrants not only utilization of discourse tasks depending on dementia types and features, but also application of consistent transcription conventions. Additionally, measures based on the discourse processing theory would enable us to systematically interpret discourse studies.

The scientific discourse about dementia in Germany-first results of the exemplary exercise of an integrative methodological approach

The analysis of the discourse in dealing with people with dementia within the nursing and healthcare research in Germany is previously missing.Aim: How are people with dementia described in the discourse of the German nursing and health care research community and what does that mean for the nursing and health research in Germany? Using an integrative methodological approach, the first steps of an analysis of dementia discourse are developed and exemplarily tested in a selected limited context datjramework. The scientific discourse is focused on the burden or the family aregivers of the person with dementia.They are identified as those who have to handle the burden with their spouse or siblings with dementia. A methodologiCal approach of integrative analysis was tested. According perspectives should be developed to incorporate the perspective of people with dementia in a stronger way.

Machine learning approaches to diagnosis and laterality effects in semantic dementia discourse

Advances in automatic text classification have been necessitated by the rapid increase in the availability of digital documents. Machine learning (ML) algorithms can ‘learn’ from data: for instance a ML system can be trained on a set of features derived from written texts belonging to known categories, and learn to distinguish between them. Such a trained system can then be used to classify unseen texts. In this paper, we explore the potential of the technique to classify transcribed speech samples along clinical dimensions, using vocabulary data alone. We report the accuracy with which two related ML algorithms [naive Bayes Gaussian (NBG) and naive Bayes multinomial (NBM)] categorized picture descriptions produced by: 32 semantic dementia (SD) patients versus 10 healthy, age-matched controls; and SD patients with left- (n = 21) versus right-predominant (n = 11) patterns of temporal lobe atrophy. We used information gain (IG) to identify the vocabulary features that were most informative to each of these two distinctions.In the SD versus control classification task, both algorithms achieved accuracies of greater than 90%. In the right- versus left-temporal lobe predominant classification, NBM achieved a high level of accuracy (88%), but this was achieved by both NBM and NBG when the features used in the training set were restricted to those with high values of IG. The most informative features for the patient versus control task were low frequency content words, generic terms and components of metanarrative statements. For the right versus left task the number of informative lexical features was too small to support any specific inferences. An enriched feature set, including values derived from Quantitative Production Analysis (QPA) may shed further light on this little understood distinction.

Dementia Discourse: From Imposed Suffering to Knowing Other-Wise

The authors revisit the troubling discourse surrounding the diagnosis of dementia. A critique of the predominant words and images in health care literature, public discourse, and policy is considered from multiple angles. The authors link the dominant words and images with a form of inter-relational violence. Contrary images grounded in research and experience offer a different view of what it is like to live with a diagnosis of dementia—a view that is life-affirming and based in relationality and possibility. Concepts of embodied selfhood and knowing other-wise are portrayed as doorways to transforming a discourse of violence toward a discourse of compassion and ethical relating.

Repetitional responses in frontotemporal dementia discourse: Asserting agency or demonstrating confusion?

Frontotemporal dementia (FTD) is a young-onset neurodegenerative dementia that primarily affects social behaviors. This paper examines the use of repetitional responses in FTD discourse, finding that patients often use repeats to assert agency or epistemic authority (i.e. to claim rights to knowledge). For example, repetitional responses are often used by patients to exert some autonomy when their interlocutors display a belief about the patients’ lack of knowledge about basic functioning. FTD has been associated with echolalia, the meaningless use of repetition; however, this analysis shows that the use of repetitional responses in FTD discourse can be meaningful and thus suggests that, at least in early stages of the dementia, echolalia is not always an accurate characterization of FTD patients’ use of repetitional responses.