title: Communicative competence in Alzheimer's disease: metaphor and sarcasm comprehension.
abstract: The purpose of this study was to evaluate the deficits of metaphor and sarcasm comprehension in Alzheimer's disease (AD), as pragmatic interpretation such as metaphor and sarcasm comprehension is required in social communication. A total of 31 young normal controls, 104 aged normal controls (ANC), 42 patients with amnesic mild cognitive impairment (aMCI), and 30 patients with mild AD were evaluated by Metaphoric and Sarcastic Scenario Test, which consists of 5 metaphoric and 5 sarcastic questions with 5 answer choices. Scores were analyzed using the repeated measures analysis of variance (metaphor/sarcasm vs 4 participant groups). Sarcasm comprehension, which requires second-order Theory of Mind (ToM), started to deteriorate in ANC, and metaphor comprehension, which requires first-order ToM, started to deteriorate in aMCI, and both deteriorated as disease progressed. Literal interpretation of pragmatic language is characteristic in patients with mild AD. Such misinterpretation would result in social miscommunication, even if they still retained semantic-lexical competence.
authors.affiliation: Gunma University Graduate School of Health Sciences, Gunma, Japan.
authors.forename: Yohko
authors.initials: Y
authors.lastname: Maki
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Koeda
authors.forename: Haruyasu
authors.initials: H
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000523:psychology*; D003142:Communication; D032882:Comprehension / Q000502:physiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D016743:Mental Competency / Q000523:psychology*; D019365:Metaphor; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D056345:Theory of Mind; D055815:Young Adult