Background: According to some studies, sentence comprehension is diminished in Alzheimer's disease (AD) patients, but they differ on what underlies the sentence comprehension impairment. Sentence comprehension in AD patients has been studied mainly in the English language. It is less clear how patients with AD speaking a morphologically rich language with grammatical morphemes indicating case and through it even thematic roles process reversible sentences.
Aims: To compare the comprehension of various syntactic constructions in Slovak-speaking AD patients and cognitively intact elderly people. We were concerned with the influence of the following aspects on sentence comprehension: its length, the order of thematic roles and the presence of a morphological cue placed on the first noun (or at the beginning of a sentence).
Methods & procedures: We used our own Slovak test of sentence comprehension based on matching pictures to spoken sentences. These sentences contain transitive verbs and two nouns (person/animal), one functioning as a subject and the other as an object, which both can perform the action expressed by the verb. We assessed 62 healthy elderly people and two groups of AD patients. The first group consisted of 34 participants with a mild degree of AD and the other group of 43 participants with a moderate degree of AD.
Outcome & results: Statistical comparisons showed that the elderly controls were significantly better in the comprehension of simple active OVS (object-verb-subject word order) sentences and complex EO sentences (a centre-embedded relative clause with a relative pronoun substituting for an object) than patients with a mild degree of AD. In patients with a moderate degree of AD, comprehension of all tested sentence types was worse than in healthy elderly people. The results also indicated that even mild AD patients have more serious problems with processing sentences with non-canonical order of thematic roles regardless of a morphological cue at the beginning of a sentence.
Conclusion & implications: The results point to diminished sentence comprehension in patients with AD. In the group of mild AD patients, the order of thematic roles played a significant role in their sentence comprehension. Even though the grammatical morphemes clearly code the functions of words in the Slovak language, mild AD patients do not process them in sentences with a non-canonical order of thematic roles at the same level as the healthy controls. Patients with moderate AD have significant problems even with the comprehension of sentences with a canonical order of thematic roles. These difficulties seem to be a consequence of insufficient resources for language processing.
Keywords: Alzheimer's disease; language processing; morphosyntax; sentence level.
© 2016 Royal College of Speech and Language Therapists.