19.6.09

WIDEN FRONTIERS

Alzheimer's disease (AD) has become the most common form of dementia in the world. Nowadays, it does not raise only a scientific, human and healthy challenge, but also a social and family one. AD is a progressive, degenerative disease that destroys vital brain cells. AD affects memory systems as well as cognitive and executive functions; that is, AD damages the ability to think, to remember, to speak and to make decisions. In addiction to affecting a person’s mental abilities, the disease can also lead to other problems such as emotional and behavioural changes, confusion and disorientation in time and space.
In the early stage of the disease, apart from memory systems, language becomes one of the affected cognitive functions. Until now, the greater part of linguistic research in AD accounts for semantic dificulties at a lexical level and their neural correlates (Imamura 1998; Venneria et al., 2008; Costa et al., 2008; Apostolova et al., 2008). These discoveries are relevant because they do not contribute only to the study of the conceptual organization of the information in the brain, but also of the anatomical ground of semantic degradation.

However, if we consider aging as a complex process, given its multi-directionality and the great internal and external variables that take part in the process, we should think about aging from a global and multidisciplinary perspective in order to comprehend the nature of aging. Also, we should keep in mind that scientists are neither exactly sure why cells fail in AD, nor have they yet identified any single cause. Because of this, one might expect that this disease has a multifactorial reason, with the greatest risk factor being increasing age. As aging, AD entails a complex process and it is not enough to think that language problems in AD are mainly characterised by a shrinking vocabulary and decreased word fluency; we must study, therefore, language within these processes from a wide perspective, beyond the lexical level.

To my knowledge, I consider Discourse Studies as the most suitable discipline for research in the communicative and linguistic dimensions in AD. It is the richest area in Neurolinguistics dealing with the complex interaction among language, cognition and brain. Thus, Discourse Studies could generate a multidisciplinary study framework around language research in AD. According to the literature, studies on the interplay between discourse processing and memory systems (Kintsch et al., 1999; Caspari, I., y Parkinson, Stanley R., 2000) as well as on discourse processes and its neural correlations have been published (Nieuwland, M. S. & van Berkum, Jos J. A. 2006; Troiani et al., 2006; Baggio et al., 2008; van Berkum et al., 2008; Martín-Loeches et al., 2008). Despite these studies, research into Alzheimer Discourse, in this particular field, hardly exists (Ash et al., 2006).

Previous research into Discourse Studies and Alzheimer’s Disease has focused, essentially, on discourse semantic level (Ulatowska, H. K. & Chapman, S. B. 1991; Vuorinen et al., 2000; Dijkstra et al., 2003; Ash et al., 2004; Ash et al., 2007). Additionally, there exist studies covering the pragmatic and sociolinguistics aspects of Alzheimer Discourse (Ramanathan 1995; Ramanathan 1997; Perkins et al., 1998; Keller, J., y Rech, T., 1998; Hamilton 1994; Hamilton 2008) as well as relatively new studies on research in artificial intelligenge (AI) for which the general motivation is to construct testable computational models that will enhance understanding of the effects of AD on communication and, specifically, to develop a computer program for training caregivers in use of assistive techniques for social conversation with persons in their care affected by AD (Green 2002; Green & Davis 2003; Green 2004).

All these different perspectives on Alzheimer Discourse research allow us to achieve an integral comprehension of how the real communication of persons living with AD is. In spite of these studies (among others), there are still not many researchers doing this kind of work; thus, more investigation in all dimensions of Alzheimer Discourse (such as pragmatic, semantic, sociolinguistic, neurologic, cognitive, technological (AI) and so on) is needed. I would like highlight the importance of crossing disciplinary boundaries in order to obtain a complete understanding about discourse and Alzheimer. That is, Discourse Studies will permit us 1) to comprehend how language is used by patients with this disease in many contexts, both experimental and natural; 2) to find out how discourse processing is carried out at a neural level and how discourse interplays with memory systems and cognitive aspects as well.

All these reflections make up part of my PhD project, which has also a therapeutic motivation: setting up new more natural and contextualized therapies in order to stimulate communicative skills of people suffering of Alzheimer. Some of these therapies could be thought through Yoga practice, which could improve in a creative way their mental (cognitive) and body balance.

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