So, You had Two Sisters, Right? Functions for Discourse Markers in Alzheimer’s Talk

  • Boyd H. Davis


Naturally occurring conversation with Alzheimer’s speakers, including embedded or co-constructed narrative, can be used to support or augment clinical findings on features of Alzheimer’s discourse, which are as highly variable as is the disease. For example, not only can speakers with moderate to moderately severe Alzheimer’s disease maintain some level of politeness (Sabat & Collins 1999; Temple et al. 1999; Rhys et al. 2000); and interaction (Hamilton 1994a, 1994b; Ramanathan 1997), their pragmatic skills can sustain more fine-tuned analysis, particularly as those skills sustain or simulate fluency. Ellis (1996) comments that problems Alzheimer’s speakers have in organizing and concentrating information are both communicative and cognitive. In the early stages, as grammatical modes of processing deteriorate for whatever reason, those “cohesion ties that structure topicality will begin to fade”; in later stages, more severe problems with maintaining topic will surface (see for example, Kempler 1995). Alzheimer’s speakers typically depend on lexical cohesion, or word-based means of holding the elements of a sentence together, as opposed to grammatical because, adds Ellis, lexical cohesion relies on “meaning,” not on grammatical structures. They lose the ability to “ground” the discourse for the hearer, or to organize meaning with thematic information via pronouns (see Almor et al. 1999)


Spontaneous Speech Discourse Marker Indirect Question Small Story Rhetorical Structure Theory 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Aijmer, Karin. (1987) “OH and AH in English Conversation.” In Corpus Linguistics and Beyond, Willem Meijs (ed.), Amsterdam: Editions Rodopi, 61–86.Google Scholar
  2. Aijmer, Karin. (2002) English Discourse Particles: Evidence from a Corpus. Amsterdam: John Benjamins.CrossRefGoogle Scholar
  3. Almor, A., Kempler, D., MacDonald, M., Andersen, E. & Tyler, L. (1999) “Why do Alzheimer patients have difficulty with pronouns? Working memory, semantics, and reference in comprehension and production in Alzheimer’s disease.” Brain and Language 67: 202–27.CrossRefGoogle Scholar
  4. Bamberg, Michael. (2004) “Talk, small stories, and adolescent identities”. Human Development 47: 366–400.CrossRefGoogle Scholar
  5. Bayles, K. (2003) “Effects of working memory deficits on the communicative functioning of Alzheimer’s dementia patients.” Journal of Communication Disorders 36: 209–19.CrossRefGoogle Scholar
  6. Blakemore, Diana. (1996) “Are apposition markers discourse markers?” Journal of Linguistics 32: 325–47.CrossRefGoogle Scholar
  7. Byron, Donna & Peter A. Heeman. (1997) “Discourse Marker Use in Spoken Dialog.” In Proceedings of the 5th European Conference On Speech Communication and Technology, Rhodes, Greece, September 1997, pp. 2223–6.Google Scholar
  8. Clark, Herbert. (2002) “Speaking in time.” Speech Communication 36: 5–13.CrossRefGoogle Scholar
  9. De Santi, Susan. (1993) “Formulaic Language in Aging and Alzheimer’s Disease.” PhD dissertation, City University of New York.Google Scholar
  10. Ellis, D. (1996) “Coherence patterns in Alzheimer discourse.” Communication Research 23: 472–95.CrossRefGoogle Scholar
  11. Erman, Britt. (2001) “Pragmatic markers revisited with a focus on you know in adult and adolescent talk.” Journal of Pragmatics 33: 1337–59.CrossRefGoogle Scholar
  12. Fischer, K. & Drescher, M. (1996) “Methods for the description of discourse particles: contrastive analysis.” Language Sciences 18: 853–61.CrossRefGoogle Scholar
  13. Fox Tree, Jean. (2002) “Interpretations of pauses and ums at turn exchanges.” Discourse Processes 34(1): 37–55.CrossRefGoogle Scholar
  14. Fox Tree, Jean and Josef Schrock. (2002) “Basic meanings of you know and I mean.” Journal of Pragmatics 34: 727–47.CrossRefGoogle Scholar
  15. Fuller, Janet. (2003) “Discourse marker use across three contexts: a comparison of native and non-native speaker performance.” Multilingua 22: 185–208.CrossRefGoogle Scholar
  16. Fuller, Janet. (2003) “The influence of speaker roles on discourse marker use.” Journal of Pragmatics 35: 23–45.CrossRefGoogle Scholar
  17. Grosz, Barbara J. & Candace L. Sidner. (1986) “Attention, intention, and the structure of discourse.” Computational Linguistics, 12(3): 175–204.Google Scholar
  18. Guendouzi, Jacqueline & Nicole Muller. (2001) “Intelligibility and rehearsed sequences in conversations with a DAT patient.” Clinical Linguistics and Phonetics 15: 91–5.CrossRefGoogle Scholar
  19. Gunlogson, Christine. (2003) True to Form: Rising and Falling Declaratives as Questions in English. NY: Routledge.Google Scholar
  20. Gunlogson, Christine. (2001) “Rising and falling declaratives.” 2001 07 29; last accessed June 19, 2004.Google Scholar
  21. Hamilton, Heidi. (1994a) Conversations with an Alzheimer’s Patient Oxford: Oxford University Press.CrossRefGoogle Scholar
  22. Hamilton, Heidi. (1994b) “Requests for Clarification as Evidence of Pragmatic Comprehension Difficulty: The Case of Alzheimer’s Disease.” Pages 185–99 in Bloom, Ronald; Obler, Loraine; De Santi, Susan & Erlich, Jonathan (eds.), Discourse Analysis and Applications: Studies in Adult Clinical Populations. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  23. Heritage, John. (1984) “A Change-of-State Token and Aspects of Its Sequential Placement. In Dwight Atkinson & John Heritage (eds.), Structures of Social Action. Cambridge: Cambridge University Press, pp. 299–345.Google Scholar
  24. Heritage, John. (1998a) “Oh-prefaced responses to inquiry.” Language in Society 27: 291–334.CrossRefGoogle Scholar
  25. Heritage, John. (1998b) “Oh-Prefacing: A Method of Modifying Agreement/Disagreement.” In Cecilia Ford et al.(eds.), The Language of Turn and Sequence. Oxford: Oxford University Press.Google Scholar
  26. Johnson, Alison. (2003) “So…?: Pragmatic Implications of So-Prefaced Questions in Formal Police Interviews.” In Janet Cotterill (ed.), Language in the Legal Process. Basingstoke and NY: Palgrave Macmillan, 91–110.Google Scholar
  27. Jucker, Andreas. (1993) “The discourse marker well: A relevance-theoretical account.” Journal of Pragmatics 19: 435–52.CrossRefGoogle Scholar
  28. Jucker, Andreas, Sara Smith & Tanja Luedge. (2003) “Interactive aspects of vagueness in conversation.” Journal of Pragmatics 35: 1737–69.CrossRefGoogle Scholar
  29. Kasher, Asa (ed.). (1998) Pragmatics: Critical Concepts, Vol. VI: Pragmatics, Grammar, Psychology; Sociology. London: Routledge.Google Scholar
  30. Katayama, H. (2001) “Beyond ‘change-of-state’: ‘oh’ as a facilitator of teacher-student interactions in an ESL conversation class.” Crossroads of Language, Interaction, and Culture 4 [n.p.]. Retrieved originally from 2001 Conference Abstracts, Scholar
  31. Katzenberger, I. (2004) “The development of clause packaging in spoken and written texts.” Journal of Pragmatics 36: 1921–48.CrossRefGoogle Scholar
  32. Keller, Joerg & Trixi Rech (1998) “Towards a modular description of the deficits in spontaneous speech in dementia.” Journal of Pragmatics 29: 313–32.CrossRefGoogle Scholar
  33. Kempler, D. (1995) “Language Changes in Dementia of the Alzheimer Type.” In R. Lubinsky (ed.), Dementia and Communication: Research and Clinical Implications. San Diego: Singular, pp. 98–114.Google Scholar
  34. Kim, Jung Hee, Michael Glass, Reva Freedman & Martha Evens. (2000) “Learning the use of discourse markers in tutorial dialogue for an intelligent tutoring system.” Proceedings of the 22nd Annual Meeting of the Cognitive Science Society, CogSci, 2000, Philadelphia, 262–7.Google Scholar
  35. Linguistics Data Consortium. (2004) “Annotation guidelines: metadata (as resumptive of turn),” last accessed 25 June 2004 at Scholar
  36. Macaulay, Ron. (2002) “You know, it depends.” Journal of Pragmatics 34: 749–67.CrossRefGoogle Scholar
  37. Mann, William C. & Sandra A. Thompson. (1988) “Rhetorical Structure Theory: towards a functional theory of text organization.” Text, 8(3): 243–81.Google Scholar
  38. Mahendra, N., Bayles, K.A. & Tomoeda, C.K. (1999) “Effect of an unfamiliar accent on the repetition ability of normal elders and individuals with Alzheimer’s disease.” Journal of Medical Speech-Language Pathology, 7: 223–30.Google Scholar
  39. Mueller, N. (2003) “Intelligibility and negotiated meaning in interaction.” Clinical Linguistics and Phonetics, 17: 317–24.CrossRefGoogle Scholar
  40. Norrick, Neal. (2000) Conversational Narrative: Storytelling in Everyday Talk. Amsterdam and Philadelphia: John Benjamins.CrossRefGoogle Scholar
  41. Obler, Loraine & De Santi, Susan. (2000) “Eliciting Language from Patients with Alzheimer’s Disease.” Pages 403–16 in Lise Menn & Nan Ratner (eds.), Methods for Studying Language Production. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  42. Perkins, L., A. Whitworth & R. Lesser. (1998) “Conversing in dementia: a conversation analytic approach.” Journal of Neurolinguistics 11: 33–53.CrossRefGoogle Scholar
  43. Perkins, Lisa, Anne Whitworth & Ruth Lesser. (1997) Conversation Analysis Profile for People with Cognitive Impairment. London: Whurr Publishers.Google Scholar
  44. Perkins, Michael. (1998) “Is pragmatics epiphenomenal? Evidence from communication disorders.” Journal of Pragmatics 29 (1998): 291–311.CrossRefGoogle Scholar
  45. Ramanathan, Vai. (1997) Alzheimer Discourse: Some Sociolinguistic Dimensions. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  46. Rhys, Catrin & Nicola Schmidt-Renfree. (2000) “Facework, social politeness and the Alzheimer’s patient.” Clinical Linguistics & Phonetics 14: 533–43.CrossRefGoogle Scholar
  47. Ripich, D. & B. Terrell. (1988) “Patterns of discourse cohesion and coherence in Alzheimer’s disease.” Journal of Speech and Hearing Disorders 53: 8–15.CrossRefGoogle Scholar
  48. Ripich, D.N., Carpenter, B. & Ziol, E. (2000) “Conversational cohesion in men and women with Alzheimer’s disease: a longitudinal study.” International Journal of Language and Communication Disorders, 35(1): 49–65.CrossRefGoogle Scholar
  49. Rosenberg, Sheldon & Leonard Abbeduto. (1987) “Indicators of linguistic competence in the peer group conversational behavior of mildly retarded adults.” Applied Psycholinguistics 8: 19–32.CrossRefGoogle Scholar
  50. Ryan, Ellen, S. Meredith, M. MacLean & J. B. Orange. (1995) “Changing the way we talk with elders: promoting health using the Communication Enhancement Model.” International Journal of Aging and Human Development 41: 89–107.CrossRefGoogle Scholar
  51. Rendle-Short, Johanna. (2003) “So what does this show us?”: analysis of the discourse marker ‘so’ in seminar talk.” Australian Review of Applied Linguistics 26: 46–62.Google Scholar
  52. Sabat, S.R. & Collins, M. (1999) “Intact social, cognitive ability, and selfood: A case-study of Alzheimer’s disease.” American Journal of Alzheimer’s Disease 14: 11–19.CrossRefGoogle Scholar
  53. Safarova Marie, Swerts Marc. (2004) “On recognition of declarative questions in English.” Proceedings of the Speech Prosody 2004 Conference, Nara (Japan), March 23–26, 2004, pp. 313–16.Google Scholar
  54. Schiffrin, Deborah. (1987) Discourse Markers. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  55. Schourup, Lawrence. (2001) “Rethinking well.” Journal of Pragmatics 33: 1025–60.CrossRefGoogle Scholar
  56. Schrock, J.C. & Fox Tree, J.E. (2000) “‘So’ and ‘and’ in spontaneous speech.” Poster presented at the 2000 meeting of the Psychonomic Society, New Orleans, LA. Last accessed 15 June 2004 at Scholar
  57. Small, J.A., G. Gutman, S. Makela & B. Hillhouse. (2003) “Strategies used by caregivers of persons with Alzheimer’s disease during activities of daily living.” Journal of Speech, Language and Hearing Research, 46: 353–67.CrossRefGoogle Scholar
  58. Stemmer, Brigitte & Paul Schoenle. (2000) “Neuropragmatics in the 21st Century.” Brain and Language 71 (special issue).Google Scholar
  59. Tappen, R.M., C. Williams-Burgess, J. Edelstein, T. Touhy & S. Fishman. (1997) “Communicating with individuals with Alzheimer’s disease: an examination of recommended strategies.” Archives of Psychiatric Nursing, 11(5): 249–56.CrossRefGoogle Scholar
  60. Temple, Valerie; Sabat, Steven; Koger, Rolf. (1999) “Intact use of politeness in the discourse of Alzheimer’s sufferers.” Language and Communication 19: 163–80.CrossRefGoogle Scholar
  61. Van de Craen, Piet. (2000) “Non-standard Dutch ‘Allez’ as a discourse particle.” Conference on Discourse particles, modal and focal particles, and all that stuff, Universitaire Stichting, Brussels, December 2000. Abstract: Scholar
  62. Waring, Hansun Zhang. (2002) “Displaying substantive recipiency in seminar discussion.” Research on Language and Social Interaction, 2002, Vol. 35: 453–79.CrossRefGoogle Scholar
  63. Wray, Alison. (2002) Formulaic Language and the Lexicon. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  64. Wray, A. & Perkins, M. (2000) “The functions of formulaic language: an integrated model.” Language and Communication 20(1): 1–28.CrossRefGoogle Scholar

Copyright information

© Boyd H. Davis 2005

Authors and Affiliations

  • Boyd H. Davis

There are no affiliations available

Personalised recommendations