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Patterns of discourse cohesion and coherence in Alzheimer's disease
Ripich DN, Terrell BY.. The Journal of speech and hearing disorders, 1988-02-01
Topic: Amyloid, tau and blood-test diagnosis
Patterns of discourse--as reflected in the use of propositions, cohesion devices, and in judgments of coherence--in the speech of 6 well elderly and 6 patients with senile dementia of the Alzheimer type (SDAT) during topic-centered interviews were compared. Compared to the well elderly, SDAT patients used significantly more words and conversational turns. The interviewer also used more words and turns when interviewing SDAT patients, making those interviews more lengthy and more interactive than those of the elderly comparison group. Although significant differences in propositional form and cohesion devices were not found, a pattern of cohesion disruptions in SDAT patients was identified that appears consistent with previously noted patterns of language dissolution. Coherence judgements by four listeners showed significant differences between the two groups. The breakdowns in coherence were related to one subtype of cohesion disruption, missing element. This suggests that incoherence may result in part from a loss of the ability to take the listener's perspective in developing thematic structure during conversation. It is argued that SDAT results not only in the impairment of linguistic abilities but also in the impairment of discourse abilities that contribute to Alzheimer patients' incoherent speech.
Key findings
- Compared to the well elderly, SDAT patients used significantly more words and conversational turns.
- Although significant differences in propositional form and cohesion devices were not found, a pattern of cohesion disruptions in SDAT patients was identified that appears consistent with previously noted patterns of language dissolution.
- Coherence judgements by four listeners showed significant differences between the two groups.
- This suggests that incoherence may result in part from a loss of the ability to take the listener's perspective in developing thematic structure during conversation.
- It is argued that SDAT results not only in the impairment of linguistic abilities but also in the impairment of discourse abilities that contribute to Alzheimer patients' incoherent speech.
Why it matters
This small study compared speech patterns in 6 people with senile dementia of the Alzheimer type and 6 well elderly people, finding differences in coherence and cohesion disruptions. It describes language features of the disease and does not test any treatment, cure or prevention.
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Study details
- Evidence strengthLow
How this study scored 36/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The Journal of speech and hearing disorders) |
| Journal's citation record | 1 / 4 | Journal of Speech and Hearing Disorders: journal h-index 113 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1988 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 195 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.9 citations a year over 40 year(s) since 1988 |
| Impact for its field and year | 2 / 6 | Cited 2.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 1 / 4 | Cited 13 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Brenda Y. Terrell: h-index 9 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Case Western Reserve University: institution h-index 1,159 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 3339870) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 36 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Ripich, D. N., & Terrell, B. Y. (1988). Patterns of discourse cohesion and coherence in Alzheimer's disease. The Journal of speech and hearing disorders. https://doi.org/10.1044/jshd.5301.08
Vancouver
Ripich DN, Terrell BY. Patterns of discourse cohesion and coherence in Alzheimer's disease. The Journal of speech and hearing disorders. 1988. doi:10.1044/jshd.5301.08. PMID: 3339870.
BibTeX
@article{ripich1988-3339870,
author = {Ripich, D. N. and Terrell, B. Y.},
title = {{Patterns of discourse cohesion and coherence in Alzheimer's disease}},
journal = {The Journal of speech and hearing disorders},
year = {1988},
doi = {10.1044/jshd.5301.08},
pmid = {3339870},
url = {https://doi.org/10.1044/jshd.5301.08}
}
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