Specificity of pragmatic features of language in elderly age: principles of diagnosis and direction of therapy

The article shows that taking into account the change in the pragmatic function of the language at a later age can not only improve the health conserve behavior and improve treatment adherence, but also plays an important role in the recognition of qualifications and effective treatment of mental, cognitive, and neurodegenerative disorders. Based on the analysis of foreign studies systematic techniques are often used for the diagnosis of pragmatic competence and presents step-by-step algorithm for estimating of socio-cognitive disorders in old age. It is shown that in normal aging we can observe selective, reversible changes in the verbal, para - and extralinguistic components of the pragmatic functions of language, and metapragmatic abilities. Systematic General symptoms of deficiency in pragmatic functions of language are neatly systematized. The analysis of the causes of changes in pragmatic competence at an elderly age was carried out with the help of deficit and resource approaches. We presented a range of pharmacological and non-pharmacological interventions aimed at improving the pragmatic function of language in old age.

1. Akinina Ju.S., Grabovskaya M.A. Biblioteka psiholingvisticheskih stimulov: novye dannye dlja russkogo i tatarskogo jazyka [Library of psycholinguistic stimuli: new data for Russian and Tatar language]. Sed'maja mezhdunarodnaja konferencija po kognitivnoj nauke: Tezisy dokladov. (Svetlogorsk, 20–24 ijunja 2016 g.) [Seventh International Conference on Cognitive Science: Abstracts. (Svetlogorsk, June 20-24, 2016)]. Moscow: Institute of Psychology, Russian Academy of Sciences, 2016, pp. 93–95. (In Russ.).
2. Melehin A.I., Sergienko E.A. Specifika social'nogo poznanija v pozhilom i starcheskom vozraste [Specificity of social cognition in elderly and old age]. Social'naja psihologija i obshhestvo [Social psychology and society], 2015, vol. 6, no. 4, pp. 60–77. doi:10.17759/sps.2015060405 (In Russ.; abstr. in Engl.).
3. MacPherson S.E. et al. Age, executive function, and social decision making: A dorsolateral prefrontal theory of cognitive aging. Psychology and Aging, 2002, vol. 17, no. 4. pp. 598–609. doi:10.1037/0882-7974.17.4.598
4. Grady C.L. et al. Age-related changes in cortical blood flow activation during the processing of faces and location. Journal of Neuroscience, 1994, vol. 14, pp. 1450–1462.
5. Lambrecht L. et al. Age-related decrease in recognition of emotional facial and prosodic expressions. Emotion, 2012, vol. 12, no. 3, pp. 529–539. doi:10.1037/a0026827
6. Nocentini U. et al. Age-Related Evolution of the Contribution of the Right Hemisphere to Language: Absence of Evidence. International journal of neuroscience, 1999, vol. 99, no. 8, pp. 59–67. doi:10.3109/00207459908994313
7. Assessment of Communication Disorders in Adults. In M.N. Hegde (ed.). NY: Plural Publishing, 2011. 480 p.
8. Baltes M.M., Carstensen L.L. The process of successful aging: Selection, optimization, and compensation. Understanding human development. In M. Staudinger, U. Lindenberger (eds.). Boston: Kluwer Academic, 2003, pp. 81–104.
9. Bara B.G. Cognitive pragmatics: The mental processes of communication. Intercultural Pragmatics, 2011, vol. 8, no. 3, pp. 443–485. doi:10.1515/IPRG.2011.020
10. Bond G.D., Thompson L.A. Vulnerability of older adults to deception in prison and nonprison contexts. Psychology and Aging, 2005, vol. 20, pp. 60–70. doi:10.1037/0882-7974.20.1.60
11. Bornhofen C., Mcdonald S. Treating deficits in emotion perception following traumatic brain injury. Neuropsychologial Rehabilitation, 2008, vol. 18, no. 1, pp. 22–44. doi:10.1080/09602010601061213
12. Boschi V. Connected Speech in Neurodegenerative Language Disorders: A Review. Front Psychol, 2017, vol. 269, no. 8, pp. 1–21. doi:10.3389/fpsyg.2017.00269
13. Bosco F.M. Communicative-pragmatic disorders in traumatic brain injury: The role of theory of mind and executive functions. Brain Lang, 2017, vol. 168, pp. 73–83. doi:10.1016/j.bandl.2017.01.007
14. Bottirolia S., Cavallini E. Theory of Mind in aging: Comparing cognitive and affective components in the faux pas test. Archives of Gerontology and Geriatrics, 2016, vol. 62, pp. 152–162. doi:10.1016/j.archger.2015.09.009
15. Carstensen L.L. The influence of a sense of time on human development. Science, 2006, vol. 312, pp. 1913–1915. doi:10.1126/science.1127488
16. Caruso A., Mueller P.B. Age-related changes in speech, voice, and swallowing. In Shadden B.B., Toner M.A. (eds.), Aging and communication: For clinicians by clinicians. Austin, TX: PRO-ED, 1997, pp. 117–134.
17. Champagne-Lavau M., Jean-Louis S. Effect of aging on the processing of non-literal language. Canadian Journal on Aging-Revue Canadienne Du Vieillissement, 2006, vol. 25, no. 1, pp. 55–64. doi:10.1353/cja.2006.0020
18. Henry J.D. et al. Clinical assessment of social cognitive function in neurological disorders. Nat Rev Neurol, 2016, vol. 12, no. 1, pp. 28–39. doi:10.1038/nrneurol.2015.229
19. Cocks N., Morgan G. Iconic gesture and speech integration in younger and older adults. Gesture, 2011, vol. 11, no. 1, pp. 24–39. doi:10.1075/gest.11.1.02coc
20. Cuerva A.G., Sabe L. Theory of mind and pragmatic abilities in dementia. Neuropsychiatry Neuropsychol Behav Neurol, 2001, vol. 14, no. 3, pp. 153–158.
21. Cummings L. Pragmatic Disorders. Perspectives in Pragmatics, Philosophy & Psychology. NY: Springer Science, 2014, pp. 31–65. doi:10.1007/978-94-007-7954-9_2
22. van Niekerk M.E. et al. Diagnosing autism spectrum disorders in elderly people. Int Psychogeriatr, 2011, vol. 23, no. 5, pp. 700–710. doi:10.1017/S1041610210002152
23. Winner E. et al. Distinguishing lies from jokes: theory of mind deficits and discourse interpretation in right hemisphere brain-damaged patients. Brain and Language, 1998, vol. 62, no. 1, pp. 89–106. doi:10.1006/brln.1997.1889
24.  D. Sidtis et al. Effects of neurological damage on production of formulaic language. Clinical Linguistics and Phonetics, 2009, vol. 23, no. 4, pp. 270–284. doi:10.1080/02699200802673242
25. Shiroma P. et al. Facial recognition of happiness among older adults with active and remitted major depression. Psychiatry Research, 2016, vol. 243, pp. 287–291. doi:10.1016/j.psychres.2016.06.020
26. Gutiérrez-Rexach J., Schatz S. Cognitive impairment and pragmatics. SpringerPlus, 2016, vol. 127, no. 5, pp. 1–5. doi:10.1186/s40064-016-1759-7
27. Hess T.M. Adaptive aspects of social cognitive functioning in adulthood: Age-related goal and knowledge influences. Social Cognition, 2006, vol. 24, no. 3, pp. 279–309. doi:10.1521/soco.2006.24.3.279
28. Mascarenhas O.A. et al. Hypothesized predictors of patient-physician trust and distrust in the elderly: implications for health and disease management [Elektronnyi resurs]. Clin Interv Aging, 2006, vol. 1, no. 2, pp. 175–188. Available at: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.358.5584&rep=rep1&type=pdf (Accessed 18.10.2017).
29. Ostberg P. et al. Impaired verb fluency: a sign of mild cognitive impairment. Brain Lang, 2005, vol. 95, no. 2, pp. 273–279. doi:10.1016/j.bandl.2005.01.010
30. Kemp J., Despres O. Theory of Mind in normal ageing and neurodegenerative pathologies. Ageing Res Rev, 2012, vol. 11, no. 2, pp. 199–219. doi:10.1016/j.arr.2011.12.001
31. Lim К.T. Aging and wisdom: age-related changes in economic and social decision making. Front Aging Neurosci, 2015, no. 7, art. 120. doi:10.3389/fnagi.2015.00120
32. Mecacci L. Cognitive failures, metacognitive beliefs and aging. Personality and Individual Differences, 2006, vol. 40, no. 7, pp. 1453–1459. doi:10.1016/j.paid.2005.11.022
33. Messer R.H. Pragmatic Language Changes During Normal Aging: Implications for Health Care. Healthy Aging & Clinical Care in the Elderly, 2015, no. 7, pp. 1–7. doi:10.4137/HACCE.S22981
34. Njomboro P. Social Cognition Deficits: Current Position and Future Directions for Neuropsychological Interventions in Cerebrovascular Disease [Elektronnyi resurs]. Behavioural Neurology, 2017, vol. 2017, art. 2627487, 11 p. Available at: https://www.hindawi.com/journals/bn/2017/2627487/abs/ (Accessed 10.10.2017).
35. Orange J.B. Language and Communication Disorders in Older Adults: Selected Considerations for Clinical Audiology [Elektronnyi resurs]. Hearing Care for Adults, 2009. pp. 87–102. Available at: https://www.phonakpro.com/content/dam/phonakpro/gc_hq/en/events/2009/adult_conference_chicago/17_P69344_Pho_Kapitel_8_S87_102.pdf (Accessed 10.10.17).
36. Phillips L.H., Allen R. Older adults have difficulty in decoding sarcasm. Dev Psychol, 2015, vol. 51, no. 12, pp. 1840–1852. doi:10.1037/dev0000063
37. Cummings L. (ed.). Pragmatic Disorders. NY: Springer, 2014. 263 p. doi:10.1007/978-94-007-7954-9
38. Holtgraves T. et al. Pragmatic language production deficits in Parkinson’s disease. Advances in Parkinson's Disease, 2013, vol. 2, no. 1, pp. 31–36. doi:10.4236/apd.2013.21006
39. Uekermann J. et al. Proverb interpretation changes in aging. Brain Cogn, 2008, vol. 67, no. 1, pp. 51–57. doi:10.1016/j.bandc.2007.11.003
40. Prutting C.A., Kirchner D.M. A clinical appraisal of the pragmatic aspects of language. Journal of Speech and Hearing Disorders, 1987, vol. 52, no. 2, pp. 105–119. doi:10.1044/jshd.5202.105
41. Research in Clinical Pragmatics. In L. Cummings (ed.). NY: Springer, 2017. 617 p. doi:10.1007/978-3-319-47489-2
42. Senecka A. Social Barriers to Effective Communication in Old Age. Journal of Education Culture and Society, 2014, no. 2, pp. 144–153. doi:10.15503/jecs20142.144.153
43. Slessor G., Phillips L.H. Age-related declines in basic social perception: evidence from tasks assessing eye-gaze processing. Psychol Aging, 2008, vol. 23, no. 4, pp. 812–822. doi:10.1037/a0014348
44. Sobhani-Rad D. A review on adult pragmatic assessments. Iranian journal of neurology, 2014, vol. 13, no. 3, pp. 113–118.
45. Sobhani-Rad D. The assessment of pragmatics in Iranian patients with right brain damage. Iranian journal of neurology, 2014, vol. 13, no. 2, pp. 83–87.
46. Natelson Love M. et al. Social Cognition in Older Adults: A Review of Neuropsychology, Neurobiology, and Functional Connectivity. Medical & Clinical Reviews, 2015, vol. 1, no. 6, pp. 1–8. doi:10.21767/2471-299X.1000006
47. Moran J.M. et al. Social-cognitive deficits in normal aging. Journal of neuroscience, 2012, vol. 32, no. 16, pp. 5553–5561. doi:10.1523/JNEUROSCI.5511-11.2012
48. Gaudreau G. et al. Verbal irony comprehension in older adults with amnestic mild cognitive impairment. Neuropsychology, 2013, vol. 27, no. 6, pp. 702–712. doi:10.1037/a0034655
49. Weed E. What’s left to learn about right hemisphere damage and pragmatic impairment? Aphasiology, 2011, vol. 25, no. 8, pp. 872–889. doi:10.1080/02687038.2010.545423
50. Zhang X. Perspective Taking in Older Age Revisited: A Motivational Perspective. Developmental Psychology, 2012, vol. 49, no. 10, pp. 1848–1858 doi:10.1037/a0031211