Posted Thu, Mar, 19,2015
This author interview is by Dr Rachel Messer, of Oklahoma State University. Dr Messer's full paper, Pragmatic language changes during normal aging: Implications for health care and quality of life, is available for download in Healthy Aging & Clinical Care in the Elderly.
Please summarise for readers the content of your article.
The article discusses some proposed mechanisms behind language changes in non-pathologically aging adults, and how these changes in older patients may affect communication with health care providers. The main area of language change during aging that is discussed in the article is pragmatic language, which is the social use of language. Pragmatic language skills include verbal (e.g., appropriate turn-taking in conversation), nonverbal (e.g., proper eye contact), and paralinguistic (e.g., appropriate syllable stress and intonation) aspects. Pragmatic language skills also include the ability to use and comprehend figurative language, such as metaphor, humour, and sarcasm.
Language functions tend to be largely lateralized to the left cerebral hemisphere, including analytical processing of words in sentences and planning and production of speech sounds. However, some language functions have shown to be more centralized in the right cerebral hemisphere, such as synthesis of verbal and nonverbal information and the aspects of pragmatic language described above. The two hemispheres are joined by the corpus callosum, which enables transmission of linguistic and other information between the two hemispheres.
As the brain ages, many adults report changes to their memory, visual and auditory senses, and other cognitive areas. Pragmatic language skills have been shown to decline during aging as well, with declines in the ability to comprehend emotional speech and facial expression, difficulty monitoring turn-taking during conversation, increased difficulty comprehending figurative language, and decreased use and comprehension of gestures during conversation. As older adults tend to have higher incidences of injury and illness than younger adults, their relationships with health care providers are more frequent and are important to health maintenance and medical plan adherence. Aspects of pragmatic language decline affect social interaction, and may be particularly detrimental to health if they occur at high frequency in the context of communication with health care providers. As the number of older adults in the population continues to increase in the next few decades, health care providers, older adults, and their families should be made aware of how pragmatic language decline can affect health care and social interaction overall.
How did you come to be involved in your area of study?
My area of training is in Developmental Psychology, with an emphasis in cognitive psychology and psycholinguistics, and I have maintained a consistent interest in pragmatic language since my early graduate career. I became interested in the relationship between pragmatic language and health after experiencing health care scenarios with older family members in which they experienced high levels of frustration and misunderstanding with health care providers. I began to think about the factors that go into language and social interaction in the patient-provider relationship and became more interested in determining how those factors can affect health. I am currently collecting data regarding the relationship between older adults' pragmatic language skills and their physical and mental health.
What was previously known about the topic of your article?
Definition of pragmatic language skills has been established for several decades. Pragmatic language declines during aging have been well-researched, along with specific disorders in which pragmatic language deficits commonly occur (e.g., autism). A small number of articles have investigated how pragmatic language declines during aging can translate into pragmatic issues in health care settings.
How has your work in this area advanced understanding of the topic?
My work has brought to light a more direct relationship that may be occurring between older patients' pragmatic language decline and their social communication with health care providers. I have also introduced some ideas for future interventions for older adults, their families, and health care providers so that some direct measures may be taken to avoid disruption in transmission of health information.
What do you regard as being the most important aspect of the results reported in the article?
The table presented at the end of the article should act as a short example guide for providers. Some tips on what to avoid linguistically and socially when working with older adults who may be experiencing pragmatic language decline may be a valuable first step to future interventions and training for providers.
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