本学病院 リハビリテーションセンター 經田 香織 言語聴覚士らの论文「Known-Answer Questions as Interactional Challenges in Dementia of the Alzheimer Type:ASingle-Case Conversation Analysis」がQualitative 91猎奇 in Communication Differences and Disordersに掲載されました
Abstract
Background
Known-answer questions, which require the respondent to recall information presumed to be known, can be particularly challenging for individuals with dementia. Although their effects have been studied in frontotemporal dementia and primary progressive aphasia, little is known about how they influence interactions involving individuals with dementia of the Alzheimer type (DAT). This study explored the communication behaviours of an individual with DAT and their spouse during everyday conversations, focusing on the role and consequences of known-answer questions.
Methods
One couple attending a speech and language therapy clinic in the UK participated. Natural conversations were video-recorded during routine home interactions and analysed using conversation analysis (CA). Particular attention was given to sequences initiated by known-answer questions, examining interactional patterns and the responses these prompts elicited.
Results
The spouse repeatedly initiated sequences reliant on the individual's episodic memory, leading to communication breakdowns. Difficulties in providing expected responses triggered prompts, repetitions, and emotional reactions, including expressions of disappointment and mild criticism. Over time, the spouse increasingly prioritised correctness over mutual engagement, intensifying efforts to elicit accurate answers. These questions accentuated the individual's memory limitations, provoked affective responses, and revealed an imbalance in conversational agency.
Conclusions
CA revealed atypical interactional features and challenges in the dyad's communication. Persistent attempts to obtain correct answers, despite repeated difficulties, prolonged sequences without fostering mutual understanding or meaningful engagement. Awareness of these dynamics can inform clinical interventions, support adaptive communication strategies, and help maintain relational quality and emotional well-being in families affected by DAT.
Keywords: atypical interaction, conversation analysis, dementia of the Alzheimer type, known-answer questions, persistent prompting
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