Conversational coherence: discourse analysis of older adults with and without dementia Katinka Dijkstra a, * , Michelle S. Bourgeois b , Rebecca S. Allen c , Louis D. Burgio c a Department of Psychology, Florida State University, Tallahassee, FL 32306-1270, USA b Department of Communication Disorders, Florida State University, Tallahassee, FL 32306-1200, USA c Center for Mental Health and Aging, The University of Alabama, Tuscaloosa, AL 35487-0315, USA Received 6 February 2003; received in revised form 28 May 2003; accepted 15 June 2003 Abstract The purpose of this study was to compare the discourse profiles of 30 nursing home residents with dementia and of 30 healthy older adults. A total of 60 transcripts of interview style conversations were analyzed using a discourse analysis schema. The results revealed a higher frequency of discourse building features, such as coherence and cohesion, for healthy adults compared to adults with dementia. Conversely, discourse-impairing features, such as disruptive topic shifts and empty phrases, were found more often in conversations of adults with dementia compared to healthy adults. Conversational partners deviated from their conversation protocol when talking to adults with dementia by including facilitative strategies in the conversation. Discourse features in interview style conversations in adults with dementia reflect declines in their memory. q 2003 Elsevier Ltd. All rights reserved. Keywords: Discourse; Dementia; Conversation; Coherence; Nursing home; Memory Much research has explored discourse impairments in persons with dementia. Most persons with dementia have limited vocabulary, frequent word finding problems (Kempler, 1991), and breakdowns in topic maintenance and coherence (Bayles, 1985) in contrast to healthy adults whose discourse is relatively intact. The occurrence of these deficits depends on the type of dementia, as well as the course and stage of the disease, with a relative absence of certain discourse deficits, such as empty phrases, in the early stages of Alzheimer’s disease (Dijkstra, Bourgeois, Petrie, Burgio, & Allen-Burge, 2002). 0911-6044/$ - see front matter q 2003 Elsevier Ltd. All rights reserved. doi:10.1016/S0911-6044(03)00048-4 Journal of Neurolinguistics 17 (2004) 263–283 www.elsevier.com/locate/jneuroling * Corresponding author. E-mail address: dijkstra@psy.fsu.edu (K. Dijkstra).