1. Discourse Production of Alzheimer’s disease patients: Sociolinguistic and cultural preservation Renné P. Alegria ¹,², Cássio M. C. Bottino², Maria Inês Nogueira ¹, ¹Neuroscience and Behavior. Institute of Psychology of the University of Sao Paulo, ²PROTER- Old Age Program, Institute of Psychiatry of the School of Medicine of the University of São Paulo 1

2. Conflict of Interest Disclosure Renné Alegria (PhD) Has no real or apparent conflicts of interest to report 2

3. Introduction -Language comprehension between Alzheimer’s patients and their caregivers has to be efficient in order to have better understanding. -It is very important to research the lexical items that are more preserved in the discourse of the patients. - Few studies of language comprehension of Alzheimer’s disease patients have stressed the importance to manage adequate communication with sociolinguistic, cultural and ideological lexicon in the oral interaction. 3

4. -For this study, we used Stablex - a program for lexical textual and discursive analysis for the patients and controls productions. -Therefore, it is necessary to research the sociolinguistic, ideological cultural underpinnings to avoid more stressful situations with patients and caregivers. 4

5. Objective To verify if Alzheimer’s disease patients have preserved lexical items with historical, ideological and cultural meanings in order to create a guide of oral communication between patients and caregivers. 5

6. Methods Participants - Eight Alzheimer’s disease patients from PROTER- Old Age program – Ambulatory Care, Institute of Psychiatry, Hospital das Clinicas, School of Medicine of the University of Sao Paulo. - Patients were four male and four female aged 80 to 86 - Six healthy elderly controls aged 75 to 86, - Three male and three female, their relatives or caregivers of the patients. -All native Portuguese speakers 6

7. - Patients and controls had 4 to 11 years of education -MMSE- Mini-Mental State Exams 13 to 30. -All patients had clinical exams, neuroimages, CAMGOG- Cambridge Cognitive Test, NPI- Neuropsychiatry Inventory and several neuropsychological tests. - Besides MMSE, the controls answered to the SRQ-20 Self Reporting questionnarie. 7

8. PatientsControlsStatistical tests and p values Age7 =80 1= 86 1=75 2=78 2= 79 1= 86 Mann-Whitney = 0,002 p = 0,022 SexM = 4 F = 4 M= 3 F = 3 Χ² (1) =0 P =1 Education1 basic 3 2 high school 5 3333 Χ² (1) = 0,2187 P =1 Work activityYes No 5151 X² (1) =1,6593 P = 0,2854 MMSE1=13 1=17 1=18 2=19 1=23 1=24 1= 25 1=27 1=28 1=29 3=30 Mann-Whitney = 0,002 P= 0,002 Table 1. Demographic and clinical data 8

9. Material - STABLEX- method of lexical, textual and discursive analysis, developed by André Camlong from the University of Toulouse, Le Mirail- France. -The method permits the construction of lexicon, tables, graphics and specific vocabularies. -It is based on mathematical-statistical-computer assisted program. - Stablex mainly distinguishes and separate the results of preferential, basic and differential vocabularies. 9

10. Procedure We talked with all the patients and controls during 15 minutes, free conversation with the themes: Education, familiy, health, food and religion. They were after transcribed and thereafter analysed by Stablex. Data analysis The results of the frecuencies of the preferential, basic and differential vocabularies of the patients and controls correlated by Chi- square. Demographic data of sex, profession and education were also analyzed and did not significat values. 10

11. Results There was a significant statistical correlation with the preferential words used by the patients. The patients expressed more preferential words because they have more lexical items preserved with historical, ideological, cultural and sociolinguistic items. 11

12. FrecuencyPreferentialBasicDifferentialtotal Patient 7381047281813 Control 4261673352134 Total 11642720633947 % PreferentialBasicDifferentialtotal Patient 40,706057,7461,5444100 Control 19,962578,39741,6401100 Table 2 Comparison of vocabularies of patients and controls 12

13. FrecuencyPreferentialBasicDifferentialtotal Patient5351294291813 Control629,331470,60552334,0622134 Total77,32732,786701880,0304110,144 65,69527,854869030,025893,57597 203,72 Table 3 Specific Values 13

14. Chi-square114,3052 P0,0004998 14

15. WordOcT1Value(z) family20174,606 Everythin’48314,183 truth11103,825 God 37243,708 other773,553 daughter154763,545 sons 61353,540 much59343,522 field663,290 coffee663,290 money873,061 time15113,046 WordOcT2Value(z) Catarina445,484 Mine445,484 saint445,484 pray655,448 is21105,108 husband334,749 daughter334,749 son334,749 Mark334,749 river334,749 south334,749 cold27104,083 Germany223,877 there223,877 Table 4. Preferential lexicon of patients T1 and T2 15

16. WordsOcT1Value(z) no41304,907 much45314,544 know19164,341 go1093,530 son30203,457 is983,280 all663,244 that105533,017 other552,961 you552,961 true552,961 she27172,879 fdaughter442,648 city442,648 WordOcT3Value (z) tmother1186,111 Barretos555,978 two555,978 years27135,681 with34155,659 sons1075,564 number334,631 father334,631 Pirassununga334,631 fiofteen544,615 came1064,600 Paulo1374,568 five223,781 Table 5. Preferential lexicon of controlsT1 and T3 16

17. Conclusions/ Discussion -This study suggests that the word choice done by the people is not by guessing or randomized, It just does not show the character of the basic idea how the discurse is formed, but it also shows the used resources that are capable of determine the ideological, historical and cultural characteristics. - The study also showed that besides Alzheimer’s disease patients have progressive lexical lose, their preferential lexicon is still preserved and the oral communication with caregivers and relatives may be possible and rehabilitated until they reach a severe stage. 17

18. 18 Thank you very much Renné : realegrias@usp.br realegrias@usp.br