Profiling conversation in Parkinson's disease with cognitive impairment

The impact of cognitive impairment on the interaction between people with Parkinson's disease (PD) and their carers was examined. A conversation analytic approach was taken to profile the nature of the communication difficulties of 12 people with PD with cognitive impairment in addition to the articulatory and prosodic disturbances typically associated with PD. Using a methodology that combined carer reports and analysis of conversational data, the complex relationship between impaired communicative behaviour, carers' perceptions and the influence of changes from premorbid conversational styles and contexts was examined. The interactional consequences of altered communication behaviour were explored by analysing the types of strategies that were spontaneously used by carers when difficulties arose in conversation. The study further compared the conversational profiles of people with PD diagnosed with two putatively different pathologies in an attempt to determine whether analysis of interaction could discriminate between (i) people with PD who developed dementia with Lewy bodies (DLB) and (ii) those whose cognitive impairment was attributed to subcortical pathology. This analysis sought to inform a wider debate as to whether particular interactional changes may be indicative of certain underlying cognitive deficits. The implications of analysing conversational interaction for working with this population are discussed.