Joëlle Berrewaerts

Pragmatic skills in the early stages of Alzheimer's disease: an analysis by means of a referential communication task

BACKGROUND Disordered discourse in cases of senile dementia of Alzheimers type (DAT) has mainly been described in conversation and picture description tasks. The referential communication task provides researchers and clinicians with new insights on the nature of these disorders. AIMS To study to what extent persons suffering from DAT can benefit from shared experience through trial repetition to achieve common reference. METHODS & PROCEDURES Thirteen persons suffering from DAT at minimal or mild stage (MMSE score range = 18-27) were compared with 13 healthy elderly adults (64-86 years) in neuropsychological assessment of executive functions and in a referential communication paradigm. To study how the two partners achieve mutual understanding by progressively elaborating a common ground, the task was repeated three times. OUTCOMES & RESULTS Persons with DAT produced a larger number of words than control participants and they benefited from the task repetition. However, they were less able to take into account previously shared information, used no definite referential expressions and were more idiosyncratic in their descriptions of the referent. This decline of communicative effectiveness was found not to relate closely to executive deficits. CONCLUSIONS Collaborative exchanges allow healthy elderly persons to ground reference in common experience. This process is severely disturbed in persons with DAT, in relation to poor memory of preceding episodes or to other cognitive impairments.

Patient Participation and the Use of Ehealth Tools for Pharmacoviligance

In recent years, pharmacovigilance has undergone some major changes. First, the patient’s active role in identifying and describing adverse drug reactions (ADRs) has gained recognition. Second, pharmacovigilance has increasingly incorporated information and communications technology (ICT). Patients can now upload their own reports of ADRs online. Data on intensive medication monitoring are now collected via the Internet and smartphones. Worldwide collection of AEs using smart phones might become the leading technique in Low and Middle Income Countries where broad mobile phone service can be managed cheaper than Internet communication. At the same time, researchers are exploring the potential for data sharing via online forums and Internet search engines. In particular we synthetize the Pros and cons of the various methods for gathering pharmacovigilance data (i.e., Web-based spontaneous reporting of adverse drug reactions; Intensive drug monitoring studies; Analysis of online forum postings; Use of mobile phone systems to monitor drug effects). This article describes these advances and highlights their respective contributions.