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Conversational assessment in memory clinic encounters: interactional profiling for differentiating dementia from functional memory disorders

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journal contribution
posted on 27.03.2015 by Danielle Jones, Paul Drew, Christopher Elsey, Daniel Blackburn, Sarah Wakefield, Kirsty Harkness, Markus Reuber
Objectives: In the UK dementia is under-diagnosed, there is limited access to specialist memory clinics, and many of the patients referred to such clinics are ultimately found to have functional (non-progressive) memory disorders (FMD), rather than a neurodegenerative disorder. Government initiatives on ‘timely diagnosis’ aim to improve the rate and quality of diagnosis for those with dementia. This study seeks to improve the screening and diagnostic process by analysing communication between clinicians and patients during initial specialist clinic visits. Establishing differential conversational profiles could help the timely differential diagnosis of memory complaints. Method: This study is based on video- and audio recordings of 25 initial consultations between neurologists and patients referred to a UK memory clinic. Conversation analysis was used to explore recurrent communicative practices associated with each diagnostic group. Results: Two discrete conversational profiles began to emerge, to help differentiate between patients with dementia and functional memory complaints, based on (1) whether the patient is able to answer questions about personal information; (2) whether they can display working memory in interaction; (3) whether they are able to respond to compound questions; (4) the time taken to respond to questions; and (5) the level of detail they offer when providing an account of their memory failure experiences. Conclusion: The distinctive conversational profiles observed in patients with functional memory complaints on the one hand and neurodegenerative memory conditions on the other suggest that conversational profiling can support the differential diagnosis of functional and neurodegenerative memory disorders.

Funding

This article presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme [grant number PB-PG-0211-24079].

History

School

  • Social Sciences

Department

  • Communication, Media, Social and Policy Studies

Published in

Aging & Mental Illness

Citation

JONES, D. ... et al, 2016. Conversational assessment in memory clinic encounters: interactional profiling for differentiating dementia from functional memory disorders. Aging and Mental Health, 20(5), pp.500-509.

Publisher

© Taylor and Francis

Version

AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Publication date

2016

Notes

This is an Accepted Manuscript of an article published in Aging and Mental Health on 24 Mar 2015, available online: http://www.tandfonline.com/10.1080/13607863.2015.1021753

ISSN

1360-7863

Language

en

Exports