Imagine yourself adrift in a disordered realm of time and space. It's a place where the ability to recognize your loved ones and everyday objects eludes you, they have lost their inherent associations and names. Every spatial anchor has lost its purpose, leaving you unable to know your position or direction. Time, too, loses its sense of continuity as experiences from the past and present jumble together in your consciousness. You are a solitary being on a secluded island, ensnared amidst the vast turmoil of your inner universe, obstructing your connection with the world beyond.
Every spatial anchor
has lost its purpose, leaving
you unable to know your
position or direction.
Sounds helpless, doesn't it? But that is the stark reality for people with severe Alzheimer's disease (AD).
The loss of neurons and synapses within the cerebral cortex and specific subcortical areas impairs their learning, memory, and cognition. From mild flickers of attention loss to profound memory defcits, every facet of life becomes entangled in the labyrinth of forgetfulness. This is a painful experience not only for the sufferers themselves but also for their loved ones. Initially, my grandma's mind radiated with clarity, but it deteriorated after we became busy and didn't speak to her frequently. Maya Zheng, a family member of an Alzheimer's patient, said, Within only two years, she became trapped in an endless loop, revisiting the same topics and occasionally erupting into nocturnal cries. At times, I even found myself evading moments of companionship with her.
Gaining lines, losing ties
AD and the widening chasm between generations has pushed innumerable older adults to the fringes of their existence. Many older adults affected by cognitive impairments experience unfulfilled social needs, leading to the emergence of psychotic and affective symptoms. This, in turn, plunges them into isolation, anxiety, and other distressing emotions, signifcantly impacting their mental wellbeing and quality of life, remarked Congchen Dai, a PhD student at Tongji University.
Language is a vital tool for
fostering communication
within social interactions.
Language is a vital tool for fostering communication within social interactions. For older adults, the aging process often results in declining hearing abilities, such as hearing loss and auditory lapses, leading to challenges in language recognition. Similarly, when attempting to convey information, the aging of articulatory organs (such as the tongue and lips) contributes to dysarthria (diffculty speaking due to muscle weakness) and reduced articulation loudness, which impedes comprehension. The loss of language proficiency can become a self-perpetuating cycle, as it discourages those around them from engaging in meaningful communication, gradually eroding their ability to express themselves.
Another problem is the care givers' subconscious tendency to avoid conversations and a lack of concern for the mental health of older adults. Research indicates that conversations in the daily care of older adults often gravitate toward silence or remain confned to task-oriented activities such as assisting with meals or dressing. There exists an imbalance of power in communications between older adults and caregivers, explained Professor Lihe Huang from the Research Center for Ageing, Language, and Care at Tongji University. Caregivers may unintentionally employ threatening language or adopt 'elderspeak,' 'patronizing talk' in conversations. Overtly criticizing, demeaning or hastily interrupting older persons also occurs frequently. Together, these result in older adults’ decreased desire for communication, hindering them from establishing connections with others.
I sometimes think that if I had talked to her more before, it could have slowed down the decline of her cognitive abilities, or at least not as fast as they did in reality, reflected Zheng.
Seeking Memories, Crafting Moments
While scientifc and clinical research focuses on molecular characteristics of the disease, such as beta-amyloid proteins, alpha-tubulin, and glial cells to unravel the causes of Alzheimer's disease, social scientists take different approaches. Linguistic researchers are trying to find the language markers of AD that might serve as an external refection of cognition.
Over the past five years, the Memory Seeker (Shi Yi) team in Shanghai has diligently accumulated a dataset concerning language and cognition in the older adult population. Drawing data from diverse sources – including neurology departments within hospitals, senior communities, and nursing homes – they have created a robust aggregation of data for gerontolinguistics. Their objective is to utilize language as a catalyst to improve the overall cognition of older adults.
Linguistic researchers are
trying to find the language
'markers' of AD that might
serve as an external
reflection of cognition.
Notably, their focus extends beyond verbal communication to multimodal interactions, such as gestures, body language, and facial expressions. As neurodegeneration impacts verbal abilities, nonverbal expressions may remain relatively intact. These multimodal behaviors enable individuals to convey their thoughts and feelings. For instance, cognitively impaired older adults may employ hand gestures as substitutes for specific directions instead of verbal expressions. Nonverbal cues can offer additional information, such as saying yes, while frowning can convey inconsistent meanings. By acknowledging these subtle cues and grasping both literal and implied meanings, we can truly comprehend the communicative intent of older individuals.
Our current study focuses on interventions in functional communication by recording taskbased interactions between volunteers and the elderly. Furthermore, we hope to amass a large body of work that covers the full range of scenarios in the elderly population’s daily life. Joining the Memory Seeker team this year, Dai shares a common aspiration with her fellow members—to establish connections with older people by immersing themselves in their lives and harmonizing through shared experiences. As Dai states, If we ‘flap the wings’ at the forefront of research, the potential for signifcant changes is boundless. By combining academic fndings and personal connections with older adults, we seek to truly comprehend and help them.
Every communication occurs only in the present, where each word, gesture, and expression holds transient significance, akin to nodes in a network. As we try to uncover the interconnections, an intangible network begins to unfold, serving as a conduit that binds together emotions, meanings, and understanding. For older adults, every moment of attentive listening and heartfelt communication becomes a treasured opportunity to reclaim temporarily lost memories and cultivate shared experiences for the future. This intricate and delicate network intertwines our present moments, forging a resilient bond between us and older adults, where time and memory converge in the here and now.