Seek, and you will find? Word finding in multilingual dementia

Purpose: Among the first linguistic symptoms of several types of dementia are word-finding problems. Multilinguals with dementia may have stronger difficulties, as multilinguals are found to retrieve words more slowly than monolinguals, possibly due to larger vocabularies and the additional cognitive load of suppressing non-target languages. A deeper insight into the factors that influence word retrieval and trigger word-search sequences in multilingual dementia may inform linguistic theory, improve dementia assessment and help caregivers in overcoming communicative challenges. Approach: In this study, we combine a usage-based and a conversation analytic approach to language and communication to explore lexical aspects of word-finding problems in multilingual speakers with dementia. Data: The participants are seven multilingual persons with dementia with different first languages, but English and Norwegian in common. They completed a picture-based naming task with nouns and verbs, took part in a semi-structured interview on their language background and went through a cognitive assessment. Naming performance was scored, and conversation analysis was further used to assess the presence of word search sequences. Findings: With one exception, the participants scored highest in their self-identified strongest language. Despite long exposure to Norwegian, all seven scored higher in English. Word-search sequences were evenly distributed between these two languages, but notably more successful in English. Higher scores and fewer searches were observed for nouns than for verbs, and for words with high imageability and low age of acquisition. High frequency and cognateness were associated with higher scores. Implications: Theoretically, combining frameworks was a prerequisite for investigating word searching and word finding in union, and the approach allowed for a nuanced understanding of the mental and interactional accomplishment of lexical retrieval as gradual and situated rather than binary. Originality: The paper proposes a psycho-conversational model of word retrieval as a gradient.