Using conversation analysis to improve dementia diagnosis

Dr Daniel Blackburn at the memory clinic at the Royal Hallamshire HospitalAdapted from Sheffield Teaching Hospitals NHS Foundation Trust news article

Researchers at Sheffield Teaching Hospitals NHS Foundation Trust and the University of Sheffield, in collaboration with a team at Loughborough University, are using ‘conversation analysis’ to distinguish between patients who may be in the early stages of dementia or patients who have memory concerns but no evidence of dementia.

Conversation Analysis involves close examination of audio or video recordings of talk between patients, carers and doctors. The research team looked for subtle differences in the use of language which can be tell-tale signs of early dementia. The analysis focused especially on the opening conversation between the neurologist and the patient, and any family or friends who accompanied them. The close examination of the recordings revealed that there are two distinct conversational profiles for patients with dementia and those with memory concerns unrelated to dementia.

These profiles are based on such features as who is most concerned about their memory (patient or family), patients’ ability to respond to complex questions (i.e. two questions in one), how much they elaborate their answers, repetitiveness and hesitancy in answering, and the frequency with which they respond that they ‘don’t know’. These features, for instance, the patient’s ability to answer complex questions fully by answering all parts of the question, can show the doctor whether the patient’s memory system is working well or not.

The research could help doctors distinguish between people with early stage dementia and those with memory concerns related to mood or anxiety-related problems.

Findings highlight that the many patients referred by GPs to specialist memory clinics do not actually suffer from dementia, meaning those who don’t can get preventative support sooner.

The findings of the study could be used by GPs and other primary care health professionals in the community better to identify those patients who should be referred to memory clinics for the early treatment of dementia and those who can be reassure that their memory concerns do not mean that they are developing dementia.

The research team innovating the use of conversation analysis in the memory clinic in Sheffield includes Professor Annalena Venneri, Professor of Neuropsychology and Dr Daniel Blackburn and Dr Harkness, who specialise in the treatment of memory disorders.