Individuals with mild cognitive impairment (MCI) and their caregivers face complex probabilistic information in a medical counselling session when seeking diagnostic work-up for early detection of Alzheimer's disease (AD). With this contribution, we aim to outline affordances and challenges of "counselling for dementia risk prediction", a specific form of helping interaction. We will shed light on the subject from both a medical and a linguistic perspective by providing insights into preparatory measures and counselling tools, parts of typical doctor-patient-interactions, and interviews with counselled individuals.
When counselling about biomarker-based AD detection, clinicians need to consider various medical and non-medical parameters in order to enable an informed decision-making: e.g., the individual's previous knowledge on the topics dementia, Alzheimer's, and risk prediction; the magnitude of cognitive impairment of the MCI-patients as well as the numeracy skills and the understanding of risk/probability of the counselled individuals (Rostamzadeh & Jessen 2020; Rostamzadeh & Schwegler et al. 2021).
From a linguistic perspective, these counselling sessions show a high susceptibility for talk at cross purposes (Imo 2013), since clinicians target a discourse on educational information in order to lead to a decision for or against risk prediction. On the other hand, patients and caregivers often expect concrete instructions for future actions, information on curing remedies, and therapy planning (Schwegler 2021). Furthermore, subjective theories (Birkner 2006) about the cognitive impairment and coping strategies to normalise the situation affect the interaction. Previous knowledge, preconceptions, assumptions, and information from other credible authorities from the patient's life – which are mentioned in subsequent interview sessions during our interdisciplinary study – encounter biomedically and statistically informed concepts of risk, disease, and symptoms. We aim at contributing in an interdisciplinary way to identify and elaborate how to manage these challenges and affordances in helping interactions.
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Imo, W. (2013) „Aneinander vorbei reden" – Wenn kommunikative Projekte scheitern. In: Deutsche Sprache 2013 (1), 52–71.
Rostamzadeh, A. & Jessen, F. (2020) Früherkennung der Alzheimer-Krankheit und Demenzprädiktion bei Patienten mit leichter kognitiver Störung: Zusammenfassung aktueller Empfehlungen. In: Der Nervenarzt 91 (9), 832–842.
Rostamzadeh, A. & Schwegler, C. et al. (2021) Biomarker-Based Risk Prediction of Alzheimer's Dementia in MCI: Psychosocial, Ethical and Legal Aspects – The PreDADQoL Project. In: Journal of Alzheimer's Disease 80 (2), 601–617.
Schwegler, C. (2021) Prädiktive Medizin als Gegenstand linguistischer Untersuchungen. In: Iakushevich, M. et al. (Hrsg.) Linguistik und Medizin. Berlin/Boston: De Gruyter. 359–377.
