Epistemic Responsibility - Labored, Loosened, and Lost: Staging Alzheimer's Disease.

ABSTRACT

Interlocutors hold one another accountable for knowing certain information about themselves (their roles, activities, and memories) and for keeping track of information in the current conversational exchange. When speakers have trouble with this expectation, they themselves work to repair the breach, often doing a memory search, or when unsuccessful they provide an account (e.g. "I don't remember"). Memory searches (like word searches) are observable, interactional accomplishments. Speakers disengage with their interlocutors (look away), produce hesitation markers, take repeated pauses, engage in pre-positioned and post-positioned repairs, make epistemic assessments, and on finding an answer, re-engage with their interlocutors (look back). For their part, interlocutors comply with the search by not interrupting and continuing to yield the floor. At progressively severe stages of Alzheimer's disease, individuals exhibit increasingly labored memory searches that often trail off into non-answers, until at the latest stages, they eschew the search and (almost smoothly) provide either grammatically appropriate but wrong and improbable answers or give answers to previous questions on now closed topics. With data from the clinical administration of a disease staging instrument (Clinical Dementia Rating) this article examines the inexorable loss of epistemic responsibility as a key discursive dynamic in the progression of the disease.