Enhancing Pragmatic Communication in Healthy Aging: A Preliminary Investigation of the Long-Term Effects of the Advanced Cognitive Pragmatic Treatment

Abstract

The aging process is associated with changes in cognitive and communicative skills, including pragmatic one, the ability to appropriately use language and other expressive means in social contexts. Despite its importance for quality of life and autonomy, the decline of pragmatic ability has received little attention in aging research and intervention. This preliminary study aims to investigate the efficacy and specificity of the Advanced Cognitive Pragmatic Treatment (Advanced-CPT), a novel training program designed to improve pragmatic performance in healthy older adults by targeting different expressive modalities, i.e., linguistic, extralinguistic, and paralinguistic, in addition to sensitivity to context. Twenty-four healthy participants aged 65–86 years completed the nine-week group training. Participants were assessed immediately before and after the training, and at a three-month follow-up. Cognitive functions, i.e., attention, memory, processing speed, executive functions and Theory of Mind (ToM) were also evaluated pre- and post-training. Participants showed a significant improvement in overall pragmatic performance from pre- to post-training, which was maintained at follow-up. Significant improvements were noted in both pragmatic comprehension and production, and in both linguistic and extralinguistic expressive means. A trend towards enhancement was also observed in paralinguistic ability, although the changes did not reach statistical significance, while no significant change emerged in sensitivity to the context. As expected, cognitive and ToM measures remained stable. The findings provide preliminary support for the potential of the Advanced-CPT to improve pragmatic ability in healthy aging, with gains that remained detectable at follow-up. Cognitive and ToM measures did not show comparable pre-post changes, suggesting that the main improvements observed in the present study were confined to the pragmatic domain.