Pragmatic competence includes the capacity to express illocutionary force and successfully achieve perlocutionary effects, in order to guarantee fully functional communication exchanges. Improved pragmatic competence in patients has been found in patients with Mild Cognitive Impairment (MCI) and early to moderate Alzheimer's Disease (AD) in the domains of jokes, self-expression and empathy after extended, targeted intranasal insulin therapy. In this paper it is argued that extended intra-nasal insulin treatment can even significantly augment the use of illocutionary and perlocutionary abilities in the areas of humor, irony and sarcasm in later stages of AD. The pragmatic capacity to relate emotionally to others in conversation with humor that can cause laughter can reduce the social isolation of AD patients from other speakers, enhance opportunities for meaningful conversation and lessen the caregiver stress.
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