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Pragmatic competence includes the capacity to express illocutionary force and successfully achieve perlocutionary effects, in order to guarantee fully functional communication exchanges. Alzheimer’s Disease is characterized by a constellation of limitations derived from progressive cognitive impairment, which is usually viewed as a global uniform phenomenon. In this paper it is argued that looking independently at the loss and recovery of pragmatic function related to illocutionary and perlocutionary abilities can be a productive way of understanding the progressive deterioration of communicative capacities by patients or their improvement under targeted treatment.

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.

BackgroundOne of the most important ingredients of felicitous conversation exchanges is the adequate expression of illocutionary force and the achievement of perlocutionary effects, which can be considered essential to the functioning of pragmatic competence.FindingsThe breakdown of illocutionary and perlocutionary functions is one of the most prominent external features of cognitive impairment in Alzheimer’s Disease, with devastating psychological and social consequences for patients, their family and caregivers.ConclusionsThe study of pragmatic functions is essential for a proper understanding of the linguistic and communicative aspects of Alzheimer’s disease.