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Language and CognitiveProcessesPublication details, includinginstructions for authors and subscriptioninformation:http://www.tandfonline.com/loi/plcp20

Comprehension oflong distance numberagreement in probableAlzheimer's diseaseAmit Almor a , Maryellen C. MacDonald a

, Daniel Kempler b , Elaine S. Andersen c

& Lorraine K. Tyler da Department of Psychology, Universityof Southern California, Los Angeles, USAb Department of Otolaryngology, andSchool of Gerontology, University ofSouthern California, Los Angeles, USAc Department of Linguistics, Universityof Southern California, Los Angeles, USAd Department of ExperimentalPsychology, University of Cambridge,Cambridge, UKPublished online: 21 Sep 2010.

To cite this article: Amit Almor , Maryellen C. MacDonald , DanielKempler , Elaine S. Andersen & Lorraine K. Tyler (2001) Comprehensionof long distance number agreement in probable Alzheimer's

disease, Language and Cognitive Processes, 16:1, 35-63, DOI:10.1080/01690960042000094

To link to this article: http://dx.doi.org/10.1080/01690960042000094

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Comprehension of long distance number agreementin probable Alzheimer’s disease

Amit Almor* and Maryellen C. MacDonald*Department of Psychology, University of Southern California,

Los Angeles, USA

Daniel Kempler*Department of Otolaryngology, and School of Gerontology, University

of Southern California, Los Angeles, USA

Elaine S. Andersen*Department of Linguistics, University of Southern California,

Los Angeles, USA

Lorraine K. TylerDepartment of Experimental Psychology, University of Cambridge,

Cambridge, UK

Requests for reprints should be addressed to Amit Almor, Hedco Neuroscience Building,University of Southern California, Los Angeles, CA 90089-2520.Email: almor@gizmo.usc.edu.

This work was supported by a grant from the National Institutes of Health to MaryellenMacDonald (NIH RO1 AG11773). We wish to acknowledge the following for referringAlzheimer patients for this research: Dr Victor Henderson, Professor of Neurology andDirector of the Clinical Core of the Alzheimer’s Disease Research Center at the University ofSouthern California (NIH AG05142); Dr Helena Chui, McCarron Professor of Neurology atthe University of Southern California and Co-Director, Alzheimer’s Disease Diagnostic andTreatment Center, Rancho Los Amigos Medical Center (DHS 94-20356), and Dr Lee Willis,USC Department of Neurology and Geriatric Neurobehavior Center, Rancho Los AmigosMedical Center. We are grateful to Lori Altmann, Mariela Gil, Laila Lalami, KarenMarblestone, Sarah Schuster and Karen Stevens for their efforts in collecting these data, andwe would like to thank the participants and their families for taking part in this project.

c 2001 Psychology Press Ltd

http://www.tandf.co.uk/journals/pp/01690965.html DOI: 10.1080/01690960042000094

LANGUAGE AND COGNITIVE PROCESSES, 2001, 16 (1), 35–63

* Also af�liated with the Program in Neural, Informational, and Behavioral Sciences at theUniversity of Southern California.

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36 ALMOR ET AL.

Two cross-modal naming experiments examined the role of working memoryin processing sentences and discourses of various lengths. In Experiment 1,10 memory impaired patients with probable Alzheimer’s disease (AD) and10 healthy elderly control participants showed similar sensitivity to violationsof subject-verb number agreement in a short sentence condition and similardegradation to this sensitivity in a long sentence condition. Performance inneither length condition correlated with performance on working memorytasks, suggesting that the processes involved in interpreting a grammaticaldependency between adjacent and nonadjacent elements are different fromthose required in the working memory tasks. In Experiment 2, the same 10AD patients were less sensitive than the 10 control participants to pronoun-antecedent number agreement violations in a short discourse condition, butneither group was affected by additional length. In this experiment,performance in both the short and long conditions correlated with workingmemory performance. These results show that grammatical and discoursedependencies pose different memory and processing demands, and that thesedifferences are not simply due to differences in the amount of interveningmaterial between dependent words. The results also suggest that while theworking memory de�cits characteristic of AD do not interfere with on-linegrammatical processing within sentences, they do compromise on-linediscourse processing across sentences.

INTRODUCTION

Patients with Alzheimer’s disease (AD) have dif�culty comprehendingspoken language (Kempler, 1995; Tomoeda, Bayles, Boone, & Kaszniak,1990). This dif�culty is apparent in their conversational interaction as wellas in their performance in many laboratory tasks (e.g., Almor, Kempler,MacDonald, Andersen, & Tyler, 1999; Emery, 1985; Kempler, Almor,Tyler, Andersen, & MacDonald, 1998b; Rochon, Waters, & Caplan, 1994;Tomoeda et al., 1990). The origins of this dif�culty, however, are not wellunderstood. One question that has received much attention in recent yearsis whether this dif�culty is due to a linguistic impairment in either thesyntactic or semantic systems, or whether it can be explained on the basisof nonlinguistic impairments, such as a working memory de�cit (Just &Carpenter, 1992; Kempler, 1995; Kempler, Almor, & MacDonald, 1998a;Kempler et al., 1998b; Kempler, Andersen, & Henderson, 1995; Kempler,Curtiss, & Jackson, 1987; Waters & Caplan, 1997). Indeed, becauselanguage processing is a complex activity that depends on many linguisticand cognitive processes, an interruption to any of these processes couldresult in a comprehension impairment (Small, Andersen, & Kempler,1997).

Evidence obtained from sentence-picture matching tasks in whichpatients have more dif�culty understanding syntactically complex vs.simple sentences, has led several researchers to conclude that AD patients’

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 37

comprehension is affected by a genuine syntactic de�cit, which interfereswith the initial interpretation of the sentence structure (e.g., Grober &Bang, 1995). Following Rochon et al. (1994) we will refer to this kind ofde�cit as an ‘‘interpretive’’ de�cit. Other researchers have noted, however,that sentence-picture matching tasks not only require successful processingof words and syntactic structure, but also require holding the sentencemeaning in mind while scanning the picture array and selecting a matchingpicture (e.g., Kempler et al., 1998a; Rochon et al., 1994). The observationthat these tasks impose signi�cant nonlinguistic (e.g., memory) require-ments has led these researchers to question whether syntactic complexityeffects in these tasks imply the existence of an interpretive de�cit in AD.Instead, these researchers suggest, AD patients may have a memory de�citthat does not interfere with initial syntactic or interpretive processing butonly affects processing that happens after that (a ‘‘post-interpretive’’de�cit; Rochon et al., 1994). Thus, patients may be able to interpret thesentence meaning adequately as they hear it, but perform poorly on asentence comprehension task because they cannot hold the meaning of thesentence in mind while performing the task.

In order to better clarify whether there is a genuine syntactic processingde�cit in AD, and to better assess the role of working memory incomprehension in general, several researchers have designed and usedlanguage processing tasks that minimise nonlinguistic memory andattentional requirements. This research has employed ‘‘on-line’’ methods,such as cross-modal naming (Marslen-Wilson & Tyler, 1980), in which theprocessing of linguistic material is assessed without requiring any consciousjudgements about the sentence structure or meaning (e.g., Almor et al.,1999; Kempler et al., 1998a; Nebes, Boller, & Holland, 1986). In thesestudies, patients and healthy control adults produce similar responsepatterns in processing basic grammatical dependencies between adjacentwords, such as a verb and its following argument (e.g., Kempler et al.,1998b). These data contrast with patients’ impaired performance in off-linetasks and are consistent with the view that comprehension de�cits in ADre�ect patients’ dif�culties with the nonlinguistic memory demandsimposed by off-line tasks.

This simple account of on- vs. off-line data is complicated by other�ndings, however. AD patients do show impairments in on-line tasks whenthe stimuli include discourse dependencies between nonadjacent words,such as a pronoun and its antecedent (Almor et al., 1999). One possibleconclusion from this research is that AD patients have a comprehensionproblem speci�c to processing discourse dependencies such as pronoun-antecedent relations, but no de�cit when interpreting grammaticaldependencies such as subject-verb agreement. However, an additional�nding of these studies, that the on-line processing of discourse

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38 ALMOR ET AL.

dependencies correlates with working memory performance (Almor et al.,1999) while the on-line processing of grammatical dependencies does not(Kempler et al., 1998a), suggests a different explanation for these data,based on the differing processing demands imposed by the two kinds ofdependencies. In speech production, subject-verb number agreement ismore tightly controlled and is less subject to semantic information than isantecedent pronoun agreement (Bock, Nicol, & Cutting, 1999). Gramma-tical dependencies therefore have a high degree of predictability in thesense that people know to expect an agreeing verb after the subject nounand may be quite surprised to encounter a verb that does not agree withthe subject. In contrast, discourse dependencies are often optional. That is,it is dif�cult to predict whether a discourse entity will be referred to again,and disagreeing references can be successfully resolved by assigning themto new referents. Furthermore, grammatical dependencies tend to occurbetween nearby words whereas discourse dependencies tend to occur overlong distances, often crossing phrase and sentence boundaries. Maintaininginformation that may or may not be important later for processing a longdistance dependency (as in the case of discourse but not grammaticaldependencies) could be especially taxing for AD patients, who typicallyhave limited working memory capacities. Thus it is not clear whetherlanguage comprehension performance is determined by the nature of thedependency probed (i.e., grammatical vs. discourse), the distance betweenthe dependent constituents, or simply the working memory demands ofprocessing these types of linguistic structures.

Resolving these issues is not only important for a precise characterisa-tion of the language comprehension de�cits of AD patients, but also hassigni�cant implications for theories of working memory and languageprocessing more generally. Just and Carpenter (1992) have argued thatthere is a single pool of verbal working memory resources from which alllinguistic processes draw (see also Carpenter, Miyake, & Just, 1994; Just,Carpenter, & Keller, 1996; Miyake, Carpenter, & Just, 1994). Because bothgrammatical and discourse dependencies can span considerable stretchesof intervening material, and it is the need to simultaneously store andprocess information which, in this theory, largely determines how muchworking memory is used, the distance between dependent words shouldaffect working memory utilisation in processing both grammatical anddiscourse dependencies. Furthermore, increasing distance between depen-dent words should especially affect processing for individuals with aworking memory de�cit, such as patients with AD.

Just and Carpenter’s single resource theory has been critiqued byWaters and Caplan, who, in a series of papers (e.g., Caplan & Waters,1999; Rochon et al., 1994; Waters & Caplan, 1996, 1997; Waters, Caplan,& Rochon, 1995), argue that there is not one but at least two resource

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 39

pools involved in language comprehension. In Waters and Caplan’stheory, one pool of working memory resources serves the interpretiveprocesses involved in extracting meaning from linguistic input includingsyntactic processing, and a separate pool of working memory resourcesserves the post-interpretive processes that are involved in further actingupon the generated representation (e.g., choosing a picture in a sentence-picture matching task, or answering a question). Accordingly, Waters andCaplan distinguish between effects of syntactic complexity, which theyattribute to interpretive processing, and effects of the number ofpropositions in an utterance, which they attribute to post-interpretiveprocessing. When they independently manipulated syntactic complexityand number of propositions in a sentence picture matching task, Waters etal. (1995) found that both AD patients and age-matched normal controlswere equally affected by an increase in syntactic complexity but thatpatients showed a selective impairment in response to an increase in thenumber of propositions. Waters et al. (1995) concluded that patients withAD have an impairment in the post-interpretive working memory systembut not in the interpretive working memory resources that are involved insyntactic processing. Thus, in contrast to Just and Carpenter, Waters andCaplan’s theory would not necessarily predict a similar effect ofintervening material on AD patients’ processing of all kinds ofdependencies. Instead, Waters and Caplan’s theory predicts that if acertain task shows a selective impairment for AD patients in processingintervening material, it must be because the task requires post-interpretiveprocessing, and therefore, this effect should be associated with the numberof propositions added by the intervening material. In other words, anyimpairment associated with intervening material that is observed in ADpatients but not in age-matched healthy controls should be related to anincrease in the number of propositions in the intervening material but notto its syntactic complexity.

A third approach draws on an analysis of task demands. As noted above,a number of researchers have previously observed that on- and off-linetasks impose differing processing requirements. Kempler et al. (1998a),who found correlations between working memory performance and off-line task performance (in a sentence picture matching task andgrammaticality judgement task) but not on-line performance (in a cross-modal naming task), suggested that one explanation for these results couldlie in an analysis of task demands: performance in the off-line tasks and theworking memory tasks was correlated because both tasks requiredsubstantial activation of semantic information (i.e., word meanings). Incontrast, performance in the on-line task that Kempler et al. used did notrequire substantial activation of semantic information and thus was notcorrelated with working memory performance. A similar analysis can be

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extended to task demands imposed by different on-line tasks, and even todemands imposed by different linguistic processes. For example, linguisticworking memory tasks typically require participants to report a series ofwords after a distraction interval; these words are kept active through somemix of phonological and semantic information (the exact mix could dependon both the task and the individual participant’s strategies). We wouldexpect on-line language comprehension tasks to correlate with workingmemory tasks to the extent that these tasks and the linguistic materials inthem impose similar demands on the maintenance of phonological andsemantic information. For example, the processing of some grammaticaldependencies, like grammatical subject verb agreement, would appear toimpose lesser demands on at least semantic representations than does theprocessing of some discourse dependencies, like co-referentiality betweenpronouns and their antecedents. This is because the semantic representa-tion of a noun is largely irrelevant to the computation of grammaticalsubject-verb number agreement—it doesn’t matter whether a particularnoun phrase is ‘‘the boy’’ or ‘‘the man’’, what matters is whether it issingular or plural. By contrast, a very rich semantic representation of nounsmay be required to determine whether ‘‘the boy’’ or ‘‘the man’’ is the mostplausible antecedent of ‘‘he’’ in a discourse; phonological or morphologicalinformation is insuf�cient. Moreover, because, in English, pronouns in andof themselves are more grammatically ambiguous than agreement markers,the interpretation and processing of pronouns may be inherently moredependent on semantic information than the interpretation and processingof agreement markers. On this view, correlations between working memorytasks and on-line processing of pronominal reference in discourse should bestronger than between working memory tasks and processing of gramma-tical number agreement.

The research described in this paper was undertaken to investigate therole of working memory in processing dependencies of different types anddifferent lengths by examining the effect of intervening material on ADpatients’ and healthy normal controls’ (NCs) on-line processing ofgrammatical and discourse number agreement. We independently ma-nipulated the nature of a number of agreement dependency (grammaticalvs. discourse) and the distance between dependent elements to test theeffects of each of these factors. We also looked for associations betweenperformance in the different comprehension conditions and performanceon working memory tasks.

Grammatical vs. discourse number agreement

Linguistic number, namely the morphological marking of words fornumber information, is a rudimentary linguistic mechanism that is

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 41

common to most human languages (Croft, 1990; Greenberg, 1966). InEnglish, both nouns and verbs are marked for number such that thegrammatical subject and the matrix verb of each sentence must agree innumber (e.g., ‘‘The boy was running’’ is grammatical but ‘‘The boy wererunning’’ is not). This subject-verb number agreement is re�ected inalmost every sentence spoken and heard by English speakers and isthought by linguistics to be entrenched in the grammar of the Englishlanguage. Research on human sentence processing has also demonstratedthat on-line sentence comprehension is sensitive to subject-verb agree-ment dependencies (Osterhout & Mobley, 1995) and is slowed down bysubject-verb number agreement violations (e.g., Nicol, Forster, & Veres,1997; Pearlmutter, Garnsey, & Bock, 1999). Furthermore, previousresearch with AD patients also found that, in spite of their manycomprehension impairments, AD patients’ sensitivity in cross-modalnaming tasks to subject-verb number agreement violations between anadjacent subject and verb does not differ from that of age-matchedhealthy controls (Kempler et al., 1998b). Finally, there is substantialevidence that intervening material between the subject and the verbinterferes with the processing of subject-verb number agreement inyoung healthy adults. In production, people tend to make moreagreement errors when they produce intervening material between thesubject and the verb (Bock & Eberhard, 1993; Eberhard, 1997), and incomprehension, people are less sensitive to agreement violations as thetext distance between the subject and the verb increases (Nicol et al.,1997).

Number agreement is re�ected not only in the grammatical dependen-cies between the elements of a single sentence but also in the discoursedependencies between elements of different sentences. For example,English requires both gender and number agreement between anaphoricpronouns and their antecedents (e.g., In ‘‘The boy was running. He seemedhappy’’, the boy and he are likely to be interpreted as co-referential,whereas in ‘‘The boys were running. He seemed happy’’, the boys and hecannot be interpreted as co-referential). As with subject-verb numberagreement, on-line sentence comprehension in healthy young adults hasbeen shown to be sensitive to number agreement between pronouns andtheir antecedents (e.g., McDonald & MacWhinney, 1995). However,unlike subject-verb number agreement, previous research found theprocessing of number agreement between pronouns and their antecedentsto be impaired in patients with AD (Almor et al., 1999). Thus, numberagreement provides an ideal opportunity to assess the effects ofintervening material on both a grammatical dependency that is known tobe processed effectively by AD patients, and a discourse dependency thatis known to be processed with dif�culty by these patients.

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Experiment 1 tests the effect of intervening material on the processingof subject-verb number agreement in AD patients and in normal elderlyadults. Experiment 2 tests the effect of intervening material on theprocessing of pronoun-antecedent number agreement in the same groupsof AD patients and elderly adults. Performance on both tasks is comparedwith independent measures of working memory. The research presentedhere thus extends our and others’ previous research in that it directlycompares the on-line processing of a grammatical dependency and adiscourse dependency with varying amounts of intervening material.

EXPERIMENT 1: SUBJECT-VERB AGREEMENTAND LENGTH

Experiment 1 employed a cross-modal naming paradigm (Marslen-Wilson, Tyler, & Koster, 1993; Tyler & Marslen-Wilson, 1977) to assessAD patients’ sensitivity to violations of intra-sentential number agree-ment and to test the effect of intervening linguistic material on thissensitivity. The cross-modal naming paradigm was chosen because itprovides an assessment of participants’ on-line processing, that is, itassesses comprehension as it is occurring, and does not impose extensivememory demands beyond what is required for comprehension itself.Previous research has shown that mild to moderate AD patients canperform a cross-modal naming task, and that in many cases theirsensitivity to grammatical violations as gauged by this task is comparableto that of healthy controls’ (Kempler et al., 1998a, 1998b; Nebes et al.,1986).

In cross-modal naming tasks, participants listen to auditory sentencefragments and then read aloud as quickly as possible a visually presentedword which appears on a computer screen at the offset of the auditorysentence fragment. The visual target is either a good (grammatical,interpretable) continuation of the sentence fragment or not. Naminglatencies for visual targets in the cross-modal task provide a measure of thedegree to which participants are sensitive to the appropriateness andgrammaticality of the target word as a continuation for the auditoryfragment. If participants are processing the sentence, then they are slowerto read anomalous continuations compared to felicitous ones. In thisexperiment, visual targets consisted of verbs that were grammaticalcontinuations for the auditory fragment and verbs that were notgrammatical because of incompatible number (‘‘The boy WAS’’ vs.‘‘The boy WERE’’). Because subject-verb agreement is a basic gramma-tical constraint that is encountered by all speakers and listeners with highfrequency, and because previous research found intact basic grammatical

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 43

processing in patients with AD, we expected both normal elderlyparticipants and AD patients to show an effect of verb grammaticality—all participants should name grammatical verb targets faster thanungrammatical ones. We also manipulated the number of interveningwords between the subject and the verb such that in the short condition,the visual target verb appeared immediately after the subject noun, and inthe long condition, the target appeared following a relative clause thatmodi�ed the subject noun. If the presence of intervening words generallyaffects people’s ability to detect subject-verb agreement violations, thenboth groups should exhibit reduced sensitivity to verb grammaticality inthe long condition compared to the short condition. However, if patientsare more affected by intervening material than are normal controls, thenthere should be a three-way interaction between population, length, andgrammaticality, such that the difference between the grammaticalityeffects in the short and long conditions is larger for the patients than forthe healthy controls.

Because working memory de�cits are widespread in AD and have beensuggested as a possible source of language comprehension de�cits, we willalso correlate language comprehension performance with independentmeasures of working memory. If the introduction of intervening materialduring processing of number agreement taxes working memory resources,then grammaticality effects in the long condition should correlate withperformance on working memory tasks, but grammaticality effects in theshort condition should correlate with working memory performance moreweakly or not at all.

Method

Participants. Ten participants diagnose with probable Alzheimer’sdisease and ten healthy age-matched controls participated in this study.The Alzheimer participants were referred by the University of SouthernCalifornia Alzheimer’s Disease Research Center and the Alzheimer’sDisease Diagnostic and Treatment Center at Rancho Los Amigos MedicalCenter. All AD participants met the NINCDS–ADRDA criteria forprobable Alzheimer’s disease (McKhann et al., 1984). Results ofneurological, laboratory (including computed tomography (CT) ormagnetic resonance (MR) scan), and neuropsychological assessment failedto suggest other causes of dementia. All participants were native speakersof Standard American English. Participant information is shown in Table 1.The AD participants were mildly to moderately demented as gauged bythe Mini-Mental State (Folstein, Folstein, & McHugh, 1975). The normalelderly control (NC) participants were slightly younger than the patients

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44 ALMOR ET AL.

and had completed slightly more years of education, though thesedifferences did not quite reach statistical signi�cance: age, t(18) = 2, p< .07; years of education, t(18) = 1.97, p < .07. However, because therewere these small differences, we included the factors of age and educationin all analyses that include a group factor.

Materials and procedure

Cross-modal naming. Twenty auditory stimuli were constructed bycombining an introductory sentence and a sentence fragment that endedafter the grammatical subject, before the main verb (see Table 2 for asample item in all conditions). In half of the items, the subject of thesentence fragment was a plural noun phrase and in the other half singular.The verbs was and were were presented as visual targets. Each verb thusconstituted a grammatical continuation to half of the items and anungrammatical continuation to the other half. Each sentence fragmentappeared in two conditions, short and long. In the short condition, thesubject of the fragment was a three-word noun phrase of the formdeterminer-adjective-noun , and the auditory fragment ended at the offsetof the noun. In the long condition, the subject noun phrase was followed bya 10–15-word relative clause. All of the relative clauses were subjectrelatives, that is, the subject of the sentence fragment was also the subject

TABLE 1Experiment 1. Participant information

MMSE Age EducationMean (SD, range) Mean (SD, range) Mean (SD, range)

AD (N = 10) 21 (3.8, 17–28) 82 (4.3, 76–89) 15 (2.5, 11–20)NC (N = 10) 29.4 (1.1, 28–30) 78 (4.2, 70–84) 17 (1.9, 14–22)

TABLE 2Sample item in Experiment 1 (visual targets in capital letters)

Short conditionSome people always lose their keys.The old lady WAS/WERE

Long conditionSome people always lose their keys.The old lady, who searched very carefully through every one of those old trash cans behindthe stores, WAS/WERE

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of the relative clause. The last word of the relative clause was always anoun that was marked for a different number than the subject noun.Appendix A shows the complete list of items. The visual targets werealways presented at the offset of the auditory fragment. Response timeswere measured from the onset of the visual target to voice initiation thatwas detected by the microphone. Thus in the short condition the visualtarget verb was presented immediately following the head noun thatcarried the number information, and in the long condition it was presentedfollowing the relative clause. The experiment therefore had three factors—population (AD, NC), grammaticality (grammatical, ungrammaticaltargets), and length (short, long).

We tested participants in four separate sessions, a minimum of one weekapart for the AD patients and three weeks apart for the controlparticipants. The stimuli presented in each sessions were counterbalancedso that a participant never encountered more than one version of the sameitem in the same session. Stimuli were pseudo-randomly mixed with �llersfrom different experiments using different sentence structures anddifferent visual targets (which included other verbs, nouns, and adjectives).In some �ller items the visual target was presented at the middle of thesentence and in others it was presented at the end of the sentence. In eachsession, 25% of the items were from this experiment and 75% were �llers(items from other experiments, including the items for Experiment 2below). In half of all items the visual target was a good continuation of theauditory context, and in the other half it was not. Ten practice items beganeach session.

Stimuli were digitally recorded using MacRecorder and a Macintoshcomputer in a sound attenuated booth with a constant mouth-to-microphone distance of 8 inches. A standard �ller word was recorded atthe end of each fragment instead of the target word (to avoidcoarticulation cues) and then digitally excised.

Each participant was tested in a quiet room, sitting in front of aMacintosh Classic computer. The experiment was controlled by thePsyScope software package (Cohen, MacWhinney, Flatt, & Provost, 1993).Auditory stimuli were presented via a high quality loudspeaker, withvolume adjusted to ensure that each participant could hear the stimuliadequately. Participants were asked to read the visual targets aloud asquickly and accurately as possible (Marslen-Wilson et al., 1993). In orderto assure that participants were paying attention to the stimuli (and not justreading the words aloud, see Tyler & Marslen-Wilson, 1977), we includedan additional comprehension task: after naming each target word, controlparticipants were asked whether the word was a good or bad continuationof the sentence. Pilot testing with AD participants indicated that thissecondary task was so distracting that they could not produce accurate and

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46 ALMOR ET AL.

fast responses to both the primary (word reading) and secondary tasks.Therefore, an alternative directed attention task was developed for theAD participants: they were asked yes/no comprehension questions for20% of the context sentences. This secondary task successfully directedtheir attention to the stimuli and did not interfere with their ability toperform the primary task. For both groups, responses to the secondary taskwere not scored, but merely served to encourage the participants tointegrate the context fragment and the visual target. It should be notedthat even though subjects from the two populations engaged in a slightlydifferent secondary task, this difference was necessary in order to ensurethat their performance of the main task would be comparable. We havenow used this combination of secondary tasks in a number of studies thatfound no difference between the performance of AD patients and normalcontrols in the main task (Kempler et al., 1998a, 1998b; also see the resultsof the present experiment below). In light of those �ndings it is highlyunlikely that the small difference in the secondary task used with the twopopulations introduced any meaningful confounds to the results of thecross-modal naming.

Working memory and mental status. Previous research with ADpatients (e.g., Waters & Caplan, 1997), as well as our pilot work, suggestedthat working memory tasks that are standardly used with youngparticipants, such as Daneman and Carpenter’s (1980) span tasks, aretoo dif�cult for AD patients and yield insuf�cient variance for meaningfulstatistical analysis. Therefore, we developed two new working memorytasks, month ordering and digit ordering, to assess linguistic workingmemory. Like listening span tasks, our ordering tasks were designed torequire simultaneous storage and manipulation of information. Tasks thatcontain both storage and processing components have been found to begood correlates of language processing abilities, in contrast to tasks withminimal processing components, such as simple forward digit span(Daneman & Carpenter, 1980). In the month ordering task, participantswere required to put into calendar sequence an increasingly long set ofmonths presented out of calendar order. For example, in a given trial, aparticipant may have heard: ‘‘June, September, February’’, and shouldhave responded: ‘‘February, June, September’’. In the digit ordering task,participants were required to put into numerical order an increasingly longset of digits presented out of order. For example, when presented with thelist of digits: ‘‘nine, three, �ve’’, the target response would have been:‘‘three, �ve, nine’’. These tasks create similar working memory andprocessing demands to those involved in auditory language comprehen-sion, in that the participant must process a speech signal (the list of monthsor digits), maintain a representation of the input in mind, convert it to a

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 47

semantic representation (i.e., establish that the phonological string ‘‘June’’means the month of June), and use this representation to re-order theinput and formulate a response. Note that due to the presentation ofnonconsecutive digits and months, participants could not perform the taskby simply comparing the items to a list of digits and months in long-termmemory. The administration procedure for these tasks was adapted fromDaneman and Carpenter (1980). There were four trials presented at eachspan level, starting with two-item trials at the �rst level, and ending withtrials containing six items at the �fth and last level. Testing was stoppedafter a participant incorrectly sequenced two trials at a span level.Participants could score from 0 to 20, which was the overall number ofcorrect sequences. Our previous research (Almor et al., 1999; Kempler etal., 1998a, 1998b) has shown that although AD patients perform poorly onthese tasks relative to elderly controls, they can generally perform the taskwith short lists and thus seem to preserve at least some knowledgeregarding the correct order of digits and months.

To evaluate the effect of overall dementia severity and to allow us tofactor out the effect of dementia severity in subsequent analyses, weadministered the Mini Mental State Examination (MMSE; Folstein,Folstein, & McHugh, 1975).

Results

Naming latencies were analysed after eliminating all machine and readingerrors (7.7% of responses) and latencies beyond 3 standard deviationsfrom a participant’s mean naming latency in each session (affecting afurther 1.4% of the data.) AD patients were overall slower than NCs(patients’ mean RT was 1676 ms whereas NCs’ was 1028 ms), but thisdifference was not statistically signi�cant, t(18) = 1.1, p < .3. To minimiseirrelevant effects due to variations in the speed of individual participantsacross sessions and establish a common basis for evaluating responses ofdifferent participants from different populations, naming latencies werenormalised by transforming them into z-scores. The z-transformation wasbased on each participant’s mean and standard deviation for trials fromthis experiment in each session. A z-transformation was chosen so as tominimise differences in variance between the different groups and ensurethat the deletion of error trials would not lead to an arti�cial change in themeans (without the z-transformation, error trial removal from ‘‘slowsessions’’ would result in the incorrect shortening of the mean RT of theconditions to which the error trials belonged).1 Filler trials were notincluded in calculation of the mean and standard deviation for the

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transformation. The normalised mean naming latencies are shown inFigure 1.

A 2 2 2 ANCOVA, Population Grammaticality Length withcovariates age and education, found a main effect of grammaticality suchthat naming ungrammatical verbs was slower than naming grammaticalones, F1(1, 18) = 63.54, p < .001, F2(1, 19) = 63.2, p < .001,2 and also aninteraction between grammaticality and length such that the grammati-cality effect was almost twice as large for the short items as for the longitems, F1(1, 18) = 8.27, p < .01, F2(1, 19) = 6.65, p < .02. There were noeffects of population, and as is evident in Figure 1, both groups wereequally sensitive to the grammaticality of the visual target and weresimilarly affected by length. There was also a main effect of length, withlonger RTs in the short condition than in the long condition, F1(1, 18) =

5.62, p < .03, F2(1, 19) = 4.34, p < .051, which may re�ect participants’increased readiness for a visual target of any kind to appear later in thesentence, as in the long condition, rather than immediately after thegrammatical subject, as in the short condition. No other main orinteraction effects were signi�cant.

1 A z-transformation was chosen because it provides an effective means for equating thevariance in different sessions and for subjects from both groups. The ANCOVAs andANOVAs reported for this and the following experiment were also performed after a logtransformation of the scores. The results of the analyses based on these log transformed scoreswere identical to the results of the analyses reported here for both experiments with theexception that the interaction of Length and Grammaticality found in Experiment 1 was onlysigni�cant at a p < .055 level with the log transformed scores. Because the log transformedscores still failed to yield homogeneous variance for the two populations and because they donot solve the problem introduced by the removal of error trials, we only report the resultsfrom the analyses of the z-transformed scores.

2 The item analyses did not include the age and education covariates.

Figure 1. Verb naming latency in Experiment 1.

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 49

Dementia severity and working memory. AD patients scored lowerthan NCs on the MMSE, 21 vs. 29.4, t(18) = 5.29, p < .001, the monthordering task, 6 vs. 13.9, t(18) = 4.98, p < .001, and the digit ordering task,9.3 vs. 17.9, t(18) = 5.03, p < .001. There was a correlation between MMSEand month ordering while controlling for age and education, Pearson r(16)= .52, p < .02, and between MMSE and digit ordering, r(16) = .57, p <.02. There was also a strong correlation between performance on themonth ordering and digit ordering tasks, r(16) = .88, p < .001, even afterthe effect of general dementia, gauged by MMSE, was factored out, r(15)= .83, p < .001. To obtain a single working memory measurement forsubsequent analyses, a composite ordering score was calculated byaveraging each participants’ month and digit ordering scores. AD patients’mean composite ordering score was 7.65, and NCs’ 15.9, t(18) = 5.4, p <.001.

To assess whether sensitivity to the grammaticality of the visual targetverbs was linked to dimentia severity and/or working memory perfor-mance, we calculated the correlation between performance in the on-linetask and scores on the MMSE and working memory tasks. Because wewanted to test for the relation between on-line performance, workingmemory, and MMSE in general, we included the data from all participants,AD patients and NCs, in these analyses. For each participant, wecalculated a ‘‘short grammaticality sensitivity score’’ and a ‘‘longgrammaticality sensitivity score’’ by subtracting the participant’s meannormalised grammatical target naming latency from his/her mean normal-ised ungrammatical target naming latency separately for the short and longconditions. We also calculated for each participant a ‘‘length score’’ bysubtracting the participant’s long grammaticality sensitivity score from his/her short grammaticality sensitivity score. This length score provides ameasure of the reduction in grammaticality sensitivity due to sentencelength.

MMSE scores did not correlate with short grammaticality sensitivityscores r(16) = .19, p < .45, long grammaticality sensitivity scores, r(16) =

.31, p < .2, or length scores, r(16) = ± .07, p < .8. Factoring out the effectof working memory by controlling for the composite working memoryscore did not enhance these correlations: with short grammaticalitysensitivity scores, r(15) = ± .05, p < .9; with long grammaticality sensitivityscores, r(15) = .26, p < .32; or with length scores, r(15) = ± .26, p < .31.Similarly, the composite working memory scores did not correlate withshort grammaticality sensitivity scores, r(16) = .4, p < .1, longgrammaticality sensitivity scores, r(16) = .18, p < .47, or length scores,r(16) = .26, p < .3. The working memory scores did not correlate with anyon-line scores even after MMSE was factored out: with short grammati-cality sensitivity scores, r(15) = .37, p < .15; with long grammaticality

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50 ALMOR ET AL.

sensitivity scores, r(15) = .01, p < .97; and with length scores, r(15) = .35, p< .16. Thus, performance in the on-line comprehension task, with orwithout intervening material, did not correlate with performance in theworking memory tasks or MMSE.

Discussion

The use of long distance dependencies within sentences did not elicit anyindication of impairment in patients’ sentence processing. NCs and ADpatients were equally sensitive to subject-verb agreement in the cross-modal naming task. Furthermore, for both populations, interveningmaterial between the head noun and the verb had a similar adverse effecton this sensitivity. We can thus conclude that previous �ndings ofunimpaired performance in the cross-modal naming task (e.g., Kempleret al., 1998a, 1998b; Nebes et al., 1986) did not stem from using only shortconditions in those studies; AD patients can process grammaticalstructures very well even in longer, more complex sentences thanpreviously tested. Participants’ sensitivity to subject-verb number agree-ment, with or without intervening material, was not linked to workingmemory performance, nor was the reduction in this sensitivity that wascaused by intervening material. Therefore, the decreased sensitivity in thelong condition was apparently not related to the working memoryperformance assessed by the digit and month ordering tasks. One likelyexplanation for the strong grammaticality effect in the short than in thelong condition (for both groups) is that participants’ expectation for a verbwas stronger in the short condition than in the long condition becauseverbs appear more often immediately after the subject than after a relativeclause. This may have caused participants to respond faster to appropriateverbs and slower to inappropriate verbs in the short condition than in thelong condition (even though their overall expectation for a visual target ofany kind was stronger in the long condition as is indicated by the overallshorter RTs in the long condition). Another possible explanation for thereduced grammaticality sensitivity in the long condition is that the lastnoun in the intervening material in the long condition always disagreedwith the number of the subject, and may have thus created an interferenceeffect much like in studies with young healthy adults (Nicol et al., 1997;Pearlmutter et al., 1999). Regardless of the interpretation for theinteraction of length and grammaticality in this experiment, the lack ofpopulation differences and lack of association with working memorysuggest that intervening material in intra-sentential grammatical depen-dencies does not place extra demands on the type of working memoryresources that are tested here and diminished in AD.

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 51

EXPERIMENT 2: PRONOUN-ANTECEDENTAGREEMENT

Although Experiment 1 found no evidence that AD patients’ grammaticalprocessing is disproportionately affected by intervening material betweendependent constituents within sentences, the longer amount of interveningmaterial that typically separates related elements in discourse could stillunderlie the impairment that AD patients show in discourse processing.Also, it may be that the lack of correlations between on-line processing inExperiment 1 and working memory performance indicates an insuf�cientpower in our various tests. Experiment 2 tested the effect of interveningmaterial on the processing of a discourse dependency, number agreementbetween pronouns and their antecedents, and assessed the role of workingmemory in this processing.

Method

Participants. The same participants as in Experiment 1 were tested inthis experiment (see Table 1) in the same four sessions.

Materials and procedure. This experiment employed the same cross-modal naming paradigm as in the previous experiment. Stimuli consistedof 20 auditory discourse fragments followed by a visual target pronoun thatin half of the trials constituted an appropriate co-referential continuationto the discourse fragment and in the other half did not (see Table 3 for asample item). The discourse fragments included an initial sentence, whichalways introduced two entities, one plural, and one singular, and concludedwith a �nal incomplete sentence fragment. The sentence fragmentmentioned one of the entities again and ended right before the otherentity was likely to be mentioned. In the short condition, items consisted ofonly the initial sentence and the �nal fragment. In these items, the targetpronouns were separated from their antecedents by 10 to 15 words; notethat this ‘‘short’’ condition contained roughly the same number of

TABLE 3Sample item in Experiment 2 (visual targets in capital letters)

Short conditionThe children loved the silly clown at the party.During the performance, the clown threw candy to HIM/THEM.

Long conditionThe children loved the silly clown at the party.The show was very funny.During the performance, the clown threw candy to HIM/THEM.

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52 ALMOR ET AL.

intervening words as in the ‘‘long’’ condition of Experiment 1. Items in thelong condition also included a middle sentence, �ve to seven words long,which continued the same topic but did not mention either entity from the�rst sentence. A complete list of items appears in Appendix B. BecauseAD patients are impaired in their ability to maintain number informationfor pronoun reference resolution (Almor et al., 1999), we expected them toexhibit reduced sensitivity to pronoun appropriateness, compared to NCs.However, we were also interested in whether this sensitivity would beaffected by length and whether any such length effects would be associatedwith working memory scores. Indeed, because working memory measureshave previously been shown to correlate with the ability to interpretpronouns, particularly in long discourses (Daneman & Carpenter, 1980),we expected that in this experiment too, performance on the workingmemory measures would correlate with pronoun processing.

Overall, like Experiment 1, this experiment had three factors—population (AD, NC), appropriateness (appropriate, inappropriate), andlength (short, long). Auditory stimuli were recorded as in Experiment 1.Participants were tested over the same four sessions as in Experiment 1such that 25% of the items in each session were from this experiment and75% were �ller items (including the items from Experiment 1 above).

Results

As in the previous experiment, naming latencies were analysed aftereliminating all machine and reading errors (6.8% of responses) andlatencies beyond 3 standard deviations from a participant’s mean naminglatency in each session (further 1.8% of the data). In this experiment, ADpatients were again slower than NCs (patients’ mean RT was 958 ms andNCs’ was 836 ms), but, again, this difference was not statisticallysigni�cant, t(18) = .8, p < .4. As in the previous experiment, data werenormalised by transforming them into z-scores based on each participant’smean and standard deviation calculated for the scores from thisexperiment separately in each session. The resulting pronoun naminglatencies are shown in Figure 2.

A 2 2 2 ANCOVA, Population Appropriateness Length withAge and Education as covariates, found a main effect of appropriatenesswith faster naming of appropriate pronouns than inappropriate ones,F1(1, 18) = 112.0, p < .001, F2(1, 19) = 60.71, p < .001, and an interactionbetween population and appropriateness such that NCs showed anappropriateness effect almost three times larger than did the patients,F1(1, 18) = 27.98, p < .001, F2(1, 19) = 24.33, p < .001. This interactionshows that the on-line task is sensitive enough to capture populationdifferences. The subject analysis also detected a marginal main effect of

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 53

population, F1(1, 16) = 4.41, p < .06, although this was not signi�cant inthe item analysis, F2 < 1. No other main or interaction effects weresigni�cant. Thus, in this experiment, although AD patients were sensitiveto the appropriateness of the visual target, their sensitivity was impaired.Note that it is unlikely that this difference between the groups is an artifactof the z-transformation. Although, in principle, the higher variability inpatients’ responses could have led to an arti�cially reduced sensitivityeffect for the patients with the z-transformed scores, the fact that we didnot observe any group difference in Experiment 1 shows that this was notthe case. If the z-transformation was the reason for the differences insensitivity between the two populations in this experiment then we wouldhave expected to �nd similar differences in group sensitivity in Experiment1, which we did not.3

The presence of intervening material did not have an effect onperformance in either group. To make sure that this lack of length effectwas not due to any group difference, we carried out a LengthAppropriateness analysis separately for the AD patients and for theNCs. Both analyses found a main effect of appropriateness but no effect oflength or a length by appropriateness interaction, thus con�rming theresults of the previous analysis. The �nding that, in contrast to the previousexperiment, there was no main effect of length in this experiment may beexplained by the fact that the visual target in both the short and the longconditions in this experiment appeared at the same position within the �nalsentence fragment—participants had no reason to expect the visual targetin the long condition more than the short condition or vice versa.

Figure 2. Pronoun naming latency in Experiment 2.

3 More credence is lent to the interpretation of this difference as indicating a truepopulation effect by the fact the same effect was also detected in the analysis of the logtransformed scores mentioned in Footnote 1.

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Dementia severity and working memory. As in the previous experi-ment, we conducted a series of correlational analyses on performance inthe on-line task and scores on the MMSE and working memory tasks. Wecalculated for each participant a ‘‘short appropriateness sensitivity score’’and a ‘‘long appropriateness sensitivity score’’ by subtracting theparticipant’s mean normalised appropriate target naming latency fromhis/her mean normalised inappropriate target naming latency separatelyfor the short and long conditions. Again, we calculated for each participanta ‘‘length score’’ by subtracting the participant’s long appropriatenesssensitivity score from his/her short appropriateness sensitivity score.

MMSE scores did not correlate with short appropriateness sensitivityscores, r(16) = .21, p < .4, marginally correlated with long appropriatenesssensitivity scores, r(16) = .46, p < .06, and did not correlate with lengthscores, r(16) = ± .24, p < .34. Factoring out the effect of working memoryby controlling for the composite working memory score totally removedthe marginally signi�cant correlation between MMSE and long appro-priateness sensitivity scores, r(15) = .15, p < .57, and there was still nocorrelation between MMSE and short appropriateness sensitivity scores,r(15) = ± .12, p < .66, or length scores, r(15) = ± .22, p < .4. However, inthis experiment, the composite working memory scores correlated withshort appropriateness sensitivity scores, r(16) = .53, p < .03, and with longappropriateness sensitivity scores, r(16) = .64, p < .004, but not withlength scores, r(16) = ± .11, p < .67. These working memory scorecorrelations were virtually unaffected by factoring out the effect of MMSE.The composite working memory scores still correlated with shortappropriateness sensitivity scores, r(15) = .5, p < .04, and with longappropriateness sensitivity scores, r(15) = .53, p < .03, but not with lengthscores, r(15) = .03, p < .91. The fact that in this experiment, performancein the on-line task, in both long and short conditions, correlated with ourmeasures of working memory even after the effect of general cognitivefunctioning was factored out shows that the ordering tasks provide ameasure that is powerful enough to allow the detection of correlations withour on-line comprehension measures. Finally, the fact that even in thisexperiment, in which overall performance in the short and long conditionscorrelated with working memory, length scores did not correlate withworking memory suggests that the addition of this amount of interveningmaterial only poses a negligible burden on the working memory resourcesof the sort that are tapped by the ordering tasks.

Discussion

The group by appropriateness interaction found in this experimentindicates that the AD patients were impaired in their ability to

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 55

differentiate between number-appropriate and number-inappropriatepronouns. The presence of intervening material, however, did not seemto affect performance of the AD patients or the controls—each group wasequally sensitive to appropriateness in the short and long conditions.Although performance on both conditions of this task appeared stronglyrelated to working memory performance, processing intervening material(the length effect) was not linked to working memory. Dementia severitydoes not appear to be an important factor in processing these types ofdiscourses, given that the only signi�cant MMSE correlation disappearedwhen the effect of working memory was factored out.

These results contrast with those of Experiment 1, in which performanceof AD patients and controls did not differ. The comparison between thelong condition of Experiment 1 and the short condition of Experiment 2 isparticularly interesting, because these two conditions contained verysimilar numbers of intervening words between the dependent items. ADpatients were no worse than controls in the long grammatical dependencyof Experiment 1, but in Experiment 2, AD patients were less sensitive todiscourse number agreement compared to the controls. This resultunderscores the importance of the kind of dependency being compre-hended; the pattern of results cannot be attributed simply to the number ofwords intervening between dependent items. While length seems tomodulate processing dif�culty in some circumstances, the nature andstrength of its effect is in turn modulated by the nature of the dependency.One factor that may explain the population differences in discourse isdiscourse focus. In all the items in this experiment the visual targetreferred to the focused discourse entity, but the fact that the nonfocusedentity appeared in the subject position of the target sentence may havebeen interpreted by subjects as an indication of focus shift (Grosz, Joshi, &Weinstein, 1995). The shift in focus may have eliminated any length effectsand may have been the reason for AD patients’ poor performance; theirworking memory impairment may interfere especially with transitions indiscourse focus. The particular role discourse focus may play in ADpatients’ impaired performance is an interesting issue that merits furtherresearch.

GENERAL DISCUSSION

Experiment 1 demonstrated that, in the cross-modal task, AD patientswere able to process grammatical dependencies just as well as controlparticipants in both short and long sentences, although performance forboth groups was signi�cantly worse in the long conditions. The �nding thatAD patients’ performance is comparable to NCs’ despite signi�cantimpairments in the working memory tasks suggests that working memory

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as we have measured it is largely irrelevant to the processing of subject-verb number agreement. Experiment 2 showed signi�cant languageprocessing de�cits in the same group of AD patients (compared tocontrols) when they were required to process a discourse dependency,pronoun-antecedent number agreement, in both short and long conditions.Performance with these discourse dependencies was strongly correlatedwith measures of working memory capacity.

The �ndings presented here suggest that the on-line processing ofgrammatical dependencies is different from the on-line processing ofdiscourse dependencies in three important ways. First, it appears thatregardless of the presence of linguistic material intervening betweendependent words, patients with AD are not impaired in the on-lineprocessing of the subject verb agreement grammatical dependency, but areimpaired in the on-line processing of the pronoun antecedent discoursedependency. Importantly, this difference holds even when there is a similarnumber of words separating the subject from the verb and the antecedentfrom the pronoun (as in the long condition of Experiment 1 and the shortcondition of Experiment 2). Second, although intervening materialbetween elements of a linguistic dependency affects comprehension forboth normal elderly and patients with AD, it only affects the processing ofthe subject-verb number agreement grammatical dependency. Bothpatients’ and healthy elderly’s on-line processing of the grammaticaldependency was compromised by the presence of intervening materialbetween the subject and the verb, but their on-line processing of thediscourse dependency was not affected by additional intervening material.Third, the on-line processing of the pronoun-antecedent number agree-ment discourse dependency but not the on-line processing of the subject-verb number agreement grammatical dependency is linked to workingmemory performance as gauged by the ordering tasks.

Implications for working memory

Our results are not compatible with Just and Carpenter’s theory of verbalworking memory and its role in language comprehension (Just &Carpenter, 1992; Just et al., 1996). While our �nding of reducedsensitivity for subject-verb number agreement when the subject and theverb are separated by intervening material is predicted by Just andCarpenter’s single verbal working memory resource theory, the fact thatthere was no difference between memory impaired patients and NCs isnot. According to Just and Carpenter’s theory, the patients should beaffected more by intervening material than NCs because of their overallreduced verbal working memory resources. The lack of differencebetween patients and NCs cannot be simply attributed to a lack of

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NUMBER AGREEMENT, SENTENCE LENGTH, ALZHEIMER’S 57

power in the cross-modal naming task because this same task used withthe same participants was in fact powerful enough to capture populationdifferences in Experiment 2. Also incompatible with the Just andCarpenter theory is our failure to �nd any correlation between workingmemory performance and the reduction in grammatical sensitivity thatwas associated with intervening material. Although, as a null result, thisfailure to �nd correlations should be interpreted with caution, the factthat the same working memory measures correlated with sensitivity topronoun appropriateness in Experiment 2 supports the notion that theeffect of intervening material on processing subject-verb numberagreement is truly independent of the resources demanded by workingmemory tasks. Thus, our results are not compatible with a single resourcetheory such as Just and Carpenter’s. In order for Just and Carpenter’stheory to account for our results, it would have to be extended toassociate very different resource demands with the processing ofgrammatical dependencies than with the processing of discoursedependencies. It is not clear that, with such an extension, Just andCarpenter’s theory would not become practically indistinguishable frommultiple resource theories (e.g., Caplan & Waters, 1999).

Although our �ndings may at �rst appear compatible with the generalidea of separate grammatical and discourse processing, they cannot beeasily accommodated by Waters and Caplan’s modular framework(Caplan & Waters, 1999; Waters & Caplan, 1996, 1997; Waters et al,1995). Waters and Caplan argued that patients with AD have animpairment in the post-interpretive working memory system but not inthe interpretive working memory resources that are involved in syntacticprocessing. The present �ndings, however, do not support this hypothesis.Patients in our studies performed normally when tested on grammaticalrelations, even when we introduced a relative clause that added bothsyntactic complexity and an additional proposition. According to Watersand Caplan, insofar as adding propositions to a sentence increases the post-interpretive load (which puts demands on ‘‘post-interpretive’’ workingmemory), the lack of a number of propositions effect is an indication thatthe comprehension task we used, cross-modal naming, is not sensitive tothe post-interpretive processing of sentences. If this task measured post-interpretive processing, we should have observed a selective impairment inthe AD patients in the long conditions of Experiment 1 because thiscondition had an additional proposition. However, if this task does notmeasure post-interpretive processing, there should also have been nopopulation differences in either experiment. The fact that Experiment 2showed a signi�cant difference between the populations appears toundermine Waters and Caplan’s contention that AD patients are impairedonly in their post-interpretive processing. In addition, the fact that

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performance in Experiment 2 was linked to working memory performanceruns counter to Waters and Caplan’s claim that working memory as gaugedby tasks such as the ones we used does not affect interpretive processing.One might imagine an extension of the Waters and Caplan account inwhich interpretive processes utilise the output of post-interpretiveprocesses from prior sentences, which could explain why AD patientsshow an impairment in interpretive processing of a sentence that includesreferences to previous discourse, as in Experiment 2. Because Waters andCaplan’s approach focuses on intra-sentential phenomena, however, it isdif�cult to assess the implication of such an extension. Thus, while ourresults are in line with the general notion that grammatical and discourseprocessing are distinct, they are not compatible with Waters and Caplan’sspeci�c version of this general theory.

The traditional modular perspective, however, is not the only theoreticalperspective that is compatible with our �ndings. The contrast betweenpatients’ intact grammatical performance in Experiment 1 and theirimpaired discourse performance in Experiment 2 can be interpreted interms of the processing demands imposed by grammatical and discoursedependencies, and relating these processing demands to statistical factsabout the language. Subject-verb number agreement is an extremely highfrequency dependency that is a necessary and predictable part of everyEnglish sentence. Although not all sentences in English show overtsubject-verb agreement, it is likely that subject-verb agreement iscomputed even when not overtly coded in the sentence (Chomsky,1981). We suggest that the frequency and regularity of this agreementpattern is re�ected in good comprehension by AD patients, even as theybecome impaired in comprehending rarer and more dif�cult structuresduring the course of the disease. One computation that suffers in AD ispronoun antecedent number agreement, which is both less frequent thansubject-verb agreement (almost all English sentences have a subject and amain verb, but not all English sentences have a pronoun) and lesspredictable (whereas a comprehender knows that a verb must arrive atsome point after a subject-noun phrase, comprehenders cannot predictwith certainty that a discourse entity will be referred to again with apronoun). On this view, the extent to which AD patients will exhibitimpairments in linguistic processing varies with the frequency andpredictability of the individual dependency; it is not necessarily the casethat all discourse dependencies will yield an impairment or that allgrammatical dependencies will be spared.

This explanation of performance on our comprehension tasks comple-ments the proposal provided by Bates, Harris, Marchman, Wulfeck, andKritchevsky (1995) to account for their AD production data. Using anelicited production task, Bates et al. found that AD patients produced the

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same range of syntactic constructions as NCs, but that the distribution ofconstructions within that range was different; the patients produced fewerof the infrequent constructions (e.g., passives) than NCs. Bates et al.interpreted this �nding as indicating that while there is no purely syntacticde�cit in language production in AD, the patients’ impairments had alarger effect on infrequent constructions than frequent ones. Together, thetwo studies show that in both language production and languagecomprehension, frequency and predictability constrain AD patients’performance.

Clearly, the data presented in this paper are insuf�cient for disentan-gling this statistical view from the more traditional modular view of Caplanand Waters (1999). This is because the grammatical and discoursedependencies that were tested here represent two ends of a range offrequency and predictability: the grammatical dependencies were veryfrequent and highly predictable while the discourse dependencies wererelatively infrequent and unpredictable. Disentangling the statistical andmodular views would require testing the processing of grammaticaldependencies that are less frequent and less predictable than subject-verbagreement as well as the processing of discourse dependencies that aremore predictable than inter-sentential pronoun antecedent agreement.Further experimentation is also required in order to determine howfrequency and predictability should be measured and in particular whetherthe frequency of subject-verb agreement should be based on the number oftimes the grammatical dependency occurs or the number of time thedependency occurs for each speci�c verb form.

The analysis we provided here can be extended more generally to therelationship between comprehension performance and working memorymeasures. We have suggested that the working memory task is moresimilar in task demands to the pronoun processing task than to theinterpretation of grammatical number agreement, in that both pronounprocessing and working memory tasks require activation of semanticinformation (word meaning) to a greater degree than grammaticalprocessing. Following MacDonald and Christiansen (in press) andChristiansen and MacDonald (1999), we further suggest that workingmemory tasks have often been accorded a special status in the literature, asthey are often seen to be the pure re�ection of a ‘‘working memorycapacity’’, and not subject to any task analysis. This view has lead tomisleading interpretations of correlations between working memory andcomprehension tasks, in that researchers have sometimes made themistake of inferring a causal relationship from this correlation andconcluding that working memory is ‘‘used’’ in the comprehension task (seeMacDonald & Christiansen, in press, for review). Our alternativeexamines the task demands imposed by working memory tasks and

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interprets correlations between working memory and comprehension tasksas indicative of the similar task demands imposed by the two tasks. Wethus consider the ordering tasks not as assessing an independent under-lying working memory resource, but as providing a good indicator forwhich linguistic tasks, off-line and on-line, would be hard for AD patients.

Manuscript received October 1998Revised manuscript received April 2000

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APPENDIX A

List of auditory stimuli used in Experiment 1. The text in parentheses was only included in thelong condition. All stimuli were followed by the visual targets WAS and WERE.1. Artists can be very strange. A famous painter, (who won awards in several recent modern

art competitions in many cities)2. Some people always lose their keys. The old lady, (who searched very carefully through

every one of those old trash cans behind the stores)3. Busy people don’t have time to return messages. The top manager, (who left on a long

trip through Europe by way of several Asian capitals)4. Women always look after everyone. The young mother, (who drove to the suburbs of

Chicago every morning through heavy traf�c jams)5. The employees were pleased with their new jobs. The friendliest worker, (who spent

every day in the narrow park down by the �ower gardens)6. The students are doing well. The young girl, (who improved greatly every day because of

the excellent teaching and good books)7. Some drivers can be reckless. The wild teenager, (who drove like a maniac through the

quiet neighbourhood on several occasions)8. The students learn things very quickly. The smartest child, (who graduated last year in

June during the longest heat spell in years)9. Some people have all the luck. The old man, (who hunted to �nd a bargain in the smallest,

rural towns and villages)10. The magicians have been practicing for weeks. The newest apprentice, (who learned

magic in grade school between studying other subjects)11. Some people like gardens. The new homeowners, (who lived in the greater metropolitan

area in a large rambling house in terrible disrepair)12. The knitting club was having fun. The new members, (who joined the club last year in the

weeks just before Christmas)13. Most people run errands in a hurry. The busiest customers, (who stopped on the way to

work just after the store had opened)14. Some people are creative. The old men, (who invented a lot of interesting things during

and after the Second World War)15. The family owns a lot of land. The oldest children, (who grew many different kinds of

vegetables from seed every summer)16. Many laborers are working on the building. The best plumbers, (who helped to maintain a

large and expensive hotel on the other side of town)17. Many housewives donate to charities. The generous women, (who had just cleaned out

closets and garages in preparation for big sale)18. The children were very attentive. The best students, (who paid attention to everything in

the class and the review session)

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19. Parents worry about their children. The nervous fathers, (who went to the hospital’sspecial class about childhood illness)

20. Everyone loves to perform. The young actors, (who wanted to be in a popular musical ordramatic play on Broadway)

APPENDIX B

List of auditory stimuli used in Experiment 2. The text in parentheses was only included in thelong condition. All stimuli were followed by the visual targets HIM and THEM.1. The football players took the lucky boy to the big game. (The stadium was completely

packed). At half-time the boy waved to2. The children loved the silly clown at the party. (The show was very funny.) During the

performance the clown threw candy to3. The sales ladies hated the manager of the store. (The business was poorly run.) Before

long, the manager would not even pay4. The judge gave the criminals life in prison. (The courtroom was very noisy.) After the

sentencing, the criminals yelled at5. The young boy took the seniors through the garden. (The air was cool and crisp.) After

the tour, the seniors tipped6. The young man sent the elderly couple on a vacation cruise. (The holiday was very

relaxing.) During the trip, the couple wrote to7. A group of students interviewed the famous professor at the cafeteria. (The meeting had

to be cut short.) Later that day, the professor called8. The school principal asked the students to stand in straight lines. (The �eld trip was

already behind schedule.) As usual the students ignored9. The bank manager begged the robbers to return the money. (The situation was nerve

wracking.) On the way out, the robbers just laughed at10. The musicians watched the conductor closely during the concert. (The auditorium was

nearly full.) After the performance, the conductor praised11. The townspeople asked the mayor for �nancial support. (The city was in a panic.)

Without delay, the mayor helped12. The priest welcomed the visitors to the chapel (The church was beautifully decorated.)

After the service, the visitors thanked13. The patients gave the retiring nurse a farewell party. (The food was low fat and delicious.)

After dessert, the nurse hugged14. The father read the children a bedtime story. (The plot was about a magic castle.)

Afterwards the children kissed15. The coach showed the swimmers around the new gym. (An indoor pool had just been

built.) As a joke, the swimmers splashed16. Mr. and Mrs. Smith called the mechanic early in the morning. (The car would not start.)

Later that day the mechanic helped17. The boss told the janitors to clean the �oors. (The hallway was especially dirty.)

Reluctantly, the janitors obeyed18. The travellers listened to the safari guide on the long bus trip. (At times the scenery was

boring.) During the dull parts, the guide entertained19. The referee yelled at the hockey players on the ice rink. (The game was very loud.) At

times the players couldn’t hear20. The demanding guests nagged the maid for a freshly washed towel. (The washing machine

was broken.) Naturally, the maid avoided

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