Pragmatic and narrative decline in healthy aging: a multilevel assessment of their interplay

Introduction: Effective communication in aging is supported by both narrative and pragmatic abilities, which are known to undergo declines in healthy older adults. Traditional language assessments may overlook these changes, especially in multimodal and ecologically valid communicative contexts. This study investigates the structure and interplay of narrative and pragmatic abilities in aging by integrating multilevel discourse analysis and the Assessment Battery for Communication (ABaCo). Methods: Forty-four healthy Italian-speaking old adults aged 65 to 86 years took part in the study. Participants completed a narrative production task based on visual stimuli, analyzed through multilevel discourse analysis to extract measures of productivity, informativeness, and coherence. Pragmatic production was assessed using the ABaCo battery. Two separate Principal Component Analyses (PCAs) identified latent components in narrative and pragmatic domains. Pearson correlations assessed interrelations between these components. Results: Narrative analysis revealed two components: “Narrative Information Organization Difficulties” (coherence errors, lexical informativeness) and “Narrative Productivity” (word fluency, word count). ABaCo subscales loaded onto a single component, “Communicative-pragmatic efficiency in production”. A significant negative correlation was found between narrative organization difficulties and pragmatic efficiency (r = –.469, p = .001), while no significant correlation emerged between narrative productivity and pragmatic efficiency. Discussion: Findings support a partially overlapping structure between narrative and pragmatic competence in aging. Pragmatic efficiency relates specifically to lexical informativeness and coherence, rather than raw verbal productivity. This distinction highlights the clinical relevance of multimodal and integrative assessments, such as ABaCo, in identifying early communicative decline. Joint assessment of narrative and pragmatic dimensions offers a comprehensive approach to profiling communicative functioning in aging.