Multimodal pragmatic assessment in healthy aging: The interplay with Executive Functioning, Theory of Mind and Cognitive Reserve

Pragmatic competence is crucial for effective social interaction and well-being, and yet it tends to decline with age. While most research has focused on basic linguistic skills, the multimodal nature of communication and the cognitive processes that support it have often been overlooked. The present study aims to address these gaps by assessing pragmatic-communicative ability in aging – including linguistic, extralinguistic, and paralinguistic expressive means - and examining the cognitive mechanisms underlying this decline, in particular Executive Functions (EFs), Theory of Mind (ToM), and Cognitive Reserve (CR). We analyzed communicative-pragmatic ability in 84 healthy adults in three age groups (20–40, 65–75, 76–86 years) using the Assessment Battery for Communication (ABaCo). A comprehensive neuropsychological battery enabled the assessment of basic cognitive functions, EFs, ToM, and CR. The results show that older adults demonstrate lower performance in both pragmatic and cognitive domains. EFs emerged as predictors of communicative-pragmatic competence, while ToM appeared to play a less important role. Noteworthy, CR, particularly as reflected in educational background, attenuated age-related decline in pragmatic ability. This study extends our understanding of the cognitive factors contributing to pragmatic decline, as well as protective mechanisms involved. It also emphasizes the need for targeted cognitive and communicative interventions to promote effective communication in older adults.