Pronoun production in the connected speech of Greek-speaking individuals with mild-to-moderate Alzheimer's Disease

This paper investigates pronoun production in the connected speech of 19 Greek-speaking individuals with mild-to-moderate Alzheimer's Disease (hence, AD) and 19 non-impaired controls (hence, NC) through three different discourse tasks, an unstructured interview for spontaneous speech elicitation, and a picture-description task and a story retelling task for the elicitation of semi-spontaneous speech. Our results revealed that Greek-speaking individuals with AD show significantly higher pronoun-to-noun ratios than non-impaired controls, confirming robust pronoun overuse across languages. We also found that pronoun use varies by discourse type, with the strongest group difference in the picture description task. In personal narratives, pronoun overuse strongly correlates with naming and working memory deficits, highlighting task-specific cognitive demands. Overall, we conclude that pronoun overuse in AD is best explained as a multifactorial phenomenon driven mainly by lexical retrieval difficulties, with contributions from working memory limitations.