Interviewing people living with cognitive impairment: a conversation analysis of supportive interactional practices

Effective qualitative interviews with individuals with cognitive impairment require careful conversational strategies to maintain dignity, support engagement, and enable meaningful narrative co-construction. Despite recognition of these challenges, practical guidance on interviewer talk in dementia research remains limited. This study applies conversation analysis (CA) to examine interviewer practices used in interviews with individuals with mild cognitive impairment or Alzheimer's disease. Analysis of 17 interviews identified five recurring practices: (1) scaffolding memory retrieval through subtle prompts, (2) normalizing cognitive lapses using humor and affiliative talk, (3) echoing and affirming responses to sustain narrative coherence, (4) managing caregiver co-participation to preserve participant voice, and (5) repairing emotional disclosures to support dignity. These practices shaped participants' experiences by validating emotions, affirming partial successes, and maintaining autonomy, thereby enhancing both ethical and empirical quality. This study addresses a key methodological gap by offering concrete, interactionally grounded strategies to improve qualitative interviews with cognitively impaired populations. Future research should examine these practices across more diverse populations and multimodal data sources.