Affective theory of mind in people with mild and moderate Alzheimer's disease

• Published in: International journal of geriatric psychiatry 2023-12, Vol.38 (12), p.e6032-n/a
• Main Authors: Lucena, Aline Tavares, Dos Santos, Tatiana Teresa Belfort Almeida, Santos, Paulo Fernando Alves, Dourado, Márcia Cristina Nascimento
• Format: Article
• Language: English
• Subjects: Aged; Alzheimer Disease - psychology; Alzheimer's disease; Cognition; Cognitive ability; cognitive functioning; Cross-Sectional Studies; dementia; emotional reasoning; Emotions; Geriatric psychiatry; Humans; Neurodegenerative diseases; Neuropsychological Tests; Older people; social cognition; Theory of Mind
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.6032

Objective This study compared the affective theory of mind (ToM) of people with mild and moderate Alzheimer's disease (AD) and healthy older adults and also investigated the relationship between affective ToM and cognitive and clinical functioning in AD people. Methods This cross‐sectional study included 156 older adults with AD and 40 healthy older adults. We used an experimental task involving reasoning processes in different contextual situations. Results The affective ToM was impaired in AD groups compared with healthy group, with moderate AD group showing lower performance than mild AD group. The affective ToM task of mild AD group was significantly correlated with the Mini‐Mental State Examination (MMSE) and education years. Linear regression showed only education years as a predictor of ToM task performance. The neuropsychiatric symptoms and functionality were not correlated with the affective ToM. Conclusions Our findings demonstrated that people with mild and moderate AD presented impairments in affective ToM that can be explained by the difficulties to infer emotion from reasoning processes. In addition, the education years variable proved to be an affective ToM performance's predictor for the mild AD group, but not for the moderate AD group, indicating that ToM abilities are affected differently in different stages of AD. Neuropsychiatric symptoms and functionality seem to have no influence on affective ToM impairments in people with AD. Key points The ToM has been highlighted in studies on older adults, specifically those affected by neurodegenerative diseases, such as Alzheimer's disease. Studies have investigated the affective ToM of people with AD using decoding of facial expression and reasoning processes. People with mild and moderate AD have impairments in affective ToM that increase with disease progression. The impairments found in the affective ToM of people with AD can be explained by the difficulties to infer emotion from reasoning processes.