Theory of Mind in normal ageing and neurodegenerative pathologies

Mini-SEA: Validity and Normative Data for the French-Quebec Population Aged 50 Years and Above

OBJECTIVE

The mini Social cognition & Emotional Assessment (mini-SEA) is a social cognition battery which assesses theory of mind and emotion recognition. Currently, no psychometrically validated measure of social cognition with adapted normative data exists for the middle-aged and elderly French-Quebec population. This project aims to determine the known-group discriminant validity of a cultural and linguistic adaptation of the mini-SEA between cognitively healthy people, those with mild cognitive impairment (MCI) or living with Alzheimer's Disease (AD). This study also aims to examine the stability of mini-SEA's performance over a 3-4-month time period, as well as to produce normative data for French-Quebec people aged 50 years. Normative data are derived for the full and an abbreviated version of the Faux Pas subtest.

METHOD

The sample included 211 French-speaking participants from Quebec (Canada) aged 50 to 89 years. Mini-SEA's performance between a sub-sample of cognitively healthy people (n = 20), those with MCI (n = 20) or with AD (n = 20) was compared. A sub-sample of cognitively healthy people (n = 30) performed the task twice to estimate test-retest reliability. Socio-demographic variables' effects on scores were examined to produce normative data in the form of regression equations or percentile ranks.

RESULTS

Significant differences emerged between cognitively healthy people and those with MCI or AD. Moreover, scores were relatively stable over a period of 3 to 4 months. Finally, for the normative data, age, gender, and education were associated with performance on the mini-SEA or its subtests.

CONCLUSIONS

This study improves and standardizes social cognition's assessment among French-Quebec individuals, which will help characterize their cognitive profile.

Can the Ability to Recognize Facial Emotions in Individuals With Neurodegenerative Disease be Improved? A Systematic Review and Meta-analysis

BACKGROUND

Facial emotion recognition (FER) is commonly impaired in individuals with neurodegenerative disease (NDD). This impairment has been linked to an increase in behavioral disorders and caregiver burden.

OBJECTIVE

To identify interventions targeting the improvement of FER ability in individuals with NDD and investigate the magnitude of the efficacy of the interventions. We also wanted to explore the duration of the effects of the intervention and their possible impacts on behavioral and psychological symptoms of dementia and caregiver burden.

METHOD

We included 15 studies with 604 individuals who had been diagnosed with NDD. The identified interventions were categorized into three types of approach (cognitive, neurostimulation, and pharmacological) as well as a combined approach (neurostimulation with pharmacological).

RESULTS

The three types of approaches pooled together had a significant large effect size for FER ability improvement (standard mean difference: 1.21, 95% CI = 0.11, 2.31, z = 2.15, P = 0.03). The improvement lasted post intervention, in tandem with a decrease in behavioral disorders and caregiver burden.

CONCLUSION

A combination of different approaches for FER ability improvement may be beneficial for individuals with NDD and their caregivers.

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

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.

Age-Related Social Cognitive Performance in Individuals With Psychotic Disorders and Their First-Degree Relatives

BACKGROUND

Social cognitive impairment is a recognized feature of psychotic disorders. However, potential age-related differences in social cognitive impairment have rarely been studied.

STUDY DESIGN

Data came from 905 individuals with a psychotic disorder, 966 unaffected siblings, and 544 never-psychotic controls aged 18-55 who participated in the Genetic Risk and Outcome of Psychosis (GROUP) study. Multilevel linear models were fitted to study group main effects and the interaction between group and age on emotion perception and processing (EPP; degraded facial affect recognition) and theory of mind (ToM; hinting task) performance. Age-related differences in the association between socio-demographic and clinical factors, and EPP and ToM were also explored.

STUDY RESULTS

Across groups, EPP performance was associated with age (β = -0.02, z = -7.60, 95% CI: -0.02, -0.01, P < .001), with older participants performing worse than younger ones. A significant group-by-age interaction on ToM (X2(2) = 13.15, P = .001) indicated that older patients performed better than younger ones, while no age-related difference in performance was apparent among siblings and controls. In patients, the association between negative symptoms and ToM was stronger for younger than older patients (z = 2.16, P = .03).

CONCLUSIONS

The findings point to different age-related performance patterns on tests of 2 key social cognitive domains. ToM performance was better in older individuals, although this effect was only observed for patients. EPP was less accurate in older compared with younger individuals. These findings have implications with respect to when social cognitive training should be offered to patients.

The interaction between motor simulation and spatial perspective-taking in action language: a cross-cultural study

Growing evidence has revealed the crucial role of motor simulation and spatial perspective-taking in action language. However, there is still a lack of understanding of how motor and spatial processes interact when there are multiple actors involved, and if embodied processes are consistent across different cultures. To address this gap, we examined the interaction between motor simulation and spatial perspective-taking in action-sentences comprehension, along with the consistency of embodied processes across cultures. We collected data from Italian and US English speakers using an online sentence-picture verification task. The participants completed four conditions: two congruent (i.e., the participant is the agent in the sentence and the photo; the agent is someone else interacting with the participant in both the sentence and the picture) and two incongruent (i.e., the agents of the sentence and the picture do not match). The results show that when the perspective of the picture matched that described in the sentence-processing reaction times (RTs) were faster than in the incongruent conditions. In the congruent conditions where the agent is someone else, RTs were slower compared to the condition where the participant is the agent. This has been interpreted as claiming that motor simulation and perspective-taking are independent processes interacting during sentence comprehension (e.g., motor simulation is always run in the role of the agent, but we can adopt multiple perspectives depending on the pronouns and the contextual cues). Furthermore, Bayesian analysis provided evidence that embodied processing of action language entwines a common mechanism, suggesting cross-cultural consistency of embodied processes.

Theory of Mind and Executive Functions in Individuals with Mild Cognitive Impairment or Healthy Aging

Social cognition involves skills for maintaining harmonious personal and social relationships throughout life. Social cognition issues, including Theory of Mind (ToM), can significantly impact the well-being of older individuals and intensify with the onset of neurological conditions. Mild Cognitive Impairment (MCI) is a state between healthy and pathological neurocognitive aging, where monitoring social functions is crucial. Despite numerous studies on ToM challenges in older adults and cognitive disorders, the underlying mechanisms remain debated. Uncertainty exists regarding whether ToM deficits are related to other cognitive functions, such as Executive Functions (EFs). Our study examined the correlation between EF and ToM performance in 32 MCI patients and 36 healthy elderly controls. The findings revealed a link between EF and ToM performance among healthy elderly individuals. Specifically, within the assessed EFs, the role of the working memory (WM) emerged. The study also highlighted distinctions between the MCI group and the healthy elderly group, showing that despite a general reduction in cognitive performance, the condition could impact these abilities in different ways. The study contributes to the literature, fostering comprehension of the mechanisms underlying ToM difficulties, while also paving the way for targeted interventions and enhanced clinical or preventative care.

Cortico-limbic disruption, material-specificity, and deficits in cognitive-affective theory of mind

The Theory of Mind deficit due to cognitive-affective disintegration is a poorly understood cognitive consequence of cortical and subcortical disruption in right temporal lobe epilepsy. Following Marr's trilevel approach, we used the material-specific processing model to understand the Theory of Mind deficit in drug-resistant epilepsy (N = 30). We examined pre- and post-surgery changes in first-order (somatic-affective, non-verbal component) and second-order Theory of Mind (cognitive-verbal component) in three groups formed using: (i) seizure side (right versus left), (ii) right temporal epilepsy (right temporal lobe epilepsy versus non-right temporal lobe epilepsy), and (iii) right temporal lobe epilepsy with amygdalohippocampectomy (right temporal lobe epilepsy versus left temporal lobe epilepsy amygdalohippocampectomy versus non-amygdalohippocampectomy). We observed a marked deficit in the first-order Theory of Mind in the right temporal lobe amygdalohippocampectomy group; we mapped this deficit to decline in the non-verbal component of Theory of Mind (somatic-affective component). Preliminary results support using a material-specific processing model to understand the Theory of Mind deficits in right temporal lobe epilepsy amygdalohippocampectomy. Malleability of verbal processing in presence of deterioration of non-verbal processing might have clinical relevance for post-surgery recovery in right temporal lobe epilepsy amygdalohippocampectomy. Documenting the material-specific nature of deficits (verbal versus non-verbal) in non-western, linguistically, and socioeconomically diverse country enables us to understand the problem of heterogeneity in post-surgery cognitive consequences in the right amygdalohippocampectomy.

Affective Theory of Mind as a residual ability to preserve mentalizing in amnestic Mild Cognitive Impairment: A 12-months longitudinal study

INTRODUCTION

Theory of Mind (ToM) decline has been outlined in people with amnestic Mild Cognitive Impairment (aMCI), but evidence from longitudinal studies is lacking. This longitudinal study aims to investigate changes in cognitive and affective ToM performance in an aMCI sample (n = 28; 14 females, mean age = 76.54 ± 4.35).

METHOD

Participants underwent two steps of neurocognitive evaluation, at the baseline (T1) and 12-month follow-up (T2), to obtain their global cognitive level and both affective (Reading the Mind in the Eyes test, ET) and cognitive (Strange Stories, SS) ToM profile. Then, participants were categorized into two groups based on ToM changes: people who worsened (ETΔ < 0; SSΔ < 0) and people who did not (ETΔ≥0; SSΔ≥0) at follow-up. Differences between groups in cognitive functions and ToM profiles at baseline have been investigated.

RESULTS

Our results showed that 46% of subjects worsened in affective (ET) and 28% in cognitive (SS) ToM at follow-up. People who worsened in ET reported a statistically significantly higher performance in ET at baseline (p = 0.002) but not at follow-up than people who did not worsen. In contrast, subjects who worsened in SS showed a lower Immediate Free Recall (IFR, p = 0.026) and Delayed Free Recall (DFR, p = 0.028) score of the Free and Cued Selective Reminding test at baseline and at follow-up, a lower ET (p = 0.020) baseline score, a lower SS and MMSE level at follow-up than people who not worsened. About 71% of MCI subjects showed the same trend of evolution of the Mini-Mental State Examination and SS. Variables that significantly differed between groups have been inserted in a stepwise logistic regression to pilot explore predictors of affective and cognitive ToM evolution. Logistic regression showed ET at baseline (p = 0.015) as the only significant predictor of affective ToM evolution (R2 = 0.450), while both ET (p = 0.044) and memory performance (p = 0.045) at baseline significantly predicted cognitive ToM evolution (R2 = 0.746).

DISCUSSION

In conclusion, our results support the role of affective ToM as a residual mentalizing ability in preserving the mentalizing level in people with aMCI.

Beyond the three-chamber test: toward a multimodal and objective assessment of social behavior in rodents

MAIN: In recent years, substantial advances in social neuroscience have been realized, including the generation of numerous rodent models of autism spectrum disorder. Still, it can be argued that those methods currently being used to analyze animal social behavior create a bottleneck that significantly slows down progress in this field. Indeed, the bulk of research still relies on a small number of simple behavioral paradigms, the results of which are assessed without considering behavioral dynamics. Moreover, only few variables are examined in each paradigm, thus overlooking a significant portion of the complexity that characterizes social interaction between two conspecifics, subsequently hindering our understanding of the neural mechanisms governing different aspects of social behavior. We further demonstrate these constraints by discussing the most commonly used paradigm for assessing rodent social behavior, the three-chamber test. We also point to the fact that although emotions greatly influence human social behavior, we lack reliable means for assessing the emotional state of animals during social tasks. As such, we also discuss current evidence supporting the existence of pro-social emotions and emotional cognition in animal models. We further suggest that adequate social behavior analysis requires a novel multimodal approach that employs automated and simultaneous measurements of multiple behavioral and physiological variables at high temporal resolution in socially interacting animals. We accordingly describe several computerized systems and computational tools for acquiring and analyzing such measurements. Finally, we address several behavioral and physiological variables that can be used to assess socio-emotional states in animal models and thus elucidate intricacies of social behavior so as to attain deeper insight into the brain mechanisms that mediate such behaviors. CONCLUSIONS: In summary, we suggest that combining automated multimodal measurements with machine-learning algorithms will help define socio-emotional states and determine their dynamics during various types of social tasks, thus enabling a more thorough understanding of the complexity of social behavior.

Dance movement therapy for neurodegenerative diseases: A systematic review

Background

The proportion of the world's elderly population continues to rise, and the treatment and improvement of neurodegenerative diseases have become issue of public health importance as people live longer and many countries have aging populations. This systematic review aims to discuss the effects of dance movement therapy (DMT) on motor function, cognitive deficit, mood, and quality of life in people with neurodegenerative diseases, such as Parkinson's disease (PD), mild cognitive impairment (MCI), Alzheimer's disease (AD).

Methods

Two reviewers independently conducted systematic search on the Cochrane library, PubMed database, Web of Science Core Collection database, and Physiotherapy Evidence database until February 1, 2022. Only systematic analyses and randomized controlled trials were included and further analyzed.

Results

Thirty-three studies on PD, 16 studies on MCI, 4 studies on AD were obtained. This systematic review found that DMT substantially improved the global cognitive function, memory, and executive function on the population with MCI. Compared with the non-dance group, DMT remarkably improved general disease condition, balance, and gait for individuals with PD. The evidence of the efficacy of DMT on AD is insufficient, and further research is needed.

Conclusion

DMT can effectively improve the motor function and cognitive deficits in neurodegenerative diseases. Positive effects of DMT on the mood and quality of life in ND patients are controversial and require further evidence. Future research on the effects of DMT on AD requires scientific design, large sample size, long-term comprehensive intervention, and clear reporting standards.

Systematic review registration

www.osf.io/wktez, identifier: 10.17605/OSF.IO/UYBKT.

Measuring cognitive and affective Theory of Mind with the Italian Yoni task: normative data and short versions

Theory of Mind (ToM), a high-order human social cognition skill, is relevant for mental health and wellbeing and frequently impaired in many clinical conditions. To detect ToM difficulties, validated and standardized measures need to be adopted in clinical practice. The Yoni task provides a comprehensive evaluation of first-order, second-order, affective and cognitive mentalistic inferences. However, the Yoni task remains a time-demanding tool without normative data. To fill this gap, we explored the convergent and discriminant validity, the inter-item reliability and provided normative data of the Italian version of the Yoni task (98 items), and developed two short versions (48 and 36 items). For the validation, internal consistency and convergent/discriminant validity have been considered. Then, the effects of demographical variables on 98 item Yoni were explored, and normative data were provided. Our data demonstrated high reliability and a good convergent validity in all the Yoni versions. Then, two composite scores were proposed to obtain: 1) a global ToM level and 2) the balance between affective and cognitive ToM components, whose alteration represents a signature of several clinical conditions. The future standardization of the short versions of Yoni will allow a comprehensive and quick examination of ToM abilities, suitable for both research and clinical settings.

Social Cognition in Adult ADHD: A Systematic Review

The aim of this systematic review was to collect and align the research on social cognition impairments in adults with Attention-deficit/hyperactivity disorder (ADHD). In particular, we selected and analyzed papers on emotion recognition and processing, Theory of Mind (TOM), empathy, and other facets of social cognition as decision making. We identified 16 papers published between 2012 and 2022 which meet inclusion criteria. Papers search, selection, and extraction followed the PRISMA guidelines. In order to summarize data from papers, we used a narrative synthesis approach. Results show different evidence of impairment in social cognition domains in adults with ADHD. Our systematic review suggests the importance of promoting more research on this topic because it is essential to keep in mind that social cognition plays a central role in socialization and social relationships.

Spiritual care for the management of Parkinson's disease: Where we are and how far can we go

An increasing number of studies have investigated the neural networks and brain regions activated by different aspects of religious faith or spiritual practice. The extent to which religiousness and spirituality are dependent on the integrity of neural circuits is a question unique to neurological illnesses. Several studies have reported that neural networks and brain areas represent the various components of religious faith or spiritual activity in recent decades. In addition to research in healthy people, another strategy is to observe if neurological abnormalities caused by stroke, tumour, brain damage, or degenerative sickness are accompanied by an alteration in religiosity or spirituality. Similarly, Parkinson's disease (PD), an ailment characterized by dopaminergic neuron malfunction, has been utilized to explore the role of dopaminergic networks in the practice, experience, and maintenance of religious or spiritual beliefs. Case-control and priming studies have demonstrated a decline in spirituality and religion in people with PD due to dopaminergic degeneration. These studies could not adequately control for confounding variables and lacked methodological rigour. Using qualitative and quantitative assessments, a mixed-method approach might shed additional light on putative religious beliefs alterations in PD. In the current review paper, we discussed the recent research on the impact of PD on spiritual beliefs and spirituality.

Metabolic disturbances, hemoglobin A1c, and social cognition impairment in Schizophrenia spectrum disorders

Social cognitive impairments are core features of schizophrenia spectrum disorders (SSD) and are associated with greater functional impairment and decreased quality of life. Metabolic disturbances have been related to greater impairment in general neurocognition, but their relationship to social cognition has not been previously reported. In this study, metabolic measures and social cognition were assessed in 245 participants with SSD and 165 healthy comparison subjects (HC), excluding those with hemoglobin A1c (HbA1c) > 6.5%. Tasks assessed emotion processing, theory of mind, and social perception. Functional connectivity within and between social cognitive networks was measured during a naturalistic social task. Among SSD, a significant inverse relationship was found between social cognition and cumulative metabolic burden (β = -0.38, p < 0.001) and HbA1c (β = -0.37, p < 0.001). The relationship between social cognition and HbA1c was robust across domains and measures of social cognition and after accounting for age, sex, race, non-social neurocognition, hospitalization, and treatment with different antipsychotic medications. Negative connectivity between affect sharing and motor resonance networks was a partial mediator of this relationship across SSD and HC groups (β = -0.05, p = 0.008). There was a group x HbA1c effect indicating that SSD participants were more adversely affected by increasing HbA1c. Thus, we provide the first report of a robust relationship in SSD between social cognition and abnormal glucose metabolism. If replicated and found to be causal, insulin sensitivity and blood glucose may present as promising targets for improving social cognition, functional outcomes, and quality of life in SSD.

Eye-gaze Strategies During Facial Emotion Recognition in Neurodegenerative Diseases and Links With Neuropsychiatric Disorders

BACKGROUND

Facial emotion recognition (FER) is primarily and severely impaired in individuals with the behavioral variant of frontotemporal dementia (bvFTD) and is often mildy impaired in individuals with Alzheimer disease (AD) or Parkinson disease (PD). Such impairment is associated with inappropriate social behaviors.

OBJECTIVE

To determine whether FER impairment is linked to the use of inappropriate eye-gaze strategies to decode facial emotions, leading to misinterpretation of others' intentions and then to behavioral disorders.

METHOD

We assessed FER in 9 individuals with bvFTD, 23 with AD, and 20 with PD, as well as 22 healthy controls (HC), using the Reading the Mind in the Eyes (RME) Test and the Ekman Faces Test. Eye movements (number and duration of fixations) were recorded with an eye-tracking device. Behavior was assessed using the Neuropsychiatric Inventory.

RESULTS

FER was mildly impaired in the AD and PD groups and severely impaired in the bvFTD group. FER impairment was accompanied by an increase in the number of fixations and a more attracted gaze toward the lower part of one's face. FER impairment and an increase in the number of fixations were positively correlated with behavioral disorders.

CONCLUSION

Our study demonstrated a link between FER impairment, modification of eye-gaze strategies during the observation of emotional faces, and behavioral disorders in individuals with bvFTD and those with AD or PD. These results suggest that an eye-gaze strategy rehabilitation program could have beneficial effects on emotion recognition and behavioral disorders in individuals with these diseases.

Social ageing: exploring the drivers of late-life changes in social behaviour in mammals

Social interactions help group-living organisms cope with socio-environmental challenges and are central to survival and reproductive success. Recent research has shown that social behaviour and relationships can change across the lifespan, a phenomenon referred to as 'social ageing'. Given the importance of social integration for health and well-being, age-dependent changes in social behaviour can modulate how fitness changes with age and may be an important source of unexplained variation in individual patterns of senescence. However, integrating social behaviour into ageing research requires a deeper understanding of the causes and consequences of age-based changes in social behaviour. Here, we provide an overview of the drivers of late-life changes in sociality. We suggest that explanations for social ageing can be categorized into three groups: changes in sociality that (a) occur as a result of senescence; (b) result from adaptations to ameliorate the negative effects of senescence; and/or (c) result from positive effects of age and demographic changes. Quantifying the relative contribution of these processes to late-life changes in sociality will allow us to move towards a more holistic understanding of how and why these patterns emerge and will provide important insights into the potential for social ageing to delay or accelerate other patterns of senescence.

Social Cognition in Patients with Amnestic Mild Cognitive Impairment and Mild Dementia of the Alzheimer Type

BACKGROUND

Social cognition (SC) is a core criterion for neurocognitive disorders. However, findings in patients with amnestic mild cognitive impairment (aMCI) and dementia of the Alzheimer type (DAT) are inconsistent.

OBJECTIVE

We report assessments of emotion recognition (ER), affective and cognitive theory of mind (ToM) in young (YC) and older controls (OC) compared to aMCI and DAT.

METHODS

28 aMCI, 30 DAT, 30 YC, and 29 OC received tests of SC and a comprehensive neuropsychological assessment. Analysis of covariance was used to determine group differences. Multiple regression models were applied to identify predictors for each SC task.

RESULTS

In controls, OC performed worse in ER and both ToM tasks compared to YC except for one subtest. No significant differences were found between OC and patients concerning ER and affective ToM. In cognitive ToM, differences between OC and patients depended on content and cognitive load with significant impairment in DAT compared to OC. A cognitive composite score predicted SC in OC, but not in patients. Associations of SC with single cognitive domains were found in all groups with language and complex attention as best predictors. Not all variance of SC performance was explained by variance in cognitive domains.

CONCLUSION

Lower performance on SC tasks in OC versus YC was confirmed, although not all tasks were equally affected. With progressive cognitive impairment, cognitive ToM is more impaired than ER or affective ToM. SC seems to be at least partly independent of other cognitive domains, justifying its inclusion in batteries for dementia diagnostic.

Research on Emotion Recognition and Dementias: Foundations and Prospects

BACKGROUND

The study of emotion recognition could be crucial for detecting alterations in certain cognitive areas or as an early sign of neurological disorders.

OBJECTIVE

The main objective of the study is to characterize research development on emotion recognition, identifying the intellectual structure that supports this area of knowledge, and the main lines of research attracting investigators' interest.

METHODS

We identified publications on emotion recognition and dementia included in the Web of Science Core Collection, analyzing the scientific output and main disciplines involved in generating knowledge in the area. A co-citation analysis and an analysis of the bibliographic coupling between the retrieved documents elucidated the thematic orientations of the research and the reference works that constitute the foundation for development in the field.

RESULTS

A total of 345 documents, with 24,282 bibliographic references between them, were included. This is an emerging research area, attracting the interest of investigators in Neurosciences, Psychology, Clinical Neurology, and Psychiatry, among other disciplines. Four prominent topic areas were identified, linked to frontotemporal dementia, autism spectrum disorders, Alzheimer's disease, and Parkinson's and Huntington disease. Many recent papers focus on the detection of mild cognitive impairment.

CONCLUSION

Impaired emotion recognition may be a key sign facilitating the diagnosis and early treatment of different neurodegenerative diseases as well as for triggering the necessary provision of social and family support, explaining the growing research interest in this area.

Reading the Mind in the Eyes: A Population-Based Study of Social Cognition in Older Adults

BACKGROUND

Social cognition indicates the cognitive processes involved in perceiving, interpreting, and processing social information. Although it is one of the six core DSM-5 cognitive domains for diagnosing neurocognitive disorders, it is not routinely assessed in older adults. The Reading the Mind in the Eyes Test assesses Theory of Mind, the social cognition mechanism which forms the root of empathy.

OBJECTIVES

To describe the distribution of, and factors associated with, scores on a 10-item version of Reading the Mind in the Eyes Test (RMET-10) in older adults.

DESIGN

Population-based cross-sectional study.

SETTING

Small-town communities in Pennsylvania.

PARTICIPANTS

Adults aged 66-105 years (N = 902, mean age = 76.6).

MEASUREMENTS

The assessment included RMET-10, demographics, cognitive screening, literacy, depression symptoms, anxiety symptoms, cognitive composites derived from a neuropsychological test battery, Social Norms Questionnaire, and Clinical Dementia Rating (CDR).

RESULTS

RMET-10 score was normally distributed in our overall study sample. Normative RMET-10 scores among those rated as CDR = 0 were calculated by age, sex, and education. RMET-10 score was significantly higher with younger age, higher education, white race, higher cognitive screening scores, literacy, social norms scores, higher scores in all five domains in cognitive composites, and lower CDR. RMET-10 score was also significantly higher with fewer depression and anxiety symptoms after adjusting for demographics.

CONCLUSIONS

The RMET is a potentially useful measure of social cognition for use in the research assessment of older adults. With appropriate calibration it should also have utility in the clinical setting.

Affective empathy in neurodegenerative disorders: The importance of measurement type

In recent years, there has been increasing attention focused on affective empathy in neurodegenerative disorders (NDs). However, prior studies have identified discrepancies not only between, but sometimes within, specific NDs. These discrepancies may reflect methodological differences in how affective empathy has been operationalized, with three quite distinct approaches to assessment possible (self-report, informant-report and performance-based). Therefore, we conducted the first meta-analytic review of affective empathy in people with NDs, that considered the potential moderating role of measurement type. Across 27 studies that included 1456 people with NDs and 832 controls, the results showed that most NDs are associated with impaired affective empathy, but that the magnitude of these difficulties differs meaningfully across disorders. However, most importantly, the results indicated that measurement type is a critical consideration in this literature, with substantive differences emerging for self- versus informant-rated measures. These results are discussed in relation to their practical implications for clinical assessment, as well as how they help to inform current theoretical understanding of affective empathic processing.

Similar Theory of Mind Deficits in Community Dwelling Older Adults with Vascular Risk Profile and Patients with Mild Cognitive Impairment: The Case of Paradoxical Sarcasm Comprehension

Recent studies deal with disorders and deficits caused by vascular syndrome in efforts for prediction and prevention. Cardiovascular health declines with age due to vascular risk factors, and this leads to an increasing risk of cognitive decline. Mild cognitive impairment (MCI) is defined as the negative cognitive changes beyond what is expected in normal aging. The purpose of the study was to compare older adults with vascular risk factors (VRF), MCI patients, and healthy controls (HC) in social cognition and especially in theory of mind ability (ToM). The sample comprised a total of 109 adults, aged 50 to 85 years (M = 66.09, SD = 9.02). They were divided into three groups: (a) older adults with VRF, (b) MCI patients, and (c) healthy controls (HC). VRF and MCI did not differ significantly in age, educational level or gender as was the case with HC. Specifically, for assessing ToM, a social inference test was used, which was designed to measure sarcasm comprehension. Results showed that the performance of the VRF group and MCI patients is not differentiated, while HC performed higher compared to the other two groups. The findings may imply that the development of a vascular disorder affecting vessels of the brain is associated from its “first steps” to ToM decline, at least regarding specific aspects of it, such as paradoxical sarcasm understanding.

Alzheimer's Disease and Empathic Abilities: The Proposed Role of the Cingulate Cortex

In recent years there has been increasing interest in examining the role of empathic abilities in Alzheimer’s disease (AD). Empathy, the ability to understand and share another person’s feelings, implies the existence of emotional and cognitive processes and is a pivotal aspect for success in social interactions. In turn, self-empathy is oriented to one’s thoughts and feelings. Decline of empathy and self-empathy can occur during the AD continuum and can be linked to different neuroanatomical pathways in which the cingulate cortex may play a crucial role. Here, we will summarize the involvement of empathic abilities through the AD continuum and further discuss the potential neurocognitive mechanisms that contribute to decline of empathy and self-empathy in AD.

The mechanism of inhibitory control on the development of theory of mind in old age-based on the two-component model of psychological theory

OBJECTIVE

Based on the two-component model of theory of mind, the current study explored the cognitive and emotional theory of mind of the elderly by using false-belief pictures and eye-reading tasks respectively, and examined effects of inhibitory control on elderly adults' cognitive and emotional theory of mind.

METHOD

One-hundred twelve elderly participants were randomly recruited, and the control task, cognitive theory of mind, emotional theory of mind and the Stroop task were used.

RESULTS

The results showed the following: (1) Elderly adults' theory of mind decreased compared with that of young people; specifically, cognitive theory of mind showed an aging trend (aged above 75 years), while emotional theory of mind developed at a relatively gentle speed during old age; (2) Compared with young people, the inhibitory control of the elderly gently declined among those aged above 75 years; (3) Inhibitory control partially mediated the relationship between age and cognitive theory of mind.

CONCLUSION

The cognitive and emotional components of theory of mind in the elderly were distinct. It was difficult for the elderly to complete psychological tasks related to social cognition that required high inhibitory control; however, they could complete psychological tasks that did not require high inhibitory control.

High Prevalence of Social Cognition Disorders and Mild Cognitive Impairment Long Term After Stroke

PURPOSE

Social cognition disorders after stroke are poorly described. Yet, rehabilitation difficulties are frequent after stroke. This study aimed to evaluate the frequency of social cognition disorders 3 years after a first-ever stroke and to assess the factors associated with this condition. The second aim was to describe all the cognitive domains altered in the same population.

METHODS

Patients who suffered from a first-ever ischemic or hemorrhagic stroke underwent clinical and neuropsychological assessment, which included the mini-Social cognition and Emotional Assessment (SEA) for evaluating social cognition.

RESULTS

The 43 included patients were 67±15 years old, with a median Neurological Institute of Health Stroke Scale (NIHSS) (± interquartile range) at 0±1, and a median modified Rankin Scale (± interquartile range) at 1±1. Twenty patients (46.5%) had poor results in the facial emotions subtest; this factor was associated with a low educational grade (P=0.001). Fourteen patients (34.2%) had poor results on the "faux-pas" recognition subtest; this factor was associated with nonverbal episodic memory disorders (P=0.01). Thirty four patients (79.1%) had cognitive impairment, with at least 1 cognitive domain affected.

CONCLUSIONS

The study demonstrates the high frequency of social cognition impairment 3 years after the first-ever stroke in young patients. Doctors and nurses should be sensitized to cognitive handicap after stroke because of difficulties for rehabilitation and returning to work.

Social cognition and social functioning in patients with amnestic mild cognitive impairment or Alzheimer's dementia

The aim of the present study was to examine social cognition and social functioning in a group of amnestic mild cognitive impairment (aMCI) and Alzheimer’s dementia (AD) patients. Thirty one people with aMCI, 29 individuals with AD, and 45 healthy older adults participated in the study. Facial expressions of happiness, anger, fear, disgust, and surprise presented in different intensities had to be labelled. Mentalizing was assessed using first‐order belief theory of mind (ToM) stories and everyday social functioning by the Inventory of Interpersonal Situations (IIS), completed by an informant. aMCI patients were impaired in recognizing the emotions anger, disgust, and fear, while AD patients were impaired in recognizing the emotions anger, disgust, and surprise. More importantly, no significant differences between aMCI and AD patients were found on overall emotion recognition. Both the aMCI and AD patients were impaired on the ToM task, but no differences between the aMCI and AD patients were found. On everyday social functioning, only the AD patients showed impairments. No associations between the IIS and ToM were found, but the IIS and emotion perception were significantly correlated. Regression analysis taking all potentially confounding variables into account showed that only mood, but not the social‐cognitive task performance or any other cognitive variable, predicted social functioning. aMCI and AD patients demonstrated impairments in mentalizing and facial emotion perception, and showed decrements in everyday social functioning. Informing caregivers about these deficits may help them to understand deficits in social cognition that may be present already in the MCI stage of Alzheimer’s disease.

Association of Epigenetic Metrics of Biological Age With Cortical Thickness

IMPORTANCE

Magnetic resonance imaging (MRI) studies of aging adults have shown substantial intersubject variability across various brain metrics, and some of this variability is likely attributable to chronological age being an imprecise measure of age-related change. Accurately quantifying one's biological age could allow better quantification of healthy and pathological changes in the aging brain.

OBJECTIVE

To investigate the association of DNA methylation (DNAm)-based biological age with cortical thickness and to assess whether biological age acceleration compared with chronological age captures unique variance in cortical thinning.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used high-resolution structural brain MRI data collected from a sample of healthy aging adults who were participating in a larger ongoing neuroimaging study that began in May 2014. This population-based study accrued participants from the greater Omaha, Nebraska, metropolitan area. One hundred sixty healthy adults were contacted for the MRI component, 82 of whom participated in both DNAm and MRI study components. Data analysis was performed from March to June 2019.

MAIN OUTCOMES AND MEASURES

Vertexwise cortical thickness, DNAm-based biological age, and biological age acceleration compared with chronological age were measured. A pair of multivariable regression models were computed in which cortical thickness was regressed on DNAm-based biological age, controlling for sex in the first model and also controlling for chronological age in the second model.

RESULTS

Seventy-nine adult participants (38 women; mean [SD] age, 43.82 [14.50] years; age range, 22-72 years) were included in all final analyses. Advancing biological age was correlated with cortical thinning across frontal, superior temporal, inferior parietal, and medial occipital regions. In addition, biological age acceleration relative to chronological age was associated with cortical thinning in orbitofrontal, superior and inferior temporal, somatosensory, parahippocampal, and fusiform regions. Specifically, for every 1 year of biological age acceleration, cortical thickness would be expected to decrease by 0.024 mm (95% CI, -0.04 to -0.01 mm) in the left orbitofrontal cortex (partial r, -0.34; P = .002), 0.014 mm (95% CI, -0.02 to -0.01 mm) in the left superior temporal gyrus (partial r, -0.36; P = .001), 0.015 mm (95% CI, -0.02 to -0.01 mm) in the left fusiform gyrus (partial r, -0.38; P = .001), 0.015 mm (95% CI, -0.02 to -0.01 mm) in the right fusiform gyrus (partial r, -0.43; P < .001), 0.019 mm (95% CI, -0.03 to -0.01 mm) in the right inferior temporal sulcus (partial r, -0.34; P = .002), and 0.011 mm (95% CI, -0.02 to -0.01 mm) in the right primary somatosensory cortex (partial r, -0.37; P = .001).

CONCLUSIONS AND RELEVANCE

To our knowledge, this is the first study to investigate vertexwise cortical thickness in relation to DNAm-based biological age, and the findings suggest that this metric of biological age may yield additional insight on healthy and pathological cortical aging compared with standard measures of chronological age alone.

Cognitive and Affective Theory of Mind in Healthy Aging

BACKGROUND

Previous studies on the effect of healthy aging on Theory of Mind (ToM) have produced mixed results. A possible explanation may be that different ToM components and types of inference have not systematically been considered. This study examined the effect of aging on ToM by assessing both first and second order cognitive and affective components within a single task.

METHODS

We compared performance of young (M = 18.3y) and older adults (M = 61.0y) on the Yoni task. This task allows for a within-subject assessment of both first and second order cognitive and affective ToM.

RESULTS

We observed that older adults had longer reaction times than young adults across cognitive and affective first order items. For second order items, this age difference was larger for affective than cognitive items. Results showed no indications that these findings could be explained by age differences in speed/accuracy trade-offs.

CONCLUSION

Our findings suggest that decision processes underlying ToM are slower in older adults on both first and second order inferences, but that age differences in these processes between cognitive and affective ToM are selective to second order inferences. We propose that the observed age differences may be associated with cortical and mental changes that occur with aging.

Social Cognition in Rehabilitation Context: Different Evolution of Affective and Cognitive Theory of Mind in Mild Cognitive Impairment

Maintaining social skills such as Theory of Mind (ToM) competences is important to counteract the conversion into dementia in Mild Cognitive Impairment (MCI). Multidimensional nonpharmacological interventions demonstrated their potential in improving cognitive and behavioral abilities; however, little is known about the long-term effect of such interventions on social skills in people with MCI. The aim of this longitudinal study was to monitor ToM competences considering both cognitive and affective domains in an amnestic MCI (aMCI) sample involved in a home-based multistimulation treatment (MST@H). 30 aMCI subjects (M : F = 15 : 15; mean age ± SD = 77.00 ± 4.60) were enrolled, and three steps of evaluation with neuropsychological tests and ToM tasks have been implemented. 21 healthy controls (HC) were also included (M : F = 9 : 12; mean age ± SD = 74.95 ± 3.88) to characterize the aMCI sample regarding differences in ToM performance compared to HC at the baseline evaluation. Our results show that the aMCI group statistically significantly underperformed the HC group only in the advanced ToM tasks, confirming an initial decline of high-level ToM competences in this population. The longitudinal evaluation revealed time changes not only in some subcognitive domains of MoCA (memory and executive functions) but also in cognitive and affective ToM dimensions in aMCI subjects. Our findings suggest that cognitive and affective ToM can be considered useful outcome measures to test the long-term effect of treatment over time.

Executive Functions do not Underlie Performance on the Edinburgh Social Cognition Test (ESCoT) in Healthy Younger and Older Adults

OBJECTIVE

Current measures of social cognition have shown inconsistent findings regarding the effects of executive function (EF) abilities on social cognitive performance in older adults. The psychometric properties of the different social cognition tests may underlie the disproportional overlap with EF abilities. Our aim was to examine the relationship between social cognition and EF abilities using the Edinburgh Social Cognition Test (ESCoT; Baksh, R.A., Abrahams, S., Auyeung, B., & MacPherson, S.E. (2018). The Edinburgh Social Cognition Test (ESCoT): Examining the effects of age on a new measure of theory of mind and social norm understanding. PloS One, 13(4), e0195818.), a test assessing four different aspects of social cognition: cognitive theory of mind (ToM), affective ToM, interpersonal understanding of social norms, and intrapersonal understanding of social norms.

METHOD

We administered the ESCoT, EF measures of inhibition, set shifting, updating, and a measure of processing speed to 30 younger and 31 older adults. We also administered the Visual Perspective Taking task (VPT) as a ToM test thought to be reliant on EF abilities.

RESULTS

Better performance on cognitive ToM was significantly associated with younger age and slower processing speed. Better performance on affective ToM and ESCoT total score was associated with being younger and female. Better performance on interpersonal understanding of social norms was associated with being younger. EF abilities did not predict performance on any subtest of the ESCoT. In contrast, on the VPT, the relationship between age group and performance was fully or partially mediated by processing speed and updating.

CONCLUSIONS

These findings show that the ESCoT is a valuable measure of different aspects of social cognition and, unlike many established tests of social cognition, performance is not predicted by EF abilities.

Theory of Mind Performance Predicts tDCS-Mediated Effects on the Medial Prefrontal Cortex: A Pilot Study to Investigate the Role of Sex and Age

Transcranial Direct Current Stimulation (tDCS) has become an increasingly promising tool for understanding the relationship between brain and behavior. The purpose of this study was to investigate whether the magnitude of sex- and age-related tDCS effects previously found in the medial prefrontal cortex (mPFC) during a Theory of Mind (ToM) task correlates with social cognition performance; in particular, we explored whether different patterns of activity would be detected in high- and low-performing participants. For this, young and elderly, male and female participants were categorized as a low- or high-performer according to their score on the Reading the Mind in the Eyes task. Furthermore, we explored whether sex- and age-related effects associated with active tDCS on the mPFC were related to cognitive functioning. We observed the following results: (i) elderly participants experience a significant decline in ToM performance compared to young participants; (ii) low-performing elderly females report slowing of reaction time when anodal tDCS is applied over the mPFC during a ToM task; and (iii) low-performing elderly females are characterized by lower scores in executive control functions, verbal fluency and verbal short-term memory. The relationship between tDCS results and cognitive functioning is discussed in light of the neuroscientific literature on sex- and age-related differences.

Age-variant and age-invariant features of functional brain organization in middle-aged and older autistic adults

Background

The majority of research effort into autism has been dedicated to understanding mechanisms during early development. As a consequence, research on the broader life course of an autism spectrum condition (ASC) has largely been neglected and almost nothing is known about ASC beyond middle age. Differences in brain connectivity that arise during early development may be maintained across the lifespan and may play protective or detrimental roles in older age.

Method

This study explored age-related differences in functional connectivity across middle and older age in clinically diagnosed autistic adults (n = 44, 30-73 years) and in an age-matched typical comparison group (n = 45).

Results

The results indicated parallel age-related associations in ASC and typical aging for the local efficiency and connection strength of the default mode network and for the segregation of the frontoparietal control network. In contrast, group differences in visual network connectivity are compatible with a safeguarding interpretation of less age-related decline in brain function in ASC. This divergence was mirrored in different associations between visual network connectivity and reaction time variability in the ASC and comparison group.

Limitations

The study is cross-sectional and may be affected by cohort effects. As all participants received their autism diagnosis in adulthood, this might hinder generalizability.

Conclusion

These results highlight the complexity of aging in ASC with both parallel and divergent trajectories across different aspects of functional network organization.

Aging, sex and cognitive Theory of Mind: a transcranial direct current stimulation study

Aging is accompanied by changes in cognitive abilities and a great interest is spreading among researchers about aging impact on social cognition skills, such as the Theory of Mind (ToM). Transcranial direct current stimulation (tDCS) has been used in social cognition studies founding evidence of sex-related different effects on cognitive ToM task in a young people sample. In this randomized, double-blind, sham-controlled study, we applied one active and one sham tDCS session on the medial prefrontal cortex (mPFC) during a cognitive ToM task, including both social (i.e., communicative) and nonsocial (i.e., private) intention attribution conditions, in sixty healthy aging individuals (30 males and 30 females). In half of the participants the anode was positioned over the mPFC, whereas in the other half the cathode was positioned over the mPFC. The results showed that: (i) anodal tDCS over the mPFC led to significant slower reaction times (vs. sham) for social intention attribution task only in female participants; (ii) No effects were found in both females and males during cathodal stimulation. We show for the first time sex-related differences in cognitive ToM abilities in healthy aging, extending previous findings concerning young participants.

Awareness of disease in Alzheimer's disease: what do patients realize about their own condition?

Objective: We aim to assess different objects of awareness of disease of people with Alzheimer's disease (AD) in mild and moderate stages Method: Semi-structured interviews were conducted with 34 participants with AD and qualitative analyses were used to analyze the participants' reports. Results: Cognitive impairment was the most peserved area of awareness. The participants' explanations were mainly categorized as biological/genetic and psychosocial causes. Also, awareness of social/emotional functioning and interpersonal relationships were generally well-preserved in this group. Among those who noticed some alterations in social life, there were reports of the feeling of being exposed and how some cognitive symptoms interfere with their functioning. In the emotional state domains, most of the participants reported more sadness than before the onset of dementia. Although most participants noticed a change in routine and the impact on daily life, many did not notice the need of help for general tasks. Conclusion: Our results underpin that most people with AD were able to provide their own subjective report of their experience of living with a disease. Participants' self-reports demonstrated the differences across domains, and this information may contribute to a better understanding of awareness of disease in AD.

Eye contact effects on social preference and face recognition in normal ageing and in Alzheimer's disease

Perceiving a direct gaze (i.e. another individual's gaze directed to the observer leading to eye contact) influences positively a wide range of cognitive processes. In particular, direct gaze perception is known to stimulate memory for other's faces and to increase their likeability. Alzheimer's disease (AD) results in social withdrawal and cognitive decline. However, patients show preserved eye contact behaviours until the middle stage of the disease. The eye contact effects could be preserved in AD and be used to compensate for cognitive and social deficits. Yet, it is unknown whether these effects are preserved in normal ageing. The aim of this study was to address whether the positive effects of eye contact on memory for faces and likeability of others are preserved in healthy older adults and in patients with early to mild AD. Nineteen AD patients, 20 older adults and 20 young adults participated in our study. Participants were first presented with faces displaying either direct or averted gaze and rated each face's degree of likeability. They were then asked to identify the faces they had previously seen during a surprise recognition test. Results showed that the effect of eye contact on other's likeability was preserved in normal ageing and in AD. By contrast, an effect of eye contact on memory for faces seems to emerge only in young participants, suggesting that this effect declines with ageing. Interestingly, however, AD patients show a positive correlation between ratings of likeability and recognition scores, suggesting that they implicitly allocated their encoding resources to most likeable faces. These results open a new way for a "compensating" therapy in AD.

What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations

Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.

Study of the theory of mind in normal aging: focus on the deception detection and its links with other cognitive functions

Detection of deception is crucial to avoid negative circumstances (financial frauds, social tricks) in daily living. Considering that this cognitive function is especially supported by the prefrontal cortex of the human brain and that these cerebral regions change with advanced age, deception detection may also change with aging. Our purpose is to study this complex ability and its potential links with other cognitive functions, such as the executive control, in normal aging. Thirty-five young adults (YA) aged from 20 to 40, thirty-five old adults (OA) aged from 65 to 79 and thirty very old adults (VOA) aged from 80 to 95 were involved in this study. We propose a novel neuropsychological test (inspired by Theory of Mind Picture Story task) assessing the ability to understand deceptive and cooperative interactions, and tasks involving executive processes (monitoring, task setting, flexibility) to all participants. Between-group analyses show that older participants performed worse than YA on deceptive, cooperative and mixed situations (involving deception and reciprocity) of our task. Significant correlations exist between the deception-cooperation detection and the executive functions. Our results show that these frontal abilities decline after 65 years, even more after 80 years, and they are involved on the deceptive-cooperative situations. The verbal IQ is also linked with the deception-cooperation detection. This suggests that mixed cognitive trainings would allow older adults to detect more easily bad intentions of others, to adjust their behavior to context and to achieve their goals with less risk.

Frontal Lobe Functions in Normal Aging: Metacognition, Autonomy, and Quality of Life

BACKGROUND

Starting from the "frontal lobe hypothesis of cognitive aging", we aim to study the metacognitive functions (deception, reciprocity, cognitive and affective theory of mind), autonomy and quality of life in normal aging.

METHODS

Eighty healthy subjects (30 young adults [YA] aged 20-40, 30 old adults [OA] aged 65-79 and 20 very old adults [VOA] aged 80 and over) participated in our study. Standard and novel neuropsychological tasks have been used, assessing abilities to understand others' mental and affective states, deceptive and cooperative situations.

RESULTS

OA and VOA's performances are significantly poorer than those of YA on first-/second-order false beliefs, deception, reciprocity and emotion recognition tasks. VOA have made more errors than other participants on control false beliefs, general cognition, and memory tasks. Normal aging seems also to be characterized by a reduction in processing speed. The level of instrumental activities of daily living decreases with aging. Theory of mind is associated with individual general cognitive state and executive functions, but not with OA and VOA's levels of autonomy and quality of life.

CONCLUSION

In this study, we have shown an age-related deterioration of metacognitive functions, which does not seem to be associated with old adults' autonomy and satisfaction of life. A good level of mental activity could be necessary to maintain satisfactory interpersonal relationships.

Empathy In Neurodegenerative Diseases: A Systematic Review

INTRODUCTION

Empathy, in its affective and cognitive components, is a crucial interpersonal ability. It is broadly studied in the field of psychopathology, whereas its study in the neurodegenerative diseases is relatively recent. Existing literature, though, focused on a reduced subset of considered diseases, which often found a compromise in empathy abilities. Organized knowledge about a more comprehensive set of diseases is lacking.

METHOD

The present PRISMA systematic review was aimed at collecting the current available literature concerning empathic alterations in adult patients affected by neurodegenerative diseases. It considered the different empathy components, evaluated existing patterns, the impact on patients' lives, and treatment considerations.

RESULTS

Overall, the 32 retrieved studies describe a spread deterioration of empathic abilities in patients, with each disease displaying its own pattern of empathy functioning. Literature in this field is fragmented and of heterogeneous quality, and further studies are warranted to increase evidence of many preliminary results.

DISCUSSION

In conclusion, we highlight the crucial importance of acknowledging empathy deficits in these diseases, showing their repercussion on both patients' and caregivers' quality of life, the establishment of a functional doctor-patient relationship, and the development of efficacious psychological intervention. These clinical approaches can be enriched by the knowledge of the spared abilities of patients affected by neurodegenerative diseases.

Plasticity in older adults' theory of mind performance: the impact of motivation

OBJECTIVE

Recently, motivation has been found to attenuate the age-related decline in Theory of Mind (ToM) performance (i.e. faux pas recognition). However, whether or not this effect could be generalized to other ToM tasks is still unknown. In the present study, we investigated whether and how motivation could enhance older adults' performance and reduce age differences in ToM tasks (Faux Pas vs. Animation task) that differ in familiarity.

METHOD

Following a previous paradigm, 171 Chinese adults (87 younger adults and 84 older adults) were recruited, and we experimentally manipulated the level of perceived closeness between participants and the experimenter before administering the ToM tasks in order to enhance participants' motivation.

RESULTS

Results showed that, for the Faux Pas task, we replicated previous findings such that older adults under the enhanced motivation conditions performed equally well as younger adults. Conversely, for the Animation task, younger adults outperformed older adults, regardless of motivation.

DISCUSSION

These results indicate that motivation can enhance older adults' performance in ToM tasks, however, this beneficial effect cannot be generalized across ToM tasks.

Cognitive and Affective Theory of Mind in Mild Cognitive Impairment and Parkinson's Disease: Preliminary Evidence from the Italian Version of the Yoni Task

The aim of the study was to explore cognitive and affective dimensions of ToM using the computerized Yoni task in participants with amnestic Mild Cognitive Impairment (aMCI=16), early stage of Parkinson's Disease (PD=14), and healthy controls (HC=18) Results demonstrated that the Yoni task was effective in discriminating between groups in 1^th order cognitive dimension (MCI<PD=HC, p_corr<.05), and in 2^nd order cognitive and affective dimensions (MCI<HC, p_corr <.05), highlighting a reduced ToM performance also in people with PD (MCI<PD<HC, p_corr <.05). Thus, the Yoni task represents a sensitive tool for detecting different dimensions of ToM impairment, across different clinical conditions.

The Edinburgh Social Cognition Test (ESCoT): Examining the effects of age on a new measure of theory of mind and social norm understanding

Current measures of social cognition have shown inconsistent findings regarding the effects of healthy aging. Moreover, no tests are currently available that allow clinicians and researchers to examine cognitive and affective theory of mind (ToM) and understanding of social norms within the same test. To address these limitations, we present the Edinburgh Social Cognition Test (ESCoT) which assesses cognitive and affective ToM and inter- and intrapersonal understanding of social norms. We examined the effects of age, measures of intelligence and the Broader Autism Phenotype (BAP) on the ESCoT and established tests of social cognition. Additionally, we investigated the convergent validity of the ESCoT based on traditional social cognition measures. The ESCoT was administered alongside Reading the Mind in Films (RMF), Reading the Mind in Eyes (RME), Judgement of Preference and Social Norm Questionnaire to 91 participants (30 aged 18–35 years, 30 aged 45–60 years and 31 aged 65–85 years). Poorer performance on the cognitive and affective ToM ESCoT subtests were predicted by increasing age. The affective ToM ESCoT subtest and RMF were predicted by gender, where being female predicted better performance. Unlike the ESCoT, better performance on the RMF was predicted by higher verbal comprehension and perceptual reasoning abilities, while better performance on the RME was predicted by higher verbal comprehension scores. Lower scores on inter-and intrapersonal understanding of social norms were both predicted by the presence of more autism-like traits while poorer interpersonal understanding of social norms performance was predicted by increasing age. These findings show that the ESCoT is a useful measure of social cognition and, unlike established tests of social cognition, performance is not predicted by measures of verbal comprehension and perceptual reasoning. This is particularly valuable to obtain an accurate assessment of the influence of age on our social cognitive abilities.

Social Cognition in the Frontal Variant of Alzheimer's Disease: A Case Study

Although frontal presentations of Alzheimer's disease (fv-AD) have already been described in the literature, we still know little about patients' social cognitive abilities, especially their theory of mind (ToM). We report the case of FT, a 61-year-old woman who was diagnosed with fv-AD. Two assessments of social cognition, using a false-belief task, the Reading the Mind in the Eyes test, and a task probing knowledge of social norms, were performed one year apart. FT exhibited cognitive ToM and social knowledge deficits from the onset. Affective ToM was initially preserved, but deteriorated as the disease progressed.

The Relationship Between Social Cognition and Awareness in Alzheimer Disease

A large body of evidence highlights the social cognitive impairment in neurodegenerative diseases such Alzheimer disease (AD). This study investigated the relationship among social and emotional functioning (SEF), awareness of disease, and other clinical aspects in people with AD (PwAD). A consecutive series of 50 people with mild to moderate AD and their 50 family caregivers were assessed. There was a significant difference between self-rated SEF and informant-rated SEF. In 56% of PwAD, self-rated SEF is lower than informant-rated SEF. People with AD mostly presented with mildly impaired awareness of the disease (56%), 20% had moderately impaired awareness of the disease, and 6% were unaware of the disease. The multivariate linear regression showed that informant-rated SEF was related to the social functioning, and relationships, domains of awareness of disease, and the PwAD informant-rated quality of life. The relationship between SEF and awareness of social functioning and relationship domain shows that they are comprised of judgments related to perceptions about oneself, values, and beliefs qualitatively different from awareness of memory or functionality, which can be directly observed.

Inefficient understanding of non-factive mental verbs with social aspect in adults: comparison to cognitive factive verb processing

INTRODUCTION

Mental verbs denote inner mental states and are an important link between language and Theory of Mind ability conceptualized as mental state understanding. Non-factive mental verbs denote an obligation or intention and constitute a discrete class of mental verbs which are characterized by their social aspect. This study aimed to examine adults' ability to understand non-factive mental verbs with the social aspect as compared to cognitive factive mental verbs which denote a true event.

METHODS

A total of 94 participants, aged 18-95 years, were examined using two tasks measuring non-factive and factive verb processing, respectively, and a working memory test.

RESULTS

The results indicated that non-factive verbs process is at a significantly lower level than those of cognitive factives.

CONCLUSION

The inspection of the way adapted to process the non-factive verbs denoting obligation or intention, as well as the confirmation of a unifactorial structure of the task developed to measure non-factives' processing, showed that adults have a common pattern of non-factive mental verb understanding, which is based on heuristic ways of thinking and is not affected by working memory capacity and age.