Visual exploration of facial emotion by healthy older adults and patients with Alzheimer disease

OBJECTIVE

The purpose of this study was to investigate eye movement patterns of patients with Alzheimer disease (AD) and healthy older adults while viewing photographs of facial expression.

BACKGROUND

Individuals with Alzheimer disease appear to have deficits in emotion perception, but the underlying mechanisms are not understood well. It is not known whether individuals with AD visually explore facial stimuli and extract information needed to make emotion identification from faces in the same way as do healthy older adults.

METHOD

Seventeen AD patients and 15 older adult control patients were shown faces that depicted different emotions and were asked to identify the emotion displayed from two alternatives. The eye movements of participants were recorded during the emotion identification task.

RESULTS

No differences were seen between AD patients and older adult controls regarding their accuracy of emotion identification. However, AD patients differed from older adult controls on eye movement patterns during the emotion identification task. Alzheimer disease patients fixated less on the face and, in particular, on the eyes. Alzheimer disease patients also spent more time viewing areas off the face. There was no relationship between the severity of cognitive impairment and emotion identification or eye movement patterns.

CONCLUSIONS

Although the AD patients and older adult controls showed similar accuracy for the emotion identification task, their visual processing strategies differed. Relative to older adult controls, AD patients fixated less on discriminating regions and attended more to irrelevant aspects of stimuli. The eye movement differences were particularly evident in AD patients who did more poorly for the emotion identification task. These differences were not attributable to the global cognitive deterioration accompanying AD, but suggested a specific deficit in visual processing abilities.

Confirmation of an association between family history of affective disorder and the depressive syndrome in Alzheimer's disease

OBJECTIVE

The authors' goal was to replicate an earlier finding of a familial liability for depression in Alzheimer's disease.

METHOD

The family histories of depression and dementia were compared in 28 patients experiencing a first episode of major depression after onset of Alzheimer's disease and 74 nondepressed patients with Alzheimer's disease.

RESULTS

Significantly more families of depressed dementia patients included depressed first-degree relatives. There was no difference between Alzheimer's disease patients with and without depression in the proportion of families with a history of dementia.

CONCLUSIONS

Major depression in Alzheimer's disease is associated with a familial liability for depression that is independent of any familial liability for dementia.

Sources of stress for family caregivers of institutionalized dementia patients

Although many caregivers place their relative in a nursing home in an attempt to reduce their own burden, caregiving stress often continues after institutionalization. This research examined sources of stress for 66 caregivers who cared for their impaired relative at home and later placed that individual in a nursing home. We hypothesized that although these caregivers no longer had primary responsibility for direct care, they would continue to experience distress because of the stressors associated with the nursing home. Results ran counter to our expectations. Although many caregivers reported stressors related to nursing home care, stressors stemming from the patient's Alzheimer's disease (AD) symptoms accounted for more variance in caregivers' levels of anxiety and depression, and in the quality of their interpersonal relations. Even though caregivers were assisted in their caregiving responsibilities by the nursing home staff, their relative's AD symptoms continued to prompt distress.

Stressors and well-being among caregivers to older adults with dementia: the in-home versus nursing home experience

We examined differences in stressors and well-being for caregivers who care for a relative with dementia at home and those who had placed their relative in a nursing home. The groups did not differ in depression or somatic complaints, but nursing home caregivers had fewer social and interpersonal disruptions. Controlling for caregiving problems, nursing home caregivers reported more stressors due to ADL (activities of daily living) assistance, their relatives' behavioral and cognitive functioning, and lack of caregiving support from family and friends.