Facial Expression Recognition Patterns in Mild and Moderate Alzheimer’s Disease

Abstract

Facial expression recognition is one of the essential abilities for social cognition. We aimed to compare facial expression recognition among people with mild and moderate Alzheimer's disease (AD) and to identify which factors were associated with impairment according to disease severity. We included 52 participants with either mild or moderate AD. FACES includes four subtasks requiring matching expressions with picture stimuli (tasks 1 and 2), labelling emotions (task 3), and recognizing situations with evident emotional content (task 4). There were significant differences between groups in FACES global scores, task 2 and task 4. In the mild AD group, FACES global score was influenced by educational background and cognitive performance, task 1 was associated with comprehension and constructive praxis, task 2 was associated with cognitive flexibility, and task 3 was associated with word finding. In subtask 4, no significant associations were found after adjusting for level of cognitive decline. In the moderate AD group, the awareness of emotional state domain was associated with FACES global score, task 1 was associated with constructive praxis, task 3 was associated with neuropsychiatric symptoms, and task 4 was associated with the ability to recognize emotions through situations. No significant associations were found on task 2, after adjusting for level of cognitive decline. Our findings suggest emotional processing difficulties across AD stages. However, when participants needed to recognize the most preponderant emotion in a situation with evident emotional content, our results suggest that in both groups there was no influence of cognitive impairment.

Social cognition: Patterns of impairments in mild and moderate Alzheimer's disease

“…(second-order) 5,14,33 or yet to recognize and discriminate more abstract emotional situation. 6,11 We assume that SC is related to personal perceptions about oneself and others' values and beliefs that evoke individual, social, cultural, and contextual factors. 2 Thus, SC is a neurocognitive domain that may be more stable as it implies an interaction between cognition and emotional processing, a factor that would explain the lack of significative decline in the moderate stage of AD.…”

“…9 In line with our results, Dourado found in the moderate stage of AD that emotion recognition was more impacted by factors associated with emotional processing per se, a factor which suggests that SC is not a by-product of changes in global cognition. 11…”

“…The mild group deficits were related to the cognitive decline, while in moderate AD, the deficits were related to factors associated with emotional processing, but not to global cognition. 11 Cosentino suggested that social and general cognition were unrelated both at baseline and over time, indicating a separability of social and general cognition in AD. In this view, social cognitive deficits in AD would not be a consequence of changes in global cognition, but rather reflect a distinct constellation of symptoms.…”

“…6,12,13 Therefore, the impact of these impairments in the QoL of PwAD and their caregivers and their treatment enhances the necessity of more investigation about the SC deficits during disease, but few studies compared the pattern of changes in SC in different stages of AD. 11,14 Because of this gap in the literature, we are interested in both self-reported SC and family caregivers' ratings of SC in mild and moderate stages of AD. This study aims to investigate the relationship between SC, global cognition, and other clinical variables according to people with mild and moderate AD and their family caregivers.…”

Focusing on Emotional and Social Intelligence Stimulation of People With Dementia by Playing a Serious Game—Proof of Concept Study

“…Technological tools such as serious games could facilitate elimination of barriers, allowing the PwD and their caregiver to communicate in a more meaningful and positive way. Technologies for evaluating and exercising emotional and social capacities are not well-studied in the dementia population (Goodkind et al, 2015;Dourado et al, 2019;Nazareth, 2019).…”