The Relationship Between Social Cognition and Awareness in Alzheimer Disease

Abstract

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.

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

“…We may consider that the QoL perception change is relatively independent on the effect of change in other clinical parameters and it is possibly dependent on individual factors 39 . We understand that SC and QoL present a similar pattern of impairment, probably more stable because it reflects common subjective indicators, like values, beliefs and social, cultural, and contextual factors 2 . In this context, our findings point that the social and emotional abilities may be more relevant for the QoL perception for the caregivers than clinical parameters in the moderate stage.…”

“…In the mild stage of AD, the outset of global cognition deterioration notably in memory and frontal functions 33 may reflect in SC deficits in more complex tasks, with more cognitive demands, like as cognitive ToM (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.…”

“…Quality of Life in Alzheimer's disease (QoL‐AD) is a questionnaire completed by both PwAD and the caregiver and includes 13 domains: physical health, energy, mood, living situation, memory, family, marriage, friends, chores, fun, money, self, and life as a whole. The 13 domains are rated as poor, 1 fair, 2 good, 3 or excellent 4 and the total score ranges from 13 to 52. The scores of the self‐rated PwAD QoL (QoL‐AD 1) and the caregiver‐rated about the PwAD QoL (QoL‐AD 2) were analyzed separately.…”

“…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. The more stable pattern of impairment in SC was also found by Cosentino, in which SC, cognition, and dependence worsened during the study period, but the deficits in SC were less prominent.…”

“…Social cognition (SC) is the ability to make judgments about others' behaviors, attitudes, and emotions 1 . It is an essential concept for the social and emotional functioning and it is related to the recognition and the evaluation of personal relevance of social and emotional signals, social knowledge awareness, personality, and social information processing 2 . The most recent proposed model to define SC was presented by Arioli, in which SC involves three main domains: social perception, social understanding, and decision‐making in the social context 3 …”