Golgi Cenci Foundation, Geriatric Institute Camillo Golgi, Abbiategrasso, (MI), Italy.
Arch Gerontol Geriatr. 2009;49 Suppl 1:135-46. doi: 10.1016/j.archger.2009.09.023.
The ability of decoding the emotional facial expressions may be early damaged in frontotemporal dementia, but relatively well preserved in the Alzheimer's disease (AD). Nevertheless, the data about the relationship of the dementia severity with the ability of recognizing the face emotions are conflicting and insufficient, mainly for the moderate-severe stage of the disease. The present study extends to the existing literature by: (1) assessing people in the moderate and severe stage of dementia, compared with people without cognitive impairment; (2) assessing not only recognition but also reactivity to the facial expression of emotion. The capability of understanding the facial emotions has been evaluated in 79 patients with dementia compared to 64 healthy elderly people. The test consisted in showing them 14 photographic representations of 7 emotions both from male and from female faces, representing happiness, sadness, fear, disgust, boredom, anger and surprise. Patients were asked to observe the face and to recognize the emotion either with a denomination or a description. Then the spontaneous reactivity to the face expressions was videotaped and classified as a congruous or incongruous reaction by two independent observers who showed a good inter-rater reliability. Of the patients, 53% with dementia recognized up to 5 emotions out of 14, while in the healthy controls this number of mean recognition raised to 8.4, a value reached by the patients who scored 16 at MMSE. The most identified emotion is happiness both for the patients and for the controls. In general, positive emotions are better recognized than the negative ones, confirming the literary data. About the reactions to face emotion stimuli, there is no significant difference for any of the face emotion between the control group and the people with dementia. These data show that patients with dementia can recognize and react to facial emotions also in the severe stage of the disease, suggesting the usefulness of a non-verbal, emotional communication and supporting the need for more emotional education for care givers, both relatives and professionals.
解读面部情绪表情的能力可能在额颞叶痴呆中早期受损，但在阿尔茨海默病（AD）中相对较好地保留。然而，关于痴呆严重程度与识别面部情绪能力之间关系的数据存在冲突且不足，主要是针对疾病的中重度阶段。本研究通过以下方式扩展了现有文献：（1）评估中度和重度痴呆患者与认知正常的患者；（2）不仅评估识别能力，还评估对面部表情情绪的反应能力。研究比较了 79 名痴呆患者和 64 名健康老年人，评估了他们理解面部情绪的能力。测试包括向他们展示 14 张代表男性和女性面部的 7 种情绪的照片，分别是快乐、悲伤、恐惧、厌恶、无聊、愤怒和惊讶。患者被要求观察面部并通过命名或描述来识别情绪。然后，将面部表情的自发反应录像并由两名独立观察者进行分类，判断反应是否一致或不一致，观察者之间具有良好的组内信度。在 79 名患者中，有 53%的患者可以识别出 14 个情绪中的 5 个，而在健康对照组中，这一平均识别数量上升到 8.4，达到这个数值的患者的 MMSE 得分为 16。患者和对照组最容易识别的情绪都是快乐。总的来说，积极情绪比消极情绪更容易被识别，这与文献数据一致。关于对面部情绪刺激的反应，在控制组和痴呆患者之间，对于任何一种面部情绪都没有显著差异。这些数据表明，即使在疾病的重度阶段，痴呆患者也可以识别和反应面部情绪，这表明非言语、情感交流是有用的，并支持为护理人员（包括亲属和专业人员）提供更多情感教育的需求。
