Department of Psychiatry, University Hospital Cologne, Medical Faculty, Cologne, Germany.
German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
J Alzheimers Dis. 2021;83(3):1173-1186. doi: 10.3233/JAD-201126.
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.
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.
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.
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.
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.
社会认知(SC)是神经认知障碍的核心标准。然而,遗忘型轻度认知障碍(aMCI)和阿尔茨海默病型痴呆(DAT)患者的研究结果并不一致。
我们报告了对年轻对照组(YC)和老年对照组(OC)与 aMCI 和 DAT 患者的情绪识别(ER)、情感和认知心理理论(ToM)的评估。
28 名 aMCI、30 名 DAT、30 名 YC 和 29 名 OC 接受了 SC 和全面神经心理学评估的测试。协方差分析用于确定组间差异。应用多元回归模型确定每个 SC 任务的预测因子。
在对照组中,OC 在 ER 和两种 ToM 任务上的表现均不如 YC,除了一个子测试。OC 和患者在 ER 和情感 ToM 方面没有差异。在认知 ToM 中,OC 和患者之间的差异取决于内容和认知负荷,与 OC 相比,DAT 患者的认知负荷显著受损。认知综合评分可预测 OC 的 SC,但不能预测患者的 SC。在所有组中,SC 与单一认知域之间存在相关性,语言和复杂注意力是最佳预测因子。SC 表现的所有方差不能完全用认知域的方差来解释。
OC 与 YC 相比,SC 任务的表现较低得到了证实,尽管并非所有任务都受到同等影响。随着认知功能的逐渐受损,认知 ToM 比 ER 或情感 ToM 受损更严重。SC 似乎至少部分独立于其他认知领域,因此有理由将其纳入痴呆诊断的测试组合中。