Shi Puyu, Chapman Hannah, Liu Lisa, Rodgers Fern, Shaw Jasmine, Livingston Gill, Rankin Katherine P, Warren Jason D, Sommerlad Andrew
Division of Psychiatry, University College London, London, UK.
Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Alzheimers Dement. 2025 Mar;21(3):e70076. doi: 10.1002/alz.70076.
Social cognition is impaired in people with dementia but the differences in social cognitive impairment between mild cognitive impairment (MCI) and dementia and its subtypes remain unclear. We therefore aimed to systematically review and meta-analyze differences in emotion recognition, theory of mind (ToM), and empathy between individuals with MCI and dementia. Across 28 cross-sectional studies (n = 2409), people with MCI had better emotion recognition (Cohen's d = 0.69) and ToM (d = 0.70) than individuals with Alzheimer's disease (AD) dementia, and larger effect sizes were observed for people with frontotemporal dementia (FTD) (emotion recognition (d = 2.09), ToM (d = 1.49), but emotional empathy was higher in AD than in MCI in included studies. Our findings suggest a progressive decline of aspects of social cognition across the MCI-dementia continuum. Longitudinal studies should investigate the diagnostic role of social cognition deficits in MCI progression to dementia, and interventions for social cognition in MCI should be developed and tested. HIGHLIGHTS: First systematic review and meta-analysis comparing social cognition between mild cognitive impairment (MCI) and dementia subtypes. Findings from 28 studies with 2409 participants show people with MCI outperform those with Alzheimer's disease (AD) and frontotemporal dementia (FTD) in emotion recognition and theory of mind. Empathy appears intact in AD dementia, suggesting that this cognitive domain is preserved throughout disease progression. Evaluation of social cognition should be built into dementia assessment as it may hold diagnostic value.
痴呆症患者存在社会认知障碍，但轻度认知障碍（MCI）与痴呆症及其亚型之间的社会认知障碍差异仍不明确。因此，我们旨在系统回顾并荟萃分析MCI患者与痴呆症患者在情绪识别、心理理论（ToM）和同理心方面的差异。在28项横断面研究（n = 2409）中，MCI患者在情绪识别（Cohen's d = 0.69）和ToM（d = 0.70）方面比阿尔茨海默病（AD）痴呆患者表现更好，额颞叶痴呆（FTD）患者的效应量更大（情绪识别（d = 2.09），ToM（d = 1.49）），但在纳入的研究中，AD患者的情感同理心高于MCI患者。我们的研究结果表明，在MCI - 痴呆症连续体中，社会认知的各个方面呈渐进性下降。纵向研究应调查社会认知缺陷在MCI进展为痴呆症中的诊断作用，并且应开发和测试针对MCI社会认知的干预措施。要点：首次系统回顾和荟萃分析比较轻度认知障碍（MCI）与痴呆症亚型之间的社会认知。来自28项研究的2409名参与者的结果表明，MCI患者在情绪识别和心理理论方面优于阿尔茨海默病（AD）和额颞叶痴呆（FTD）患者。AD痴呆患者的同理心似乎完好无损，这表明该认知领域在疾病进展过程中得以保留。应将社会认知评估纳入痴呆症评估，因为它可能具有诊断价值。
