Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-18T14:14:35.732Z Has data issue: false hasContentIssue false

Social Cognition and Social Functioning in MCI and Dementia in an Epidemiological Sample

Published online by Cambridge University Press:  06 September 2021

Ranmalee Eramudugolla
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia Neuroscience Research Australia, Sydney, Australia
Katharine Huynh
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia Neuroscience Research Australia, Sydney, Australia
Shally Zhou
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia Neuroscience Research Australia, Sydney, Australia UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
Jessica G. Amos
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia Neuroscience Research Australia, Sydney, Australia
Kaarin J. Anstey*
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia Neuroscience Research Australia, Sydney, Australia UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
*
*Correspondence and reprint requests to: Professor Kaarin Anstey, School of Psychology, University of New South Wales, Randwick, Sydney, NSW2031, Australia. Email: k.anstey@unsw.edu.au

Abstract

Objective:

Social cognition is impaired in mild cognitive impairment (MCI) and dementia. However, its relationship to social functioning and perceived social support has yet to be explored. Here, we examine how theory of mind (ToM) relates to social functioning in MCI and dementia.

Methods:

Older adults (cognitively normal = 1272; MCI = 132; dementia = 23) from the PATH Through Life project, a longitudinal, population-based study, were assessed on the Reading the Mind in the Eyes Test (RMET), measures of social functioning, and social well-being. The associations between RMET performance, social functioning, and cognitive status were analysed using generalised linear models, adjusting for demographic variables.

Results:

Participants with MCI (b=−.52, 95% CI [−.70, −.33]) and dementia (b=−.78, 95% CI [−1.22, −.34]) showed poorer RMET performance than cognitively normal participants. Participants with MCI and dementia reported reduced social network size (b=−.21, 95% CI [−.40, −.02] and b=−.90, 95% CI [−1.38, −.42], respectively) and participants with dementia reported increased loneliness (b = .36, 95% CI [.06, .67]). In dementia, poorer RMET performance was associated with increased loneliness (b=−.07, 95% CI [−.14, −.00]) and a trend for negative interactions with partners (b=−.37, 95% CI [−.74, .00]), but no significant associations were found in MCI.

Conclusions:

MCI and dementia were associated with poor self-reported social function. ToM deficits were related to poor social function in dementia but not MCI. Findings highlight the importance of interventions to address social cognitive deficits in persons with dementia and education of support networks to facilitate positive interactions and social well-being.

Type
Research Article
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, R.B. Jr., Rule, N.O., Franklin, R.G. Jr., Wang, E., Stevenson, M.T., Yoshikawa, S., … Ambady, N. (2010). Cross-cultural reading the mind in the eyes: An fMRI investigation. Journal of Cognitive Neuroscience, 22(1), 97108. doi: 10.1162/jocn.2009.21187 CrossRefGoogle Scholar
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Association.CrossRefGoogle Scholar
Anstey, K.J., Christensen, H., Butterworth, P., Easteal, S., Mackinnon, A., Jacomb, T., … Jorm, A.F. (2012). Cohort profile: the PATH through life project. International Journal of Epidemiology, 41(4), 951960. doi: 10.1093/ije/dyr025 CrossRefGoogle ScholarPubMed
Ayers, E., Gulley, E., & Verghese, J. (2020). The effect of personality traits on risk of incident pre-dementia syndromes. Journal of the American Geriatrics Society, 68(7), 15541559. doi: 10.1111/jgs.16424 Google ScholarPubMed
Bailey, P.E., Henry, J.D., & Von Hippel, W. (2008). Empathy and social functioning in late adulthood. Aging & Mental Health, 12(4), 499503. doi: 10.1080/13607860802224243 Google ScholarPubMed
Baksh, R.A., Abrahams, S., Auyeung, B., & MacPherson, S.E. (2018). The Edinburgh Social Cognition Test (ESCoT): Examining the effects of age on a new measure of theory of mind and social norm understanding. PLoS One, 13(4), e0195818.CrossRefGoogle ScholarPubMed
Baron-Cohen, S., Bowen, D.C., Holt, R.J., Allison, C., Auyeung, B., Lombardo, M.V., … Lai, M.-C. (2015). The “Reading the Mind in the Eyes” test: Complete absence of typical sex difference in ˜400 men and women with Autism. PLoS One, 10(8), e0136521e0136521. doi: 10.1371/journal.pone.0136521 CrossRefGoogle ScholarPubMed
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the Mind in the Eyes” test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2), 241251.CrossRefGoogle ScholarPubMed
Beadle, J.N., & de la Vega, C.E. (2019). Impact of aging on empathy: Review of psychological and neural mechanisms. Frontiers in Psychiatry, 10, 331.Google ScholarPubMed
Berg-Weger, M. & Morley, J.E. (2020). Loneliness in old age: An unaddressed health problem. The Journal of Nutrition, Health & Aging, 24(3), 243245. doi: 10.1007/s12603-020-1323-6 CrossRefGoogle ScholarPubMed
Bora, E., Eryavuz, A., Kayahan, B., Sungu, G., & Veznedaroglu, B. (2006). Social functioning, theory of mind and neurocognition in outpatients with schizophrenia; mental state decoding may be a better predictor of social functioning than mental state reasoning. Psychiatry Research, 145(2), 95103. doi: 10.1016/j.psychres.2005.11.003 Google ScholarPubMed
Bora, E., Walterfang, M., & Velakoulis, D. (2015). Theory of mind in behavioural-variant frontotemporal dementia and Alzheimer’s disease: A meta-analysis. Journal of Neurology, Neurosurgery and Psychiatry, 86(7), 714. doi: 10.1136/jnnp-2014-309445 CrossRefGoogle ScholarPubMed
Bora, E., & Yener, G.G. (2017). Meta-analysis of social cognition in mild cognitive impairment. Journal of Geriatric Psychiatry and Neurology, 30(4), 206213.CrossRefGoogle ScholarPubMed
Brioschi Guevara, A., Knutson, K.M., Wassermann, E.M., Pulaski, S., Grafman, J., & Krueger, F. (2015). Theory of mind impairment in patients with behavioural variant fronto-temporal dementia (bv-FTD) increases caregiver burden. Age and ageing, 44(5), 891895.Google ScholarPubMed
Cabello, R., Navarro, B., Latorre, J.M., & Fernández-Berrocal, P. (2014). Ability of university-level education to prevent age-related decline in emotional intelligence. Frontiers in Aging Neuroscience, 6(37). doi: 10.3389/fnagi.2014.00037 Google ScholarPubMed
Cohen-Mansfield, J., Hazan, H., Lerman, Y., & Shalom, V. (2016). Correlates and predictors of loneliness in older-adults: A review of quantitative results informed by qualitative insights. International Psychogeriatrics, 28(4), 557576. doi: 10.1017/S1041610215001532 Google ScholarPubMed
de Achával, D., Costanzo, E.Y., Villarreal, M., Jáuregui, I.O., Chiodi, A., Castro, M.N., … Guinjoan, S.M. (2010). Emotion processing and theory of mind in schizophrenia patients and their unaffected first-degree relatives. Neuropsychologia, 48(5), 12091215. doi: 10.1016/j.neuropsychologia.2009.12.019 Google ScholarPubMed
Denissen, J., & Penke, L. (2008). Neuroticism predicts reactions to cues of social inclusion. European Journal of Personality, 22, 497517. doi: 10.1002/per.682 CrossRefGoogle Scholar
Desmarais, P., Lanctôt, K.L., Masellis, M., Black, S.E., & Herrmann, N. (2018). Social inappropriateness in neurodegenerative disorders. International Psychogeriatrics, 30(2), 197207.Google ScholarPubMed
Dodell-Feder, D., Ressler, K.J., & Germine, L.T. (2020). Social cognition or social class and culture? On the interpretation of differences in social cognitive performance. Psychological Medicine, 50(1), 133145. doi: 10.1017/S003329171800404X CrossRefGoogle ScholarPubMed
Dyer, A.H., Murphy, C., Lawlor, B., Kennelly, S.P., & Study Group for the Nilvad. (2020). Social networks in mild-to-moderate Alzheimer disease: Longitudinal relationships with dementia severity, cognitive function, and adverse events. Aging & Mental Health, 17. doi: 10.1080/13607863.2020.1745146 Google ScholarPubMed
Eramudugolla, R., Mortby, M.E., Sachdev, P., Meslin, C., Kumar, R., & Anstey, K.J. (2017). Evaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a population-based cohort of older adults. Alzheimer’s Research & Therapy, 9(1), 15. doi: 10.1186/s13195-017-0246-x CrossRefGoogle Scholar
Eysenck, H.J., & Eysenck, S.B.G. (1975). Manual of the Eysenck Personality Questionnaire (Junior and Adult). London: Hodder and Stoughton.Google Scholar
Ferman, T.J., Smith, G.E., Kantarci, K., Boeve, B.F., Pankratz, V.S., Dickson, D.W., … Petersen, R.C. (2013). Nonamnestic mild cognitive impairment progresses to dementia with Lewy bodies. Neurology, 81(23), 20322038.Google ScholarPubMed
Fernández-Abascal, E.G., Cabello, R., Fernández-Berrocal, P., & Baron-Cohen, S. (2013). Test-retest reliability of the ‘Reading the Mind in the Eyes’ test: a one-year follow-up study. Molecular Autism, 4(1), 33. doi: 10.1186/2040-2392-4-33 CrossRefGoogle ScholarPubMed
Fratiglioni, L., Wang, H.-X., Ericsson, K., Maytan, M., & Winblad, B. (2000). Influence of social network on occurrence of dementia: A community-based longitudinal study. The Lancet, 355(9212), 13151319. doi: 10.1016/S0140-6736(00)02113-9 CrossRefGoogle ScholarPubMed
Frith, U. (1994). Autism and theory of mind in everyday life. Social Development, 3(2), 108124. doi: 10.1111/j.1467-9507.1994.tb00031.x CrossRefGoogle Scholar
Hackett, R.A., Steptoe, A., Cadar, D., & Fancourt, D. (2019). Social engagement before and after dementia diagnosis in the English Longitudinal Study of Ageing. PLoS One, 14(8), e0220195. doi: 10.1371/journal.pone.0220195 CrossRefGoogle ScholarPubMed
Hansen, T. & Slagsvold, B. (2016). Late-life loneliness in 11 European countries: Results from the Generations and Gender Survey. Social Indicators Research, 129(1), 445464. doi: 10.1007/s11205-015-1111-6 CrossRefGoogle Scholar
Henry, J.D., Phillips, L.H., Ruffman, T., & Bailey, P.E. (2013). A meta-analytic review of age differences in theory of mind. Psychol Aging, 28(3), 826839. doi: 10.1037/a0030677 Google ScholarPubMed
Henry, J.D., von Hippel, W., Thompson, C., Pulford, P., Sachdev, P., & Brodaty, H. (2012). Social behavior in mild cognitive impairment and early dementia. Journal of Clinical and Experimental Neuropsychology, 34(8), 806813.CrossRefGoogle ScholarPubMed
Hindmarch, I., Lehfeld, H., de Jong, P., & Erzigkeit, H. (1998). The Bayer Activities of Daily Living (B-ADL) Scale. Dementia and Geriatric Cognitive Disorders, 9(suppl 2), 2026.CrossRefGoogle ScholarPubMed
Hooker, C.I., Bruce, L., Fisher, M., Verosky, S.C., Miyakawa, A., D’Esposito, M., & Vinogradov, S. (2013). The influence of combined cognitive plus social-cognitive training on amygdala response during face emotion recognition in schizophrenia. Psychiatry Research, 213(2), 99107.Google Scholar
Hughes, M.E., Waite, L.J., Hawkley, L.C., & Cacioppo, J.T. (2004). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26(6), 655672.CrossRefGoogle Scholar
Kennedy, D.P. & Adolphs, R. (2012). The social brain in psychiatric and neurological disorders. Trends in Cognitive Sciences, 16(11), 559572.Google ScholarPubMed
Khondoker, M., Rafnsson, S.B., Morris, S., Orrell, M., & Steptoe, A. (2017). Positive and negative experiences of social support and risk of dementia in later life: An investigation using the English Longitudinal Study of Ageing. Journal of Alzheimer’s Disease, 58(1), 99108.CrossRefGoogle ScholarPubMed
Kindell, J., Keady, J., Sage, K., & Wilkinson, R. (2017). Everyday conversation in dementia: A review of the literature to inform research and practice. International Journal of Language & Communication Disorders, 52(4), 392406.CrossRefGoogle ScholarPubMed
Kirkland, R.A., Peterson, E., Baker, C.A., Miller, S., & Pulos, S. (2013). Meta-analysis reveals adult female superiority in “Reading the Mind in the Eyes” Test. North American Journal of Psychology, 15(1), 121146.Google Scholar
Knopman, D.S. & Petersen, R.C. (2014). Mild cognitive impairment and mild dementia: a clinical perspective. Mayo Clinic Proceedings, 89(10), 14521459. doi: 10.1016/j.mayocp.2014.06.019 CrossRefGoogle ScholarPubMed
Kunda, Z. (1999). Social Cognition: Making Sense of People: MIT press.CrossRefGoogle Scholar
Kynast, J., Quinque, E.M., Polyakova, M., Luck, T., Riedel-Heller, S.G., Baron-Cohen, S., … Schroeter, M.L. (2020). Mindreading from the eyes declines with aging – Evidence from 1,603 subjects. Frontiers in Aging Neuroscience, 12(368). doi: 10.3389/fnagi.2020.550416 CrossRefGoogle ScholarPubMed
Lubben, J., Blozik, E., Gillmann, G., Iliffe, S., von Renteln Kruse, W., Beck, J.C., & Stuck, A.E. (2006). Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. The Gerontologist, 46(4), 503513.CrossRefGoogle ScholarPubMed
McCade, D., Savage, G., & Naismith, S.L. (2011). Review of emotion recognition in mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 32(4), 257266.CrossRefGoogle ScholarPubMed
McHugh Power, J.E., Lawlor, B.A., & Kee, F. (2017). Social support mediates the relationships between extraversion, neuroticism, and cognitive function in older adults. Public Health, 147(1476–5616 (Electronic)), 144152. doi: 10.1016/j.puhe.2017.02.015 CrossRefGoogle ScholarPubMed
Michaelian, J.C., Mowszowski, L., Guastella, A.J., Henry, J.D., Duffy, S., McCade, D., & Naismith, S.L. (2019). Theory of mind in mild cognitive impairment – Relationship with limbic structures and behavioural change. Journal of the International Neuropsychological Society, 25(10), 10231034. doi: 10.1017/S1355617719000870 CrossRefGoogle ScholarPubMed
Miguel, F.K., Caramanico, R.B., Huss, E.Y., & Zuanazzi, A.C. (2017). Validity of the Reading the Mind in the Eyes Test in a Brazilian sample. Paidéia (Ribeirão Preto), 27, 1623.CrossRefGoogle Scholar
Moreau, N., Rauzy, S., Bonnefoi, B., Renié, L., Martinez-Almoyna, L., Viallet, F., & Champagne-Lavau, M. (2015). Different patterns of theory of mind impairment in mild cognitive impairment. Journal of Alzheimer’s Disease, 45(2), 581597.CrossRefGoogle ScholarPubMed
Olderbak, S., Wilhelm, O., Olaru, G., Geiger, M., Brenneman, M.W., & Roberts, R.D. (2015). A psychometric analysis of the reading the mind in the eyes test: Toward a brief form for research and applied settings. Frontiers in Psychology, 6, 15031503. doi: 10.3389/fpsyg.2015.01503 CrossRefGoogle Scholar
Pardini, M., Emberti Gialloreti, L., Mascolo, M., Benassi, F., Abate, L., Guida, S., … Cocito, L. (2013). Isolated theory of mind deficits and risk for frontotemporal dementia: A longitudinal pilot study. J Neurol Neurosurg Psychiatry, 84(7), 818821. doi: 10.1136/jnnp-2012-303684 CrossRefGoogle ScholarPubMed
Penninkilampi, R., Casey, A.-N., Singh, M.F., & Brodaty, H. (2018). The association between social engagement, loneliness, and risk of dementia: A systematic review and meta-analysis. Journal of Alzheimer’s Disease, 66(4), 16191633.CrossRefGoogle ScholarPubMed
Peñuelas-Calvo, I., Sareen, A., Sevilla-Llewellyn-Jones, J., & Fernández-Berrocal, P. (2019). The “Reading the Mind in the Eyes” Test in autism-spectrum disorders comparison with healthy controls: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders, 49(3), 10481061. doi: 10.1007/s10803-018-3814-4 CrossRefGoogle ScholarPubMed
Peterson, C.C., Garnett, M., Kelly, A., & Attwood, T. (2009). Everyday social and conversation applications of theory-of-mind understanding by children with autism-spectrum disorders or typical development. European Child & Adolescent Psychiatry, 18(2), 105115. doi: 10.1007/s00787-008-0711-y CrossRefGoogle ScholarPubMed
Plassman, B., Langa, K., Fisher, G., Heeringa, S., Weir, D., Ofstedal, M., … Wallace, R. (2007). Prevalence of dementia in the United States: The aging, demographics, and memory study. Neuroepidemiology, 29(1–2), 125132. doi: 10.1159/000109998 CrossRefGoogle ScholarPubMed
Poletti, M. & Bonuccelli, U. (2013). Alteration of affective Theory of Mind in amnestic mild cognitive impairment. Journal of Neuropsychology, 7(1), 121131.CrossRefGoogle ScholarPubMed
Radecki, M.A., Cox, S.R., & MacPherson, S.E. (2019). Theory of mind and psychosocial characteristics in older men. Psychology and Aging, 34(1), 145.CrossRefGoogle ScholarPubMed
Rankin, K.P. (2020). Brain networks supporting social cognition in dementia. Current Behavioral Neuroscience Reports, 7, 203211. doi: 10.1007/s40473-020-00224-3.CrossRefGoogle Scholar
Saito, T., Murata, C., Saito, M., Takeda, T., & Kondo, K. (2018). Influence of social relationship domains and their combinations on incident dementia: A prospective cohort study. Journal of Epidemiology and Community Health, 72(1), 7. doi: 10.1136/jech-2017-209811 CrossRefGoogle ScholarPubMed
Schurz, M., Radua, J., Tholen, M.G., Maliske, L., Margulies, D.S., Mars, R.B., … Kanske, P. (2020). Toward a hierarchical model of social cognition: A neuroimaging meta-analysis and integrative review of empathy and theory of mind. Psychological Bulletin, 147(3), 293. doi: 10.1037/bul0000303 CrossRefGoogle Scholar
Schuster, T.L., Kessler, R.C., & Aseltine, R.H. (1990). Supportive interactions, negative interactions, and depressed mood. American Journal of Community Psychology, 18(3), 423438.CrossRefGoogle ScholarPubMed
Sharp, E.S. & Gatz, M. (2011). Relationship between education and dementia: An updated systematic review. Alzheimer Disease and Associated Disorders, 25(4), 289304. doi: 10.1097/WAD.0b013e318211c83c Google Scholar
Spoletini, I., Marra, C., Di Iulio, F., Gianni, W., Sancesario, G., Giubilei, F., … Spalletta, G. (2008). Facial emotion recognition deficit in amnestic mild cognitive impairment and Alzheimer disease. The American Journal of Geriatric Psychiatry, 16(5), 389398.CrossRefGoogle ScholarPubMed
Szanto, K., Dombrovski, A.Y., Sahakian, B.J., Mulsant, B.H., Houck, P.R., Reynolds, C.F. III, & Clark, L. (2012). Social emotion recognition, social functioning, and attempted suicide in late-life depression. The American Journal of Geriatric Psychiatry, 20(3), 257265.CrossRefGoogle ScholarPubMed
Tang, M.X., Cross, P., Andrews, H., Jacobs, D.M., Small, S., Bell, K., … Mayeux, R. (2001). Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan. Neurology, 56(1), 4956. doi: 10.1212/wnl.56.1.49 CrossRefGoogle ScholarPubMed
Vellante, M., Baron-Cohen, S., Melis, M., Marrone, M., Petretto, D.R., Masala, C., & Preti, A. (2013). The “Reading the Mind in the Eyes” test: Systematic review of psychometric properties and a validation study in Italy. Cognitive Neuropsychiatry, 18(4), 326354. doi: 10.1080/13546805.2012.721728 CrossRefGoogle Scholar
Whitwell, J.L., Petersen, R.C., Negash, S., Weigand, S.D., Kantarci, K., Ivnik, R.J., … Jack, C.R. Jr. (2007). Patterns of atrophy differ among specific subtypes of mild cognitive impairment. Archives of Neurology, 64(8), 11301138. doi: 10.1001/archneur.64.8.1130 CrossRefGoogle ScholarPubMed
Winblad, B., Palmer, K., Kivipelto, M., Jelic, V., Fratiglioni, L., Wahlund, L.O., … Almkvist, O. (2004). Mild cognitive impairment–beyond controversies, towards a consensus: Report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256(3), 240246.CrossRefGoogle Scholar
Yaffe, K., Petersen, R.C., Lindquist, K., Kramer, J., & Miller, B. (2006). Subtype of mild cognitive impairment and progression to dementia and death. Dementia and Geriatric Cognitive Disorders, 22, 312319.CrossRefGoogle ScholarPubMed
Yates, J.A., Clare, L., & Woods, R.T. (2017). Subjective memory complaints, mood and MCI: A follow-up study. Aging & Mental Health, 21(3), 313321. doi: 10.1080/13607863.2015.1081150 CrossRefGoogle ScholarPubMed
Yi, Z., Zhao, P., Zhang, H., Shi, Y., Shi, H., Zhong, J., & Pan, P. (2020). Theory of mind in Alzheimer’s disease and amnestic mild cognitive impairment: A meta-analysis. Neurological Sciences, 41(5), 10271039. doi: 10.1007/s10072-019-04215-5 CrossRefGoogle ScholarPubMed
Zhu, Y., Liu, J., Qu, B., & Yi, Z. (2018). Quality of life, loneliness and health-related characteristics among older people in Liaoning province, China: A cross-sectional study. BMJ Open, 8(e021822). doi: 10.1136/bmjopen-2018-021822 CrossRefGoogle ScholarPubMed
Supplementary material: File

Eramudugolla et al. supplementary material

Table S1

Download Eramudugolla et al. supplementary material(File)
File 15.9 KB