Introduction: Alzheimer’s disease is a neurodegenerative disease characterized by a progressive deterioration of each area of the brain, gradually reducing the patient’s autonomy. The symptoms make it a difficult pathology to manage and to live with for the family, friends and caregivers. As a result, it is not uncommon to observe a change in interpersonal behavior and a deterioration in social relationships. Indeed, the scientific literature reports relative difficulties in the field of social cognition, with a deterioration for the recognition of emotional facial expressions (Goutte & Ergis, 2011), as well as in the theory of mind (Ladernois, Besnard, & Allain, 2017). Theory of mind refers to the ability to attribute a mental state to others. However, to be adapted to the social environment and to have good social relationships, it is essential to know how to decode people’s emotional and affective signals. Thus, the main objective of this study was to explore whether there may be a link between social cognition difficulties and reduced interpersonal behavior efficiency in people with Alzheimer’s disease.
Hypotheses: We hypothesized that there is a correlation between social cognition difficulties and interpersonal behavior among participants with Alzheimer’s disease. This was verified through the following two operational hypotheses:
(1): In different tasks (identification of emotional facial expressions; theory of mind) exploring social cognition, Alzheimer’s participants will perform lower than control participants.
(2): For Alzheimer’s participants, links should be observed between performance in social cognition tasks and the quality of interpersonal behavior.
Methods: This study included 10 participants who had the diagnostic criteria for Alzheimer’s disease and 10 elderly control participants. All participants were recruited on a voluntary basis in nursing homes for elderly.
The cognitive functioning was assessed with the Batterie d’Efficience Cognitive (BEC-96, Signoret, Allard, Benoit, Bolgert, Eustache & Bonvarlet, 1996) and executive functioning with the Batterie Rapide d’Efficience Frontale (BREF, Dubois, Slachevsky, Litvan & Pillon, 2000). For social cognition, theory of mind was evaluated using the adapted version of the Yoni Test (Shamay-Tsoory & Aaron-Peretz, 2007) and the recognition of emotional facial expressions by using the Ekman 60 Faces Test (adaptation on 35 faces, Bertoux, 2012). Interpersonal behavior was assessed using the translated version of the Interpersonal Behavior Checklist (IBC, Shimokawa et al., 2001). It provides two scores: “Difficulty of caring for the patient” and “Interpersonal Relationship”. The assessment of interpersonal behavior was conducted by members of the health care team who worked in the nursing homes included in our study.
Results: Our results indicate that Alzheimer’s participants perform lower than control participants for the Ekman Test which evaluates the recognition of emotional facial expressions. Moreover, emotions which are the less well recognized by Alzheimer’s participants are sadness and disgust. Finally, and still linked to the recognition of emotional facial expressions, we have observed that the emotion which is the best recognized by Alzheimer’s participants is joy, they even have a performance which is similar to those of control participants.
Regarding interpersonal behavior among Alzheimer’s participants, the results indicate that we can observe a link between the Yoni Test score and the Interpersonal Behavior Checklist’s (IBC) “Difficulty of caring for the patient” score. In addition, it has also highlighted that the result obtained at the BEC-96 is also correlated with the Interpersonal Behavior Checklist’s (IBC) “Difficulty of caring for the patient” score.
Conclusion: Our study partially allows us to validate our hypotheses. For social cognition, Alzheimer’s participants perform less well than control participants for the recognition of emotional facial expressions. However, our results don’t show any difference between our two groups for the theory of mind abilities. With regard to the interpersonal behavior, the Alzheimer’s participants with the lowest theory of mind abilities are the one’s who are perceived by the health care team as being difficult to caring for. Finally, Alzheimer’s participants with the lowest cognitive efficiency are also the ones who are identified by the health care team as difficult to caring for.
Key words: Alzheimer’s disease; Social cognition; Theory of mind; Recognition of facial emotional expressions; Interpersonal behavior.
Words I have learned :
– To caring for = prendre en charge.
– Field = domaine.
Bibliography:
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Amandine Templet, M2 PPCECC