Regular Research Article
Emotion-Discrimination Deficits in Mild Alzheimer Disease

https://doi.org/10.1097/00019442-200511000-00002Get rights and content

Objective

Mild Alzheimer disease (AD) preferentially affects temporal lobe regions, which represent important structures in memory and emotional processes. This study investigated emotion discrimination in people with mild AD, versus Caretakers.

Methods

Twenty AD subjects and 22 caretakers underwent computerized testing of emotion recognition and differentiation. Performances between groups were compared, controlling for possible effects of age and cognitive abilities.

Results

AD subjects showed diminished recognition of happy, sad, fearful, and neutral expressions. They also exhibited decreased differentiation between happy and sad expressions. Controlling for effects of cognitive dysfunction, AD subjects differed on recognition of happy and sad, and differentiation of sad facial expressions, and in error patterns for fearful and neutral faces.

Conclusions

Diminished abilities for emotion discrimination are present in persons with mild AD. In persons with mild AD, who frequently reside in their own home or with close family, this diminished ability may adversely affect social functioning and quality of life.

Section snippets

Subjects

Persons with AD (N = 20; M:F = 11:9) and healthy Caretakers (N = 22; M:F = 9:13) were recruited through the Alzheimer Disease Center (ADC) at the University of Pennsylvania. For participation in this study, inclusion criteria for AD subjects were 1) clinical symptoms consistent with the diagnosis of probable AD; 2) mild severity of functional impairment, as rated on the Clinical Dementia Rating Scale (CDR);25 3) fluency in English and a reading level ≥6th grade; 4) lack of medical illness that

RESULTS

On the Emotion Recognition Test (ER40), AD patients differed from Caretakers and were impaired in recognition of all emotions and neutral faces combined (z = −3.67; p <0.001). When compared by emotion, AD patients were impaired for Happy (z = −2.94; p = 0.003), Sad (z = −2.96; p = 0.003), and Fearful (z = −3.28; p = 0.001), but not Angry (z = −1.32; p = 0.19) and Neutral (z = −1.80; p = 0.072) faces (Table 3). When adjusted for overall cognition, however, the results did not remain significant.

CONCLUSIONS

Our study compared emotion-discrimination in community-based persons with mild AD and their caretakers. Overall, AD subjects were able to identify the target emotion in the majority of presentations, indicating decreased, but not absent, abilities of emotion-discrimination. Recognition of specific emotions was diminished for happy, sad, fearful and neutral faces, but not for anger. Recognition of emotions in Caretakers was similar to what we have reported previously in younger control-groups,

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    This work was previously presented at the Psychiatry Research Society Meeting, February 11–14, 2004, in Park City, UT.

    The work was supported by NIMH grants MH-01839 and NIA P30-AG010124.

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