Social cognition: Patterns of impairments in mild and moderate Alzheimer's disease

Social cognition (SC) deficits in Alzheimer's Disease (AD) are commonly associated with the progression of the disease, and mainly as a result of global cognition deterioration. We aimed to investigate the relationship between SC, global cognition, and other clinical variables in mild and moderate people with AD and their caregivers. We also investigated the differences between self-reported SC and family caregivers' ratings of SC.

We included 137 dyads of people with AD (87 mild and 50 moderate) and caregivers. We evaluated social cognition, global cognition, quality of life, dementia severity, mood, functionality, neuropsychiatric symptoms, and caregiver burden.

SC presented a specific pattern of impairment, especially when related to global cognition deficits. Although the moderate AD group showed significant worsening in cognition, functionality and neuropsychiatric symptoms, when compared to the mild group, SC did not present significant differences between the groups. The multivariate regression analysis showed that in the mild group, self-reported SC was related to age and years of education. In the moderate group, SC was related to gender. For caregivers, in the mild group, SC was related to functionality and quality of life, while in the moderate group, was associated with quality of life.

The pattern of impairment of SC may be more stable as it implies interaction with cognition, mainly in the mild stage, but also include subjective factors as a personal perception about oneself and others, values, and beliefs that evokes individual, social, cultural, and contextual factors.