Study on Associating Emotions in Verbal Reactions to Facial Expressions in Dementia

The purpose of this study was to provide basic data on cognitive therapy and to improve social support programs for the elderly with dementia by identifying the difficulties they experienced in emotional communication by identifying how they recognized emotions in verbal reactions to facial expressions using Ekman's photographs of facial expressions and comparing their responses with the general elderly population. There were 141 participants in this study. Data collection was conducted from 3 April 2019 to 30 June 2019 in Seoul, in the Gyeonggi-do and Gangwon-do provinces of South Korea. This study performed descriptive research in which subjects made participative decisions with their guardian through recruitment. The tools used in this study included a general characteristic questionnaire and the Ekman 6 facial expressions photographs tool, which underwent intensive validity studies. The collected data were analyzed using the R version 3.5.1 statistic computing platform. The ability of the elderly with dementia to associate verbal expressions with facial expressions differed from that of the general elderly population. The rates of correct associations of verbal expressions to facial expressions were similar across dementia grades. There was a significant difference in the proportion of correct associations between positive and negative emotions in the elderly with dementia compared to the general elderly population. In the elderly with dementia, pictures showing fear, anger, and disgust had higher wrong rates of incorrect answers than correct answers. The average score of elderly with dementia in associating verbal expressions with six facial expressions was 2.69, which was even lower when they were asked to associate verbal expressions with pictures showing facial expressions of anger or disgust. This study shows that elderly persons with dementia have difficulties identifying two negative emotions (anger, disgust) and find it much easier to identify a positive emotion of happiness represented by a smiling face. Since the ability of the elderly with dementia to interpret verbal expressions to facial expressions was different from that of the general elderly population, careful attention and consideration are needed to support and communicate emotions to the elderly with dementia.