Introducing ISPA-AD: Interactive social problem-solving assessment for Alzheimer's disease

Social adaptation difficulties in Alzheimer's disease (AD) are frequently associated with impairments in social cognition, including theory of mind and emotion recognition. However, social problem-solving (SPS) may also be a crucial yet understudied component of these deficits. This study aimed to develop and conduct an exploratory evaluation of the Interactive Social Problem-Solving Assessment for Alzheimer's Disease (ISPA-AD), an experimental tool addressing the lack of instruments to evaluate SPS in AD. ISPA-AD presents interactive scenarios designed to evaluate verbal and non-verbal components of SPS. Forty-one participants (19 AD patients and 22 healthy controls) completed the task. Psychometric analyses examined internal consistency, construct validity and discriminative ability. ISPA-AD showed good internal consistency (α = .811), strong construct validity and excellent accuracy in distinguishing AD participants from controls (AUC = .906). AD patients exhibited significantly lower SPS performance, revealing a specific pattern of deficits across the task dimensions. ISPA-AD provides a novel, ecologically grounded approach to assessing SPS in AD. These preliminary findings support its clinical relevance and suggest that the tool may offer valuable insights into the social cognitive mechanisms underlying adaptive behaviour in AD. Further validation in larger and more diverse samples, including reliability studies, is warranted.