Young-onset Alzheimer's disease (YOAD) is defined as when the disease starts before 65 years old. Compared with late-onset AD (LOAD), the progression is faster and more aggressive. However, the impact on social cognition deficits may not follow the same clear pattern.
Objective
The present study aims to investigate the relationship between social cognition, global cognition, and other clinical variables in people with YOAD and LOAD and their caregivers.
Methods
Using a cross-sectional design, we included 48 people with YOAD and 118 with LOAD, and their caregivers. We assessed social cognition, global cognition, quality of life, dementia severity, mood, functionality, neuropsychiatric symptoms, and caregiver burden.
Results
The YOAD group was more impaired in general cognition (p = 0.002, d = 0.06), had a worse quality of life (p = 0.036, d = 0.36), and presented more neuropsychiatric symptoms (p = 0.044, d = 0.35). However, social cognition did not exhibit the same disease progression and showed no difference when compared with the reports of their caregivers or with individuals with LOAD. The multifactorial regression analyses showed that functionality was related to social cognition impairment in YOAD (p = 0.035), and LOAD (p = 0.001).
Conclusions
Our study found that people diagnosed with YOAD showed more global cognitive impairment but maintained social and emotional functioning.
MendezMF. Early-onset Alzheimer disease and its variants. Contin Lifelong Learn Neurol2019; 25: 34–51.
2.
HelvikASHvidstenLEngedalK, et al.Living with young-onset dementia in the family–a mixed method study. Aging Ment Heal2024; 28: 254–261.
3.
JohannessenAEngedalKThorsenK. Family carers of people with young-onset dementia: their experiences with the supporter service. Geriatrics (Basel)2016; 1: 28.
4.
BaptistaMATSantosRLKimuraN, et al.Differences in awareness of disease between young-onset and late-onset dementia. Alzheimer Dis Assoc Disord2019; 33: 129–135.
5.
ErikssonHFereshtehnejadFFalahatiF, et al.Differences in routine clinical practice between early and late onset Alzheimer’s disease: data from the Swedish dementia registry (SveDem). J Alzheimers Dis2014; 41: 411–419.
6.
AyodeleTRogaevaEKurupJT, et al.Early-onset Alzheimer’s disease: what is missing in research?Curr Neurol Neurosci Rep2021; 21: 4.
7.
SpreadburyJHKippsCM. Measuring younger onset dementia: a comprehensive literature search of the quantitative psychosocial research. Dementia2016; 18: 135–156.
8.
KimuraNRSBaptistaMATDouradoMCN. Differences in the predictors of the resilience between carers of people with young-and late-onset dementia: a comparative study. Dement Neuropsychol2022; 16: 292–299.
9.
BaptistaMATKimuraNLacerdaIB, et al.Domains of awareness in young and late onset dementia. J Alzheimers Dis2021; 81: 169–178.
10.
MarkováISClareLWhitakerCJ, et al.Phenomena of awareness in dementia: heterogeneity and its implications. Conscious Cogn2014; 25: 17–26.
11.
DouradoMCNDe Melo FádelBNetoJPS, et al.Facial expression recognition patterns in mild and moderate Alzheimer’s disease. J Alzheimers Dis2019; 69: 539–549.
12.
Belfort Almeida Dos SantosTTNogueiraMMLLacerdaIB, et al.A longitudinal evaluation of the pattern of social cognition impairment in Brazilians with Alzheimer’s disease. Alzheimer Dis Assoc Disord2023; 37: 363–369.
13.
HutchingsRHodgesJRPiguetO, et al.Why should I care? Dimensions of socio-emotional cognition in younger-onset dementia. J Alzheimers Dis2015; 48: 135–147.
14.
BoraEWalterfangMVelakoulisD. Theory of mind in behavioural-variant frontotemporal dementia and Alzheimer’s disease: a meta-analysis. J Neurol Neurosurg Psychiatry2015; 86: 714–719.
15.
BelfortTSimõesJPSantosRL, et al.Social cognition: patterns of impairments in mild and moderate Alzheimer’s disease. Int J Geriatr Psychiatry2020; 35: 1385–1392.
16.
Klein-KoerkampYBaciuMHotP. Preserved and impaired emotional memory in Alzheimer’s disease. Front Psychol2012; 3: 331.
17.
Setién-SueroEMurillo-GarcíaNSevilla-RamosM, et al.Exploring the relationship between deficits in social cognition and neurodegenerative dementia: a systematic review. Front Aging Neurosci2022; 14: 778093.
18.
BramhamJMorrisRHornakJ, et al.Social and emotional functioning following bilateral and unilateral neurosurgical prefrontal cortex lesions. J Neuropsychol2009; 3: 125–143.
19.
KellyMNelisSMartyrA, et al.Trajectories of socio-emotional functioning in early-stage dementia: implications for the individual with dementia and their family carer. Aging Ment Health2021; 26: 1069–1077.
20.
BelfortTBramhamJNetoJPS, et al.Cross-cultural adaptation of the social and emotional questionnaire in dementia to the Brazilian population. São Paulo Med J2015; 133: 358–366.
21.
SchildA-KVolkJScharfenbergD, et al.Social cognition in patients with amnestic mild cognitive impairment and mild dementia of the Alzheimer type. J Alzheimers Dis2021; 83: 1173–1186.
22.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders – DSM-5. 5th ed. Washington: Association American Psychiatric, 2013.
23.
ShimokawaAYatomiNAnamizuS, et al.Comprehension of emotions: comparison between Alzheimer type and vascular type dementias. Dement Geriatr Cogn Disord2000; 11: 268–274.
24.
DouradoMCNMograbiDSantosR, et al.Awareness of disease in dementia: factor structure of the assessment scale of psychosocial impact of the diagnosis of dementia. J Alzheimers Dis2014; 41: 947–956.
25.
FolsteinMFolsteinSMcHughP. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res1975; 12: 189–198.
26.
BertolucciPBruckiSCampacciS, et al.O Mini-exame do estado mental em uma população geral. Impacto da escolaridade. Arq Neuropsiquiatr1994; 52: 1–7.
27.
SchultzRSivieroMBertolucciP. The cognitive subscale of the ‘Alzheimer’s disease assessment scale’ in a Brazilian sample. Brazilian J Med Biol Res2001; 34: 1295–1302.
28.
LogsdonRGibbonsLMcCurryS, et al.Assessing quality of life in older adults with cognitive impairment. Psychosom Med2002; 64: 510–519.
29.
NovelliMNitriniRCaramelliP. Validation of the Brazilian version of the quality of life scale for patients with Alzheimer disease and their caregivers (QOL-AD). Aging Ment Health2010; 14: 624–631.
30.
PfefferRKurosakiTHarrahC, et al.Measurement of functional activities in older adults in the community. J Gerontol1982; 37: 323–329.
31.
CummingsJMegaMGrayK, et al.The neuropsychiatric inventory. Comprehensive assessment of psychopathology in dementia. Neurology1994; 44: 2308–2314.
32.
CamozzatoAKochhannRSimeoniC, et al.Reliability of the Brazilian Portuguese version of the neuropsychiatric inventory (NPI) for Alzheimer s disease patients and their caregivers. Int Psychogeriatr2008; 20: 383–393.
33.
ZaritSReeverKBahc-PetersonJ. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist1980; 20: 649–655.
34.
ScazufcaM. Brazilian Version of the Burden Interview scale for the assessment of burden of care in carers of people with mental illnesses. Rev Bras Psiquiatr2002; 24: 12–17.
35.
HaukoosJSLewisRJ. Advanced statistics: bootstrapping confidence intervals for statistics with ‘difficult’ distributions. Acad Emerg Med2005; 12: 360–365.
36.
LakensD. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol2013; 4: 863.
37.
GumusMMultaniNMackML, et al.Progression of neuropsychiatric symptoms in young-onset versus late-onset Alzheimer’s disease. Geroscience2021; 43: 213–223.
38.
HartmannJRoßmeierCRiedlL, et al.Quality of life in advanced dementia with late onset, young onset, and very young onset. J Alzheimers Dis2021; 80: 283–297.
39.
HvidstenLEngedalKSelbækG, et al.Quality of life in people with young-onset Alzheimer’s dementia and frontotemporal dementia. Dement Geriatr Cogn Disord2018; 45: 91–104.
40.
KimuraNBaptistaMASantosRL, et al.Caregivers’ perspectives of quality of life of people with young- and late-onset Alzheimer disease. J Geriatr Psychiatry Neurol2018; 31: 76–83.
41.
DixitDSpreadburyJOrlandoR, et al.Quality of life assessments in individuals with young-onset dementia and their caregivers. J Geriatr Psychiatry Neurol2021; 34: 426–433.
42.
HutchingsRPalermoRPiguetO, et al.Disrupted face processing in frontotemporal dementia: a review of the clinical and neuroanatomical evidence. Neuropsychol Rev2017; 27: 18–30.
43.
AdolphsR. The social brain: neural basis of social knowledge. Annu Rev Psychol2009; 60: 693–716.
44.
BelfortTSantosRNogueiraM, et al.The relationship between social cognition and executive functions in Alzheimer’s disease: a systematic review. Curr Alzheimer Res2020; 17: 487–497.
45.
FlissRLe GallDEtcharry-BouyxF, et al.Theory of mind and social reserve: alternative hypothesis of progressive theory of mind decay during different stages of Alzheimer’s disease. Soc Neurosci2016; 11: 409–423.
46.
TorresBSantosRSousaMFB, et al.Facial expression recognition in Alzheimer's disease: a longitudinal study. Arq Neuropsiquiatr2015; 73: 383–389.
47.
ArioliMCrespiCCanessaN. Social cognition through the lens of cognitive and clinical neuroscience. Biomed Res Int2018; 2018: 4283427.
48.
PappaletteraCCarrariniCMiragliaF, et al.Cognitive resilience/reserve: myth or reality? A review of definitions and measurement methods. Alzheimers Dement2024; 20: 3567–3586.
49.
WilsonRSYuLLamarM, et al.Education and cognitive reserve in old age. Neurology2019; 92: E1041–E1050.
50.
MarshallGRentzDFreyM, et al.Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer’s disease. Alzheimers Dement2011; 7: 300–308.
