Facial Emotion Recognition Ability May Improve in Alzheimer Disease: A Pilot Study

BACKGROUND Facial emotion recognition (FER) deficits in Alzheimer disease (AD) are associated with atypical eye-gaze strategies and exacerbated behavioral and psychological symptoms of dementia (BPSD). This results in increased caregiver burden and impacts social interactions and quality of life.

OBJECTIVE To evaluate the effects of Training of Affect Recognition (TAR), a targeted cognitive remediation program, on FER, eye-gaze patterns, and BPSD in individuals with AD, as well as caregiver burden. We hypothesized improvements in emotional processing and associated clinical outcomes.

METHODS Twenty-four patient-caregiver dyads participated in this single-blind randomized controlled pilot study. Each patient was assigned to participate in the TAR program (ie, the AD-TAR group; n = 12) or to receive cognitive stimulation intervention twice weekly for 6 weeks (ie, the AD-CS group; n = 12). We assessed FER using static (n = 24) and dynamic (n = 16) stimuli with eye-tracking. We used the Neuropsychiatric Inventory to assess BPSD and the Zarit Burden Interview to assess caregiver burden. Each assessment was completed at baseline, post-intervention, and 1-month follow-up.

RESULTS The AD-TAR group showed improvements in static FER accuracy and recognition speed, as well as increased dynamic FER speed. There were concomitant beneficial changes in eye-gaze strategies in static FER and reinforced observation strategies for dynamic FER. Reductions in BPSD and caregiver burden persisted at the 1-month follow-up.

CONCLUSION Targeted FER remediation is a promising intervention for improving emotional processing in AD, with potential clinical implications for managing BPSD and enhancing quality of life for individuals with AD and their caregivers.