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Original Article
Dementia and Neurocognitive Disorders 2023: 22: 4: 158-168

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Facial Emotion Recognition in Older Adults With Cognitive Complaints
YongSoo Shim
Department of Neurology, The Catholic University of Korea, Eunpyeong St. Mary’s Hospital, Seoul, Korea
Facial Emotion Recognition in Older Adults With Cognitive Complaints
YongSoo Shim
Department of Neurology, The Catholic University of Korea, Eunpyeong St. Mary’s Hospital, Seoul, Korea
Background and Purpose: Facial emotion recognition deficits impact the daily life,
particularly of Alzheimer’s disease patients. We aimed to assess these deficits in the following
three groups: subjective cognitive decline (SCD), mild cognitive impairment (MCI), and
mild Alzheimer’s dementia (AD). Additionally, we explored the associations between facial
emotion recognition and cognitive performance.
Methods: We used the Korean version of the Florida Facial Affect Battery (K-FAB) in 72
SCD, 76 MCI, and 76 mild AD subjects. The comparison was conducted using the analysis
of covariance (ANCOVA), with adjustments being made for age and sex. The Mini-Mental
State Examination (MMSE) was utilized to gauge the overall cognitive status, while the Seoul
Neuropsychological Screening Battery (SNSB) was employed to evaluate the performance in
the following five cognitive domains: attention, language, visuospatial abilities, memory, and
frontal executive functions.
Results: The ANCOVA results showed significant differences in K-FAB subtests 3, 4, and 5
(p=0.001, p=0.003, and p=0.004, respectively), especially for anger and fearful emotions.
Recognition of ‘anger’ in the FAB subtest 5 declined from SCD to MCI to mild AD.
Correlations were observed with age and education, and after controlling for these factors,
MMSE and frontal executive function were associated with FAB tests, particularly in the FAB
subtest 5 (r=0.507, p<0.001 and r=−0.288, p=0.026, respectively).
Conclusions: Emotion recognition deficits worsened from SCD to MCI to mild AD, especially
for negative emotions. Complex tasks, such as matching, selection, and naming, showed greater
deficits, with a connection to cognitive impairment, especially frontal executive dysfunction.
Key Words: Emotions; Facial Recognition; Alzheimer Disease; Cognitive Dysfunction
대한치매학회지 (Dementia and Neurocognitive Disorders)