Social cognition is crucial to optimal social functioning outcomes in older adults, with implications for overall health and wellbeing. Moreover, poor social cognition is a diagnostic criterion for neurocognitive disorders (NCDs). Prior work has studied the social cognitive subdomains (theory of mind (ToM), affective empathy, emotion recognition, and social behaviour) and found mild cognitive impairment and dementia to be associated with poorer performance in specific tasks and informant-reported changes respectively. These patterns in NCDs need to be distinguished from normal age-related changes, and more information is needed to ascertain what factors predict social cognitive decline in healthy ageing. 132 non-demented participants [mean MMSE 29.23 (SD 0.99)] aged 60 to 100 underwent comprehensive social cognitive assessments that varied based on modality of information (Figure 1), alongside neurocognitive assessments and affective questionnaires. Participants were divided based on decades to study age-related changes. Linear regression models identified significant predictors of social cognition performance amongst demographic, neuropsychological assessment scores, affective scores, and social networks. Age was associated with poorer performance in ToM tasks, specifically the Reading the Mind in the Eyes Test (RMET), Multifaceted Empathy Test (MET) Cognitive subscale, and The Awareness of Social Inference Test (TASIT) part 3, and emotion recognition tasks, specifically the FACES task and TASIT 1, for expressions of anger, disgust, and sadness (Table 1). In regression models (Table 2), age was a significant predictor of RMET and FACES performance. In MET cognitive and both TASITs, neuropsychological tasks, mainly executive function, were predictive. Poorer executive function predicted performance for identifying unspoken emotions (“Feel” subscore) in TASIT 3. MET Emotional and the self-rated Interpersonal Reactivity Index (IRI) Empathic Concern subscale was associated with less anxiety and more positive emotions at assessment. In ToM and emotion recognition, unimodal task performance was associated with age and some cognitive factors, and multimodal task performance was largely associated with executive function. Performance in affective empathy tasks was linked to affective measures. Poor performance in multimodal tasks likely reflects executive dysfunction in consolidating multiple streams of social information, while some declining performance in unimodal tasks may be normative to ageing.

OBJECTIVE:To study general and subdomain performance in measures of social cognition in individuals with mild cognitive impairment (MCI), and dementia, and to explore associations between social cognitive and neuropsychological subdomains. DESIGN:Cross-sectional study of participants from the Sydney Memory and Ageing Study (MAS). SETTING:Current data was collected in 2016-2018. PARTICIPANTS:Community-dwelling older adults (n=321) aged 80 years and above, with no history of neurological or psychiatric conditions. Participants had dementia, MCI, or no cognitive impairment (NCI). MEASURES:Social cognition was indexed using the Reading the Mind in the Eyes Test (RMET), the Interpersonal Reactivity Index - Perspective Taking (IRI-PT) and Empathic Concern (IRI-EC) subscales, and the Emotion Recognition Task (ERT). These subdomain scores were used to make a composite social cognition score. Apathy was measured via the Apathy Evaluation Scale (AES). Neurocognitive function was indexed using the Addenbrooke Cognitive Examination v3 (ACE-3). RESULTS:Dementia was associated with poorer overall social cognitive composite performance. MCI and dementia participants performed poorer on RMET and recognition of anger, disgust and happiness on ERT. RMET and ERT disgust remained significant after controlling for relevant covariates. Dementia participants performed poorer than MCI and NCI on the IRI-PT, IRI-EC, and AES. AES remained significant after regression. RMET was correlated with ACE-3 Fluency and/or Language in all study groups. CONCLUSIONS:MCI is associated with poorer scores in specific social cognitive assessments. Dementia is somewhat associated with poorer scores in informant-rated social cognition scales, though this is no longer significant after accounting for apathy.

Empathy is a core component of social cognition that can be indexed via behavioral, informant-report, or self-report methods of assessment. However, concerns have been raised regarding the lack of convergence between these assessment approaches for cognitive empathy. Here, we provided the first comparison of all three measurement approaches for cognitive and affective empathy in a large adult sample ( N = 371) aged 18 to 101 years. We found that poor convergence was more of a problem for cognitive empathy than affective empathy. While none of the cognitive empathy measures correlated with each other, for affective empathy, self-report was significantly associated with both behavioral and informant-report assessments. However, for both cognitive and affective empathy, there was evidence for poor discriminant validity within the measures. Out of the three assessment approaches, only the informant-report measures were consistently associated with indices of social functioning. Importantly, age did not moderate any of the tested relationships, indicating that both the strengths and the limitations of these different types of assessment do not appear to vary as a function of age. These findings highlight the variation that exists among empathy measures and are discussed in relation to their practical implications for the assessment of empathy.

Abstract Empathy is essential for navigating complex social environments. Prior work has shown associations between rs53576, a single nucleotide polymorphism (SNP) located in the oxytocin receptor gene (OXTR), and generalized empathy. We undertook a systematic review and meta-analysis to assess the effects of rs53576 on subdomains of empathy, specifically cognitive empathy (CE) and affective empathy (AE), in healthy adults. Twenty cohorts of 8933 participants aged 18–98 were identified, including data from the Sydney Memory and Ageing Study, a cohort of older community adults. Meta-analyses found G homozygotes had greater generalized empathic abilities only in young to middle-aged adults. While meta-analyses of empathy subdomains yielded no significant overall effects, there were differential effects based on ethnicity. G homozygotes were associated with greater CE abilities in Asian cohorts (standardized mean difference; SMD: 0.09 [2.8·10−3–0.18]), and greater AE performance in European cohorts [SMD: 0.12 (0.04–0.21)]. The current literature highlights a need for further work that distinguishes between genetic and ethnocultural effects and explores effects of advanced age on this relationship.

AbstractBackgroundAging is associated with changes in general cognition and social cognition. Many studies have detailed these functions in isolation, comparing young and older adults. More information is needed on how social cognition, including theory of mind (ToM), affective empathy (AE), social perception (SP), and social behavior (SB), is affected at different cognitive stages in older adults.MethodCross‐sectional study of 305 older adults from the Sydney Memory and Ageing Study. Dementia was classified based on clinical consensus using DSM‐IV criteria, while mild cognitive impairment (MCI) was classified using the International Working Group criteria. Cognitively normal (CN), MCI, and dementia participants were compared on social cognitive domains including: ToM, via the Reading the Mind in the Eyes Test (RMET) and the Interpersonal Reactivity Index – Perspective Taking subscale (IRI‐PT); AE, via the IRI – Empathic Concern subscale (IRI‐EC); and SP, via the Emotion Recognition Task (ERT). Apathy, which is related to SB, was measured via the Apathy Evaluation Scale (AES).ResultMean age 87.00 ± 4.05 years, mean education 11.89 ± 3.36 years, 60.3% female. 141 were CN, 103 had MCI, and 61 had dementia. Across cognitive groups, significant differences were observed for the RMET, ERT (specifically for the recognition of anger, disgust, and happiness), AES, IRI‐PT, and IRI‐EC. In posthoc comparisons, RMET and ERT were significantly poorer in MCI and dementia compared to CN, but not between MCI and dementia. IRI ratings and AES were poorer for dementia compared to MCI and CN, but not between MCI and CN (Table 1). In multivariable logistic regression adjusting for significant risk factors for cognitive impairment, RMET and ERT disgust performance were associated with lower risk of MCI over CN. Only AES significantly differentiated dementia from MCI (Table 2).ConclusionNeurocognitive disorders are associated with social cognition changes. ToM and SP appear to be affected in MCI relative to CN. Apathy, known to be linked to SB, appears to be affected in dementia. MCI seems to be associated with impaired ability to recognize specific social cognitive cues, while dementia may be more associated with overall worse social cognitive functioning and observed behavioral changes.

BackgroundThe Reading the Mind in the Eyes test (RMET) is a 36‐item assessment for theory of mind (ToM) performance. While this measure has been shown to be sensitive to age‐related ToM difficulties, there are no established cutoffs or guidelines currently available that are specific to older adults. This article seeks to validate a short‐form version of the RMET appropriate for use in such populations.MethodsCross‐sectional data from 295 participants (mean age 86 years) from the Sydney Memory and Ageing Study, a longitudinal community observational cohort. Participants underwent an assessment battery that included the RMET. Individuals who scored >1SD below the RMET scores of cognitively normal participants were deemed to have below average RMET scores. Various model‐building methods were used to generate short‐form solutions of the RMET, which were compared with previously validated versions in their predictive power for below average full RMET performance.ResultsIndividuals with below average RMET performance tended to be older and have poorer global cognition. Of the eight short‐form solutions, the 21‐item version generated using genetic algorithm exhibited the best classification performance with an area under the receiver operating curve (AUROC) of 0.98 and had 93.2% accuracy in classifying individuals with below average ToM. A shorter 10‐item solution derived by ant colony optimization also had acceptable performance.ConclusionWe recommend the 21‐item version of the RMET for use in older adult populations for identifying individuals with impaired ToM. Where an even shorter version is needed with a trade‐off of slightly reduced performance, the 10‐item version is acceptable.