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Theory of mind in Alzheimer’s disease and amnestic mild cognitive impairment: a meta-analysis

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Abstract

Background

The assessment of theory of mind (ToM) performance in Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI) remains inconclusive. We conducted a meta-analysis to investigate ToM performance in patients with aMCI and AD.

Methods

A systematic literature search was performed for eligible studies published up to July 2019 in three international databases (PubMed, Embase, and Web of Science). Due to heterogeneity between studies, a random-effects model was used. Individual ToM tasks were meta-analyzed separately and possible sources of heterogeneity were examined.

Results

In total, 36 studies involving 701 individuals with AD and 197 with aMCI were identified. Compared with healthy controls, ToM was impaired in both AD (d = 1.45) and aMCI patients (d = 0.65). In AD patients, ToM was particularly impaired in advanced tasks such as Faux Pas Recognition (d = 1.26). In patients with aMCI, ToM deficits were relatively modest, with the exception of the reading the mind in the eyes task (d = 1.22). ToM was significantly more impaired in AD than that in aMCI (d = 0.88).

Conclusions

This is the first meta-analysis examining ToM performance in AD and aMCI simultaneously. The results showed that ToM deficits were more severe in AD than that in aMCI in most individual ToM tasks. Longitudinal studies are warranted to determine whether ToM abilities in aMCI patients can be used for prognostic purposes.

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Abbreviations

AD:

Alzheimer’s disease

aMCI:

Amnestic mild cognitive impairment

CI:

Confidence interval

FB:

False belief task

FB1:

First-order FB

FB2:

Second-order FB

FPR:

Faux Pas Recognition Task

IFG:

Inferior frontal gyrus

MCI:

Mild cognitive impairment

MMSE:

Mini mental state examination

NOS:

Newcastle-Ottawa Scale

pSTS:

Posterior superior temporal sulcus

RMET:

Reading the mind in the eyes task

ToM:

Theory of mind

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Acknowledgments

We would like to thank all the authors of the included studies.

Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81601161) and Jiangsu Provincial Commission of Health and Family Planning (Grant No. QNRC2016466).

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Authors and Affiliations

  1. Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, People’s Republic of China

    ZhongQuan Yi, PanWen Zhao, Hui Zhang, YuanYuan Shi & PingLei Pan

  2. Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, West Xindu Road 2#, Yancheng, 224001, Jiangsu Province, People’s Republic of China

    HaiChun Shi, JianGuo Zhong & PingLei Pan

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  1. ZhongQuan Yi
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  2. PanWen Zhao
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  3. Hui Zhang
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Correspondence to JianGuo Zhong or PingLei Pan.

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Yi, Z., Zhao, P., Zhang, H. et al. Theory of mind in Alzheimer’s disease and amnestic mild cognitive impairment: a meta-analysis. Neurol Sci 41, 1027–1039 (2020). https://doi.org/10.1007/s10072-019-04215-5

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