The recognition of facial expressions of emotion in Alzheimer's disease: a review of findings

Objective: To provide a selective review of the literature on the recognition of facial expressions of emotion in Alzheimer's disease (AD), to evaluate whether these patients show variation in their ability to recognise different emotions and whether any such impairments are instead because of a general decline in cognition. Methods: A narrative review based on relevant articles identified from PubMed and PsycInfo searches from 1987 to 2007 using keywords 'Alzheimer's', 'facial expression recognition', 'dementia' and 'emotion processing'. Conclusion: Although the literature is as yet limited, with several methodological inconsistencies, AD patients show poorer recognition of facial expressions, with particular difficulty with sad expressions. It is unclear whether poorer performance reflects the general cognitive decline and/or verbal or spatial deficits associated with AD or whether the deficits reflect specific neuropathology. This under-represented field of study may help to extend our understanding of social functioning in AD. Future work requires more detailed analyses of ancillary cognitive measures, more ecologically valid facial displays of emotion and a reference situation that more closely approximates an actual social interaction.