Impairments of Social Cognition and Decision Making in Alzheimer's Disease

Objective: To investigate the nature of deficits in social cognition and real-life decision making in a group of patients with Alzheimer's disease (AD). Desigii: A comprehensive neuropsychological and psychiatric assessment, including the Moral Judgment Interview and the Bechara's Card Test, was carried out in 25 patients with AD and 20 age- comparable normal controls. Setting: Outpatient clinic. Results: AD patients had significantly lower scores in the Moral Judgment Interview and obtained significantly less earnings in the card test when compared to the normal control group. The Moral Judgment Interview score correlated significantly with Raven's Progressive Matrices and Block Design, whereas the card test correlated significantly with both the Benton Visual Retention Test and the Buschke Selective Reminding Test. No significant correlations were observed between the experimental tasks and the psychiatric variables. Conclusions: AD patients demonstrated significant deficits on tasks assessing social cognition and real-life decision making. These impairments correlated with deficits on specific neuropsychological tasks, but not with behavioral problems frequently found in AD patients. Behavioral disturbances such as depres- sion, anxiety, and irritability are frequent findings among patients with Alzheimer's disease (Burns et al., 1990). In a recent study that included a consecutive series of 196 patients with AD, we found aggressive behavior to be significantly associated with