Abstract
Background: Patients with Alzheimer disease consistently demonstrate impaired performance on tests of facial emotion processing. However, it remains unclear how early in the neurodegenerative process these deficits emerge. Methods: We approached this question by examining facial emotional processing in a ‘pre-dementia’ condition, amnestic mild cognitive impairment (MCI). Nine single-domain amnestic MCI subjects, 14 multiple-domain amnestic MCI subjects (MCI-MD), and 68 normal control subjects were assessed with the Florida Affect Battery. Results: After adjustment for age and gender, analyses of performance across the facial affect processing subtests of the Florida Affect Battery demonstrated intact performance in the single-domain MCI group but significantly impaired performance in the MCI-MD group, particularly on a test of facial affect discrimination. Within the MCI-MD group, men performed disproportionately worse than women. Performance on facial affect discriminations in the MCI-MD group correlated most robustly with performance on tests of frontal/executive function. Conclusion: These data suggest that facial emotion processing can be impaired in MCI prior to the more marked cognitive deficits seen with clinically diagnosed Alzheimer disease.