The relationship between social cognitive processes and behavior changes in people with amnestic Mild Cognitive Impairment or dementia using the Edinburgh Social Cognition Test (ESCoT)

Objectives: People with amnestic Mild Cognitive Impairment (aMCI) or dementia often exhibit a decline in their social abilities, but few tests of social cognition exist that are suitable for clinical use. Moreover, the relationship between changes in behaviour and impairments in social cognition is poorly understood. We examined the utility of the Edinburgh Social Cognition Test (ESCoT) in people with aMCI/dementia and explored associations between social cognition performance and behaviour changes.
Methods: We administered the ESCoT and two established social cognition tests (Reading the Mind in the Eyes; RME and the Social Norms Questionnaire; SNQ) to 28 people with aMCI or dementia and 28 age and sex matched cognitively healthy controls. Behaviour change was measured using a semi-structured interview which assesses behavioural abnormalities found in frontotemporal dementia.
Results: People with aMCI/dementia were impaired on the ESCoT affective ToM, ESCoT total score and the RME. Behaviour changes in the domains of apathy, loss of sympathy/empathy, perseveration, and psychotic symptoms were associated with poorer affective ToM scores. Disinhibition, loss of sympathy/empathy and hyperorality or altered food preferences were associated with cognitive ToM. All behaviours were significantly associated with poorer performance on ESCoT total score, but not the RME or SNQ.
Conclusion: The ESCoT was sensitive to social cognition impairments in people with aMCI/dementia and it relates to behaviour change in aMCI/dementia unlike established tests. Different subtests of the ESCoT were related to different behaviour changes. These findings suggest that the ESCoT may be a clinically valuable tool when examining social cognition.