A – 110 Emotional Versus Cognitive Perspective-Taking in Early-Stage Alzheimer’s Disease Subtypes

Abstract Objective This study examined whether cognitive and emotional perspective-taking (PT) are differentially affected across Alzheimer’s disease (AD) subtypes and severity stages. We hypothesized that cognitive PT would be more impaired than emotional PT and that this discrepancy would be consistent across clinical variants of AD. Method Participants were 217 older adults recruited from a university-based clinic, including individuals with typical AD (TypAD), behavioral variant AD (bvAD), logopenic variant primary progressive aphasia (lvPPA), and older healthy controls (HCs). Only patients at mild disease severity (Clinical Dementia Rating [CDR] 0.5 or 1) were enrolled. Emotional PT was assessed with informant reports using the PT subtest of the Interpersonal Reactivity Index (IRI-PT), and cognitive PT with the face-to face Cognitive and Emotional PT Test (CEPT-cToM). Z-scores computed using HC norms were analyzed with linear mixed-effects models adjusted for age, gender, and education to evaluate effects of PT type, diagnosis, and severity. Tukey-Kramer testing was used for post-hoc pairwise comparisons. Results Compared to HCs, all subtypes scored lower on both PT types (p<.05), with larger effects observed for cognitive PT. Cognitive PT scores were significantly lower than emotional PT across all AD groups (p<.001), with a larger discrepancy at CDR 1 (p<.001). Within-group comparisons showed significant emotional > cognitive PT differences in TypAD and lvPPA at CDR 0.5 (p<.001), and in all subtypes at CDR 1 (p<.001). Conclusion Emotional PT was consistently more preserved than cognitive PT across AD subtypes. Given early social cognition changes across syndromes, PT measures should be included in dementia evaluations and treatment planning.