A Review of Theory of Mind in Aging in Clinical Situations

Year 2023, Volume: 16 Issue: 2, 94 - 103, 30.12.2023

Ayten Ekinci

https://doi.org/10.46414/yasad.1329891

Abstract

Mechanisms that enable older adults to lead active social lives have been regarded as promising ways to promote health and well-being into old age. Theory of Mind (ToM) is one of the most important social cognitive abilities to maintain efficient and compatible social functioning. While lighting the changes in ToM in healthy aging, it is emphasized that research should also evaluate the changes that occur with pathological aging. Understanding the studies that analyze ToM functionality is crucial as these impairments worsen patients’ quality of life and pose a risk that may increase patients’ social isolation. Impaired ToM which represents a fundamental feature of most clinical conditions in older patients, has been described in various neurological and psychiatric disorders. In addition, extensive research has been conducted on patients with dementia and schizophrenia. There are mechanisms that mediate the role of effective processes in the ability to make sense of the behavior of others and to plan socially appropriate actions. In this review, based on different mechanisms deepening research on ToM related to neurodegenerative and psychiatric diseases in older adults has been evaluated. As the current situation on the subject is still obscure, this review may offer the opportunity to explore limitations and be a starting point for future research. In addition, aim to increase awareness by drawing attention to the crucial role of including ToM function scales in neuropsychological protocols for detecting pathological cases or evaluating early-stage symptoms and following their progression.

Keywords

aging, theory of mind, social cognition, pathology

Yaşlanmada Zihin Kuramı’nın Klinik Durumlarda Gözden Geçirilmesi

Abstract

Yaşlı yetişkinlerin aktif sosyal yaşamı sürdürmesine imkan veren mekanizmalar, ileri yaşlara kadar sağlığı ve iyi oluşu teşvik etmek için umut verici bir yol olarak görülmektedir. Zihin Kuramı (ZK) etkili ve uyumlu sosyal işleyişin devamı için en önemli sosyal bilişsel becerilerden biridir. Sağlıklı yaşlanmada ZK’deki değişiklikler aydınlatılırken araştırmaların patolojik yaşlanma ile ortaya çıkan değişiklikleri de değerlendirmesi ve ulaşılan sonuçların göz önünde bulundurulmasının gerekliliği üzerinde durulmaktadır. ZK işlevselliğini analiz eden araştırmaların anlaşılması, klinik durumlarda sık görülen bir bulgu olan bu bozulmaların hastaların yaşam kalitesini kötüleştirdiği ve sosyal izolasyonunu artırabilecek risk oluşturduğu için önemlidir. Yaşlı yetişkinlerde çoğu klinik durumun temel bir özelliğini temsil eden bozulmuş ZK çeşitli nörolojik ve psikiyatrik hastalıklarda tanımlanmış, en kapsamlı araştırmalar demans ve şizofreni için yapılmıştır. Diğerlerinin davranışlarını anlamlandırma ve sosyal olarak uygun eylemleri planlama becerisinde etkili süreçlerin rolüne aracılık eden mekanizmalar vardır. Bu derleme çalışmasında, farklı mekanizmalar temelinde yaşlı yetişkinlerde nörodejeneratif ve psikiyatrik hastalıklarla ilişkili derinleşen ZK araştırmaları ele alınmıştır. Konuyla ilgili mevcut durum hala netleşmediği için bu derleme sınırlılıkları keşfetme olanağı sunabilir ve gelecekteki araştırmalar için bir başlangıç noktası olabilir. Ayrıca patolojik olguları saptamaya veya erken evre belirtilerini değerlendirmeye ve ilerleyişi takibe yönelik nöropsikolojik protokollerde ZK işlev ölçeklerinin de yer almasının kilit rolüne dikkat çekerek farkındalığı artırmak amaçlanmıştır.

Keywords

yaşlanma, zihin kuramı, sosyal biliş, pataloji

References

• Abu-Akel, A., & Shamay-Tsoory, S. (2011). Neuroanatomical and neurochemical bases of theory of mind. Neuropsychologia, 49(11), 2971-2984. doi: 10.1016/j.neuropsychologia.2011.07. 012
• Afshar, P. F., Foroughan, M., Vedadhi, A. A., & Ghazi Tabatabaei, M. (2017). Relationship between social function and social well-being in older adults. Iranian Rehabilitation Journal, 15(2), 135-140. doi:10.18869/nrip.irj.15.2.135
• Allain, P., Havet-Thomassin, V., Verny, C., Gohier, B., Lancelot, C., Besnard, J., … & Le Gall, D. (2011). Evidence for deficits on different components of theory of mind in Huntington's disease. Neuropsychology, 25(6), 741. doi:10.1037 /a0024408
• Arioli, M., Crespi, C., & Canessa, N. (2018). Social cognition through the lens of cognitive and clinical neuroscience. BioMed Research International, 4283427. doi:10.1155/2018/4283427
• Beadle, J. N., & De la Vega, C. E. (2019). Impact of aging on empathy: Review of psychological and neural mechanisms. Frontiers in Psychiatry, 10, 331. doi:10.3389/fpsyt.2019.00331
• Berecz, H., Tényi, T., & Herold, R. (2016). Theory of mind in depressive disorders: A review of the literature. Psychopathology, 49(3), 125-134. doi:10.1159/000446707
• Bertoux, M., Delavest, M., de Souza, L. C., Funkiewiez, A., Lépine, J. P., Fossati, P., … & Sarazin, M. (2012). Social cognition and emotional assessment differentiates frontotemporal dementia from depression. Journal of Neurology, Neurosurgery & Psychiatry, 83(4), 411-416. doi:10.1136/jnnp-2011-301849
• Bora, E., Bartholomeusz, C., & Pantelis, C. (2016). Metaanalysis of Theory of Mind (ToM) impairment in bipolar disorder. Psychological Medicine, 46(2), 253-264. doi:10.1017/ S0033291715001993
• Bora, E., Walterfang, M., & Velakoulis, D. (2015). Theory of mind in Parkinson’s disease: a meta-analysis. Behavioural Brain Research, 292, 515-520. doi:10.1016/j.bbr.2015.07.012
• Bora, E., & Yener, G. G. (2017). Meta-analysis of social cognition in mild cognitive impairment. Journal of Geriatric Psychiatry and Neurology, 30(4), 206-213. doi:10.1177/0891988 717710337
• Bottiroli, S., Cavallini, E., Ceccato, I., Vecchi, T., & Lecce, S. (2016). Theory of Mind in aging: Comparing cognitive and affective components in the faux pas test. Archives of Gerontology and Geriatrics, 62, 152-162. doi:10.1016/j.archger.2015.09.009
• Brüne, M. (2005). “Theory of mind” in schizophrenia: a review of the literature. Schizophrenia Bulletin, 31(1), 21-42. doi:10.1093/schbul/sbi002
• Chander, R. J., Grainger, S. A., Crawford, J. D., Mather, K. A., Numbers, K., Cleary, R., … & Sachdev, P. S. (2020). Development of a short-form version of the Reading the Mind in the Eyes Test for assessing theory of mind in older adults. International Journal of Geriatric Psychiatry, 35(11), 1322-1330. doi:10.1002/gps.5369
• Chainay, H., & Gaubert, F. (2020). Affective and cognitive theory of mind in Alzheimer’s disease: The role of executive functions. Journal of Clinical and Experimental Neuropsychology, 42(4), 371-386. doi:10.1080/13803395.2020.1726293
• Clegg, A., Young, J., Iliffe, S., Rikkert, M. O., & Rockwood, K. (2013). Frailty in elderly people. The Lancet, 381(9868), 752-762. doi:10.1016/S0140-6736 (12)62167-9
• Demichelis, O. P., Coundouris, S. P., Grainger, S. A., & Henry, J. D. (2020). Empathy and theory of mind in Alzheimer’s disease: A meta-analysis. Journal of The International Neuropsychological Society, 26(10), 963-977. doi:10.1017/S1355617720000478
• Dodich, A., Crespi, C., Santi, G. C., Cappa, S. F., & Cerami, C. (2020). Evaluation of discriminative detection abilities of social cognition measures for the diagnosis of the behavioral variant of Frontotemporal Dementia: A systematic review. Neuropsychology Review, 31(2), 251-266. doi:10. 1007/s11065-020-09457-1
• Dolu, N. (2010). Yaşlanmanın nörobiyolojisi. S. Karakaş (Ed.), Kognitik Nörobilimler içinde (s.267-280). Ankara: Nobel Tıp Kitapevleri.
• Duclos, H., Bejanin, A., Eustache, F., Desgranges, B., & Laisney, M. (2018). Role of context in affective theory of mind in Alzheimer's disease. Neuropsychologia, 119, 363-372. doi:10.1016/ j.neuropsychologia. 2018.08.025
• Duval, C., Piolino, P., Bejanin, A., Eustache, F., & Desgranges, B. (2011). Age effects on different components of theory of mind. Consciousness and Cognition, 20(3), 627-642. doi:10.1016/j.concog.2010.10.025
• Eddy, C. M., Mahalingappa, S. S., & Rickards, H. E. (2014). Putting things into perspective: The nature and impact of theory of mind impairment in Huntington’s disease. European Archives of Psychiatry and Clinical Neuroscience, 264(8), 697-705. doi:10.1007/s00406-014-0498-4
• Fett, A. K. J., Viechtbauer, W., Penn, D. L., van Os, J., & Krabbendam, L. (2011). The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neuroscience & Biobehavioral Reviews, 35(3), 573-588. doi:10.1016/j.neubiorev.2010.07. 001.
• Fliss, R., Le Gall, D., Etcharry-Bouyx, F., Chauviré, V., Desgranges, B., & Allain, P. (2016). Theory of mind and social reserve: Alternative hypothesis of progressive Theory of Mind decay during different stages of Alzheimer’s disease. Social Neuroscience, 11(4), 409-423. doi:10.1080/17470919.2015.1101014
• Fischer, A. L., O’Rourke, N., & Loken Thornton, W. (2017). Age differences in cognitive and affective theory of mind: Concurrent contributions of neurocognitive performance, sex, and pulse pressure. The Journals of Gerontology: Series B, 72(1), 71-81. doi:10.1093/geronb/ gbw088
• François, Q., & Rossetti, Y. (2020). What do theory-ofmind tasks actually measure? Theory and practice. Perspectives on Psychological Science, 15(2), 384-396. doi:10.1177/174569161 9896607
• Grainger, S. A., Steinvik, H. R., Henry, J. D., & Phillips, L. H. (2019). The role of social attention in older adults’ ability to interpret naturalistic social scenes. Quarterly Journal of Experimental Psychology, 72(6), 1328-1343. doi:10.1177/1747021818791774
• Grainger, S. A., Mead, J. K., Vanman, E. J., & Henry, J. D. (2021). The relationship between testosterone and social cognition in younger and older adults. Biological Psychology, 161, 108072. doi:10.1016/ j.biopsycho.2021.108072
• Gourlay, C., Collin, P., D’Auteuil, C., Jacques, M., Caron, P. O., & Scherzer, P. B. (2022). Age differences in social- cognitive abilities across the stages of adulthood and path model investigation of adult social cognition. Aging, Neuropsychology, and Cognition, 29(6), 1033-1067.1-35. doi:10.1080/13825585.2021.1962789
• Happe, F. G. E., Winner, E., & Brownell, H. (1998). The getting of wisdom: Theory of mind in old age. Developmental Psychology, 34(2), 358-362. doi:10.1037/0012-1649.34.2.358
• Henry, J. D., Cowan, D. G., Lee, T., & Sachdev, P. S. (2015). Recent trends in testing social cognition. Current Opinion in Psychiatry, 28(2), 133-140. doi:10.1097/YCO.0000000000000139
• Henry, J. D., Von Hippel, W., Molenberghs, P., Lee, T., & Sachdev, P. S. (2016). Clinical assessment of social cognitive function in neurological disorders. Nature Reviews Neurology, 12(1), 28-39. doi:10.1038/nrneurol.2015.229
• Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Medicine, 7(7), e1000316. doi:10.1371/journal.pmed.1000316
• Hutchins, T. L., Prelock, P. A., Morris, H., Benner, J., LaVigne, T., & Hoza, B. (2016). Explicit vs. applied theory of mind competence: A comparison of typically developing males, males with ASD, and males with ADHD. Research in Autism Spectrum Disorders, 21, 94-108. doi:10.1016/j.rasd.2015. 10.004
• Kemp, J., Després, O., Sellal, F., & Dufour, A. (2012). Theory of mind in normal ageing and neurodegenerative pathologies. Ageing Research Reviews, 11(2), 199-219. doi:10.1016/j.arr.2011. 12.001
• Kennedy, D. P., & Adolphs, R. (2012). The social brain in psychiatric and neurological disorders. Trends in Cognitive Sciences, 16(11), 559-572. doi:10.1016/j.tics.2012.09.006
• Kosutzka, Z., Kralova, M., Kusnirova, A., Papayova, M., Valkovic, P., Csefalvay, Z., & Hajduk, M. (2019). Neurocognitive predictors of understanding of intentions in Parkinson disease. Journal of Geriatric Psychiatry and Neurology, 32(4), 178-185. doi:10.1177/0891988719841727
• Lagravinese, G., Avanzino, L., Raffo De Ferrari, A., Marchese, R., Serrati, C., Mandich, P., ... & Pelosin, E. (2017). Theory of mind is impaired in mild to moderate Huntington’s disease independently from global cognitive functioning. Frontiers in Psychology, 8(80). doi:10.3389/fpsyg.2017.00080
• Lahera, G., Montes, J. M., Benito, A., Valdivia, M., Medina, E., Mirapeix, I., & Sáiz-Ruiz, J. (2008). Theory of mind deficit in bipolar disorder: Is it related to aprevious history of psychotic symptoms? Psychiatry Research, 161(3), 309-317. doi:10.1016 /j.psychres.2007.08.009
• Larsen, I. U., Vinther-Jensen, T., Gade, A., Nielsen, J. E., & Vogel, A. (2016). Do I misconstrue? Sarcasm detection, emotion recognition, and theory of mind in Huntington disease. Neuropsychology, 30(2), 181-189. doi:10.1037/neu0000224
• Lee, S., Jacobsen, E. P., Jia, Y., Snitz, B. E., Chang, C. C. H., & Ganguli, M. (2021). Reading the Mind in the Eyes: A population-based study of social cognition in older adults. The American Journal of Geriatric Psychiatry, 29(7), 634-642. doi:10.1016/j.jagp.2020.11.009
• Lin, X., Zhang, X., Liu, Q., Zhao, P., Zhang, H., Wang, H., & Yi, Z. (2021). Theory of mind in adults with traumatic brain injury: A meta-analysis. Neuroscience & Biobehavioral Reviews, 121, 106-118. doi:10.1016/j.neubiorev.2020.12.010
• Maggi, G., Cima Muñoz, A. M., Obeso, I., & Santangelo, G. (2022). Neuropsychological, neuropsychiatric, and clinical correlates of affective and cognitive theory of mind in Parkinson’s disease: A meta-analysis. Neuropsychology, 36(6), 483-504. doi:10.1037/neu0000807.
• Michaelian, J. C., Mowszowski, L., Guastella, A. J., Henry, J. D., Duffy, S., McCade, D., & Naismith, S. L. (2019). Theory of mind in mild cognitive impairment–relationship with limbic structures and behavio-ural change. Journal of the International Neuropsychological Society, 25(10), 1023-1034. doi:10.1017/S1355617719000870
• Mitchell, J. P. (2005). The false dichotomy between simulation and theory-theory: The argument's error. Trends in Cognitive Sciences, 9(8), 363-364. doi:10.1016/j.tics.2005.06.010
• Moran, J. M. (2013). Lifespan development: The effects of typical aging on theory of mind. Behavioural Brain Research, 237, 32-40. doi:10.1016/j.bbr.2012.09.020
• Morellini, L., Izzo, A., Ceroni, M., Rossi, S., Zerboni, G., Rege-Colet, L., … & Sacco, L. (2022). Theory of mind in patients with mild cognitive impairment: A systematic review. Frontiers in Psychology, 13, 994070. doi:10.3389/fpsyg.2022.994070
• Orso, B., Arnaldi, D., Famà, F., Girtler, N., Brugnolo, A., Doglione, E., … & Pardini, M. (2020). Anatomical and neurochemical bases of theory of mind in de novo Parkinson's disease. Cortex, 130, 401-412. doi:10.1016/j.cortex.2020.06.012
• Orso, B., Lorenzini, L., Arnaldi, D., Girtler, N., Brugnolo, A., Doglione, E., … & Pardini, M. (2022). The role of hub and spoke regions in theory of mind in early Alzheimer’s disease and frontotemporal dementia. Biomedicines, 10(3), 544. doi:10.3390/biomedicines10030544
• Paans, N. P., Korten, N., Orhan, M., Ensing, A., Schouws, S. N., Kupka, R., … & Dols, A. (2022). Is social functioning in older age patients with bipolar disorder associated with affective and/or non-affective cognition? International Journal of Geriatric Psychiatry. doi:10.1002/gps.5676
• Pardini, M., Gialloreti, L. E., Mascolo, M., Benassi, F., Abate, L., Guida, S., … & Cocito, L. (2013). Isolated theory of mind deficits and risk for frontotemporal dementia: a longitudinal pilot study. Journal of Neurology, Neurosurgery & Psychiatry, 84(7), 818-821. doi:10.1136/jnnp-2012-303684
• Péron, J., Vicente, S., Leray, E., Drapier, S., Drapier, D., Cohen, R., … & Vérin, M. (2009). Are dopaminergic pathways involved in theory of mind? A study in Parkinson's disease. Neuropsychologia, 47(2), 406-414. doi:10.1016/j.neuropsychologia.2008.09.008
• Peters, M., & Schulz, H. (2022). Theory of mind abilities in older patients with common mental disorders a cross sectional study. Aging & Mental Health, 26(8), 1661-1668. doi:10.1080/13607863.2021.1935461
• Phillips, L. H., Bull, R., Allen, R., Insch, P., Burr, K., & Ogg, W. (2011). Lifespan aging and belief reasoning: Influences of executive function and social cue decoding. Cognition, 120(2), 236-247. doi:10.1016/j.cognition.2011.05.003
• Poletti, M., Enrici, I., & Adenzato, M. (2012). Cognitive and affective theory of mind in neurodegenerative diseases: Neuropsychological, neuroanatomical and neurochemical levels. Neuroscience & Biobehavioral Reviews, 36(9), 2147-2164. doi:10.1016/j.neubiorev.2012.07.004
• Premack, D., & Woodruff, G. (1978). Does the chimpanzee have a theory of mind? Behavioral and Brain Sciences, 1(4), 515-526. doi:10.1017/S0140525X 00076512
• Roheger, M., Hranovska, K., Martin, A. K., & Meinzer, M. (2022). A systematic review and meta-analysis of social cognition training success across the healthy lifespan. Scientific Reports, 12(1), 3544. doi:10.1038/s41598-022-07420-z
• Romosan, A. M., Dehelean, L., Romosan, R. S., Andor, M., Bredicean, A. C., & Simu, M. A. (2019). Affective theory of mind in Parkinson’s disease: The effect of cognitive performance. Neuropsychiatric Disease and Treatment, 15, 2521-2535. doi:10.2147/NDT.S219288
• Rossetto, F., Baglio, F., Massaro, D., Alberoni, M., Nemni, R., Marchetti, A., & Castelli, I. (2020). Social cognition in rehabilitation context: different evolution of affective and cognitive theory of mind in mild cognitive impairment. Behavioural Neurology, 5204927. doi:10.1155/2020/5204927
• Ruitenberg, M. F., Santens, P., & Notebaert, W. (2020). Cognitive and affective theory of mind in healthy aging. Experimental Aging Research, 46(5), 382-395. doi:10.1080/0361073X. 2020.1802980
• Saltzman, J., Strauss, E., Hunter, M., & Archibald, S. (2000). Theory of mind and executive functions in normal human aging and Parkinson's disease. Journal of the International Neuropsychological Society, 6(7), 781-788. doi:10.1017/ s1355617700677056
• Schurz, M., Radua, J., Tholen, M. G., Maliske, L., Margulies, D. S., Mars, R. B., … & Kanske, P. (2021). Toward a hierarchical model of social cognition: A neuroimaging meta-analysis and integrative review of empathy and theory of mind. Psychological Bulletin, 147(3), 293-327. doi:10.1037/bul0000303
• Smeets-Janssen, M. M. J., Meesters, P. D., Comijs, H. C., Eikelenboom, P., Smit, J. H., De Haan, L., … & Stek, M. L. (2013). Theory of mind differences in older patients with early-onset and late-onset paranoid schizophrenia. International Journal of Geriatric Psychiatry, 28(11), 1141-1146. doi:10.1002/gps.3933
• Şencan, B. (2019). Theory of mind in major depressive disorder. Current Approaches in Psychiatry, 11(1), 42-54. doi:10.18863/pgy.383349
• Trompeta, C., Fernández Rodríguez, B., & Gasca-Salas, C. (2021). What do we know about theory of mind impairment in Parkinson’s Disease? Behavioral Sciences, 11(10), 130. doi:10.3390/bs111 00130
• Tsentidou, G., Moraitou, D., & Tsolaki, M. (2021). Similar theory of mind deficits in community dwelling older adults with vascular risk profile and patients with mild cognitive impairment: The case of paradoxical sarcasm comprehension. Brain Sciences, 11(5), 627. doi:10.3390/brainsci110 50627
• United Nations. (2022). World Population Prospects 2022: Summary of Results. https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/wpp2022_summary_of_results.pdf.
• Vogel, A., Jørgensen, K., & Larsen, I. U. (2022). Normative data for emotion hexagon test and frequency of impairment in behavioral variant frontotemporal dementia, Alzheimer’s disease and Huntington’s disease. Applied Neuropsychology: Adult, 29(1), 127-132. doi:10.1080/23279095. 2020.1720686
• Wang, Z., & Su, Y. (2013). Age-related differences in the performance of theory of mind in older adults: A dissociation of cognitive and affective components. Psychology and Aging, 28(1), 284-291. doi:10.1037/a0030876
• Youmans, G., & Bourgeois, M. (2010). Theory of mind in individuals with Alzheimer-type dementia. Aphasiology, 24(4), 515-534. doi:10.1080/02687030902801573
• Zegarra-Valdivia, J. A., Rijpma, M. G., Shany-Ur, T., Kramer, J. H., Miller, B. L., & Rankin, K. P. (2023). Cognitive and emotional theory of mind in dementia. Impact on real life behaviors. Alzheimer's & Dementia, 19, e067855. doi:10.1002/alz.067855