Determinants of Theory of Mind performance in Alzheimer’s disease: A data-mining study

Ramanan, Siddharth, Cruz de Souza, Leonardo, Moreau, Noémie, Sarazin, Marie, Teixeira, Antônio L., Allen, Zoe, Guimarães, Henrique C., Caramelli, Paulo, Dubois, Bruno, Hornberger, Michael ORCID: and Bertoux, Maxime (2017) Determinants of Theory of Mind performance in Alzheimer’s disease: A data-mining study. Cortex, 88. pp. 8-18. ISSN 0010-9452

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Whether theory of mind (ToM) is preserved in Alzheimer’s disease (AD) remains a controversial subject. Recent studies have showed that performance on some ToM tests might be altered in AD, though to a lesser extent than in behavioural-variant Frontotemporal Dementia (bvFTD). It is however, unclear if this reflects a genuine impairment of ToM or a deficit secondary to the general cognitive decline observed in AD. Aiming to investigate the cognitive determinants of ToM performance in AD, a data-mining study was conducted in 29 AD patients then replicated in an independent age-matched group of 19 AD patients to perform an independent replication of the results. 44 bvFTD patients were included as a comparison group. All patients had an extensive neuropsychological examination. Hierarchical clustering analyses showed that ToM performance clustered with measures of executive functioning in AD. ToM performance was also specifically correlated with the executive component extracted from a principal component analysis. In a final step, automated linear modelling conducted to determine the predictors of ToM performance showed that 48.8% of ToM performance was significantly predicted by executive measures. Similar findings across analyses were observed in the independent group of AD patients, thereby replicating our results. Conversely, ToM impairments in bvFTD appeared independent of other cognitive impairments. These results suggest that difficulties of AD patients on ToM tests do not reflect a genuine ToM deficit, rather mediated by general (and particularly executive) cognitive decline. They also suggest that executive functioning has a key role in mental state attribution, which support interacting models of ToM functioning. Finally, our study highlights the relevancy of data-mining statistical approaches in clinical and cognitive neurosciences.

Item Type: Article
Additional Information: This is an open access article under the CC BY-NC-ND license (
Uncontrolled Keywords: theory of mind,alzheimer’s disease,behavioral variant frontotemporal dementia,data mining,data driven
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Mental Health
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
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Depositing User: Pure Connector
Date Deposited: 09 Dec 2016 00:07
Last Modified: 19 Oct 2023 01:52
DOI: 10.1016/j.cortex.2016.11.014


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