神经病学和神经科学杂志

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Theory of Mind in Unsuccessful Neurocognitive Aging: Preliminary Evidence from an aMCI-Converter to AD and From an aMCI Reverter to Near-Normal Cognition

Ilaria Castelli, Francesca Baglio, Federica Savazzi, Francesca Lea Saibene, Raffaello Nemni and Antonella Marchetti

Background: Two case reports of patients with Mild Cognitive Impairment (MCI) are presented with the aim to study Theory of Mind (ToM) in the evolution from successful to unsuccessful neurocognitive aging.

Methods: A 75-year-old man, six years of education, who converted to Alzheimer's Disease (AD) (Case 1), and a 60- year-old woman, five years of education, who reverted to near-normal aging (Case 2), are studied at Time 1 and at Time 2 after five years under the ToM profile and the neuropsychological profile (MMSE, Corsi-Span, Digit span forward/backward, delayed recall of Rey’s complex figure task, test of Prose Memory, Naming Task, Token Task, Phonemic and Semantic Fluencies, Coloured Progressive Matrices, Attentive Matrices). Their results are compared with demographically matched healthy controls, and with AD patients for the former case and with MCI patients for the latter case.

Findings: Case 1 showed the typical pattern of conversion from the MCI condition to the AD condition, with a decline in general cognitive functioning, in long-term memory, in language understanding and in frontal functions. Regarding ToM, a decline in the most complex levels of ToM competence (Strange Stories) was observed. Case 2 showed a pattern of reversion from the MCI condition to a near-normal aging condition, both under the NPS and the ToM functioning.

Conclusion: Results are discussed in light of the possible protective factors (including ToM) operating against the switching to unsuccessful neurocognitive aging.