Deficits in Emotional Face Processing as an Early Marker of Subjective Cognitive Decline: Preliminary Results

Jessie Jenson, Marquette University, Milwaukee, United States
Kaley Davis, Marquette University, Milwaukee, United States
Shawn Obarski, Medical College of Wisconsin, Milwaukee, United States
Laura Umfleet, Medical College of Wisconsin, Milwaukee, United States
Adam Greenberg, Medical College of Wisconsin, Milwaukee, United States
Jacklynn Fitzgerald, Marquette University, Milwaukee, United States


Subjective Cognitive Decline (SCD) is self-reported experience of worsening cognitive function and is a risk factor for later development of Alzheimer’s Disease (AD). There are currently no clear markers available to determine what individuals will progress from SCD to AD. Poor emotion recognition is a common deficit often observed in patients with various dementias, while those with SCD are often referred to as “worried well”. Yet, emotion recognition is rarely assessed using objective markers in this population. In the current study, we examined group differences in emotion recognition between those with SCD and healthy controls to determine if early, objective signs of cognitive decline are detectable.

Participants and Methods:

Participants were individuals ages 55-76 who were referred to the Medical College of Wisconsin’s adult neuropsychology department for concerns of SCD (n = 11). These individuals received a standard battery of neuropsychological (NP) assessments and were found to have no significant impairments based on typical age-based norms. Controls (n = 11) completed an abbreviated battery of NP tests. Both groups completed an emotional face matching behavioral task on a laptop. Participants were asked to match a target face (presented centrally) to two other emotional faces (presented to left and right, below target). Central target faces were either negative (fearful, angry) or positive (happy). Participants also completed shape matching trials as a control condition. Between group differences in reaction time (RT) and accuracy were compared using independent samples t-tests (two tailed) within each condition. Follow-up analyses controlling for age were also completed using ANCOVA and partial correlation. Participants also completed self-reported symptoms of physical and emotional and cognitive status via the PROMIS.


SCD and controls did not differ in education or gender (p’s > .160); however, groups differed on age (p = .016). During the task, groups did not differ with respect to accuracy across conditions (p’s > .100); however, patients with SCD exhibited longer RTs when matching positive faces compared to their age-matched controls (p = .017). Controlling for age, this effect remained trending at p = 0.08. Across the sample, longer RTs when matching positive faces was related to less self-reported cognitive functioning as indexed by PROMIS cognitive functioning subscale scores (r = -0.45, p = 0.036). Controlling for age, this effect remained trending at p = 0.06.


These findings suggest individuals with SCD experience greater difficulty in recognizing positive faces, although this effect was also driven in part by age. Results support the need for the development of more sensitive neuropsychological assessments in the domain of emotion processing to detect age-related decline, possibly also linked to SCD. The small sample size of this group warrants further research, precisely in parsing out SCD vs. age-specific effects.

Category: Dementia (Non-AD)

Keyword 1: aging disorders
Keyword 2: face processing
Keyword 3: cognitive functioning