Beyond losing language: Empathy changes in dementia

You’re in a café looking at the cake display while you wait for your morning coffee. Suddenly you hear a thud, and realise a woman has dropped her chocolate mud cake that emapthy-smallreads “Happy Birthday Dad” directly on the ground in front of her. From witnessing the woman’s reaction, you understand that she feels disappointed that she has dropped her cake and you may share this feeling of disappointment with her. This is empathy.

The ability to empathise with others is crucial in our everyday life and supports our social interactions with others. This skill enables us to place ourselves in the shoes of another person and share an emotional response with them.

Changes in empathy have been documented in patients with frontotemporal dementia. Less is known about empathy in a related group of dementia syndromes, known as Primary Progressive Aphasia (PPA). In PPA, the earliest symptom is language difficulties. Depending on the type of language difficulty, patients can be diagnosed with semantic dementia, progressive nonfluent Aphasia (PNFA) or logopenic progressive aphasia (LPA).
Our study investigated how empathy is affected in PNFA and LPA, as brain regions that become damaged in these syndromes are also used in empathy.

We assessed empathy via carer reports on the Interpersonal Reactivity Index (IRI). We asked carers to consider the level of empathy each patient showed before the illness onset and at present, to assess how they might have changed over time.

Results of our study found a decline in empathy in both patient groups. Overall, these findings showed that both patient groups had difficulties in: (i) understanding the perspective of others and (ii) experiencing emotional reactions toward others.

Importantly, we found that the reduced ability to experience emotional reaction towards others was associated with increased carer burden. This finding highlights the impact changes in empathy can have on families and friends.

Our study is the first to document empathy changes in PNFA and LPA patients. This finding is important as it helps us to better understand how these syndromes may present, in addition to the language problems they experience as part of the syndrome.

The relationship between carer burden and empathy loss is also important. This finding can help to educate patients and their families by providing more information about these syndromes and the possible changes in empathy which may occur. We plan to conduct more research to further explore empathy changes in these patients groups, with the long term aim of helping patients with dementia interact successfully and meaningfully in social situations.

For the full article see:
Hazelton, J. L., Irish, M., Hodges, J. R., Piguet, O., & Kumfor, F. (2016). Cognitive and Affective Empathy Disruption in Non-Fluent Primary Progressive Aphasia Syndromes. Brain Impairment, 1-13. Doi:

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