{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:47:15Z","timestamp":1782798435054,"version":"3.54.5"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"\n Background<\/jats:title>\n Facial emotion recognition (FER) is increasingly recognized as a functionally relevant domain in the Alzheimer\u2019s disease (AD) spectrum, yet whether baseline FER is associated with subsequent clinical decline remains insufficiently established.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We studied 328 participants [subjective cognitive decline (SCD)\n n<\/jats:italic>\n \u202f=\u202f94, mild cognitive impairment (MCI)\n n<\/jats:italic>\n \u202f=\u202f142, AD dementia\n n<\/jats:italic>\n \u202f=\u202f92] from a longitudinal memory clinic cohort; 148 had follow-up assessments (mean 1.59\u202f\u00b1\u202f0.67\u202fyears). FER was assessed using the Korean version of the Florida Affect Battery (K-FAB; five subtests, FER_mean). Linear mixed-effects models examined group-differential trajectories of the Mini-Mental State Examination (MMSE), Clinical Dementia Rating\u2013Sum of Boxes (CDR-SOB), and FER_mean, adjusted for age, sex, education, and baseline values.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n FER_mean decreased stepwise across groups at baseline (SCD 17.3\u202f\u00b1\u202f1.5, MCI 16.4\u202f\u00b1\u202f2.1, AD 15.3\u202f\u00b1\u202f2.0;\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). CDR-SOB showed more consistent group-differential longitudinal trajectories: MCI increased at +0.550 points\/year (\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), with SCD significantly slower (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.491,\n p<\/jats:italic>\n \u202f=\u202f0.008) and AD faster (\n \u03b2<\/jats:italic>\n \u202f=\u202f+0.371,\n p<\/jats:italic>\n \u202f=\u202f0.038). FER_mean showed a modest decline in MCI (\n \u03b2<\/jats:italic>\n \u202f=\u202f\u22120.169\/yr.,\n p<\/jats:italic>\n \u202f=\u202f0.078) and SCD showed significantly attenuated decline relative to MCI (\n \u03b2<\/jats:italic>\n \u202f=\u202f+0.376,\n p<\/jats:italic>\n \u202f=\u202f0.035). Lower baseline FER was associated with faster CDR-SOB worsening (\n \u03c1<\/jats:italic>\n \u202f=\u202f\u22120.221,\n p<\/jats:italic>\n \u202f=\u202f0.006) but not MMSE decline (\n \u03c1<\/jats:italic>\n \u202f=\u202f0.093,\n p<\/jats:italic>\n \u202f=\u202f0.255). FER change rates showed a weak, non-significant correlation with MMSE change (\n \u03c1<\/jats:italic>\n \u202f=\u202f0.004,\n p<\/jats:italic>\n \u202f=\u202f0.960) but a modest significant correlation with CDR-SOB change (\n \u03c1<\/jats:italic>\n \u202f=\u202f\u22120.195,\n p<\/jats:italic>\n \u202f=\u202f0.018), suggesting partially distinct longitudinal patterns.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Baseline FER was modestly associated with longitudinal worsening in clinical severity (CDR-SOB), but not cognitive screening performance (MMSE) across the pre-dementia to dementia spectrum. FER trajectories showed limited correlation with traditional measures. These findings indicate that FER may have a potential complementary role of social cognitive assessment in the AD continuum, pending further validation.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1863175","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:41:59Z","timestamp":1782798119000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Baseline facial emotion recognition is associated with clinical decline across the Alzheimer\u2019s disease spectrum: a multi-instrument longitudinal assessment study"],"prefix":"10.3389","volume":"18","author":[{"given":"YongSoo","family":"Shim","sequence":"first","affiliation":[{"name":"Department of Neurology, St. Vincent\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Ye","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Eunpyeong St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"ref1","volume-title":"The Validity and Reliability of the Korean Version of Florida Facial Affect Battery: A Preliminary Study","author":"Ahn","year":"2009"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/j.jalz.2011.03.008","article-title":"The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease","volume":"7","author":"Albert","year":"2011","journal-title":"Alzheimers Dement."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"377","DOI":"10.3389\/fnagi.2017.00377","article-title":"Subjective cognitive decline as a preclinical marker for Alzheimer's disease: the challenge of stability over time","volume":"9","author":"\u00c1vila-Villanueva","year":"2017","journal-title":"Front. 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