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Ann Clin Psychiatry. 2018 Aug;30(3):220-232.

Empathy changes in neurocognitive disorders: A review.

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Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri 63104-1027 USA; E-MAIL:



Empathy can be broadly defined as the ability to understand what others feel (cognitive empathy) and feel what others feel (affective empathy). The capacity to empathize may be impaired in certain major neurocognitive disorders (MNCDs), affecting not only the patient, but also the caregivers.


PubMed and Google Scholar databases were searched for studies investigating empathy changes, using an objective scale, in patients with MNCDs.


The Interpersonal Reactivity Index was most commonly used to evaluate empathy in this population. Impairments in cognitive but not affective empathy were found in patients with Alzheimer's disease (AD), and may be attributable to overall cognitive decline. Patients with frontotemporal dementia (FTD) have demonstrated severe deficits in empathy, correlating with greater caregiver burden. Empathy changes in patients with dementia with Lewy bodies, vascular dementia, and Parkinson's disease dementia have not yet been studied. Intranasal oxytocin has emerged as a promising therapeutic approach for empathy loss, but it has not been explored yet in patients with MNCDs.


Caregivers need to be educated about empathy loss, which is an important part of the disease process in AD and FTD. Future research should further assess empathy changes in other MNCDs, as well as explore novel treatment options in this field.

[Indexed for MEDLINE]

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