Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep;19(3):603-618.
doi: 10.1111/jnp.12431. Epub 2025 May 14.

Understanding barriers and optimizing socio-cognitive assessment in the diagnosis of neurocognitive disorders

Chiara Cerami  1   2 , Marina Boccardi  3   4 , Claudia Meli  5 , Andrea Panzavolta  1 , Giulia Funghi  5 , Cristina Festari  6 , Stefano F Cappa  1   2 , Thanos Chatzikostopoulos  7 , Christian Chicherio  8 , Florencia Clarens  9 , Fabricio Ferreira de Oliveira  10 , Francesco Di Lorenzo  11   12 , Marco Filardi  13 , Agustin Ibanez  14   15   16 , Nicola Girtler  17 , Thibaud Lebouvier  18 , Giancarlo Logroscino  13 , Antonella Luca  19 , Sarah E MacPherson  20 , Jordi A Matias-Guiu  21 , Tommaso Piccoli  22 , Olivier Piguet  23   24 , Simone Pomati  25 , Mirella Russo  26   27 , Leonardo Sacco  28 , Ann-Katrin Schild  29 , Stefano L Sensi  26   27 , Steven D Shirk  30   31 , Marc Sollberger  32   33 , Miguel Tábuas-Pereira  34 , Magda Tsolaki  7 , Esther van den Berg  35 , Maxime Bertoux  36   37 , Fiona Kumfor  23   24 , Jan Van den Stock  38   39 , Kathleen A Welsh-Bohmer  40 , Alessandra Dodich  5 ; SIGNATURE initiative
Affiliations

Understanding barriers and optimizing socio-cognitive assessment in the diagnosis of neurocognitive disorders

Chiara Cerami et al. J Neuropsychol. 2025 Sep.

Abstract

Harmonized neuropsychological assessment for neurocognitive disorders (NCDs) is an urgent priority in clinics. Neuropsychology assessments in NCDs seldom include tests exploring social cognitive skills. In 2022, we launched the SIGNATURE initiative to optimize socio-cognitive assessment in NCDs. Here, we report findings from the first initiative phase, including consortium creation and evaluation of the state of the art in socio-cognitive assessment in memory clinics. We developed an ad hoc online survey to explore practices and measures, relevance, and obstacles preventing the use of socio-cognitive testing in clinics. The survey was distributed within the SIGNATURE network. National coordinators were identified to disseminate the survey to local collaborators and scientific societies active in the field of dementia and/or neuropsychology. Data were analysed in aggregate form and stratified by geographical area and variables of interest. Four hundred and thirteen (413) responses from 10 European and Latin American geographical regions were recorded. Responders were balanced between physicians and psychologists. Seventy-eight (78) % of respondents reported no/limited experience with socio-cognitive measures; more than 85% agreed on their relevance in clinics. Ekman-60 faces was the most well-known and/or used task, followed by the Faux-Pas and Reading-the-Mind-in-the-Eyes tests. Lack of clinical measures, assessment time, guidelines, and education/training were reported as main obstacles. Real-life barriers prevent the adoption of socio-cognitive testing in clinics. Bidirectional collaboration between clinicians and researchers is required to address clinical needs and constraints and facilitate consistent socio-cognitive assessment.

Keywords: dementia; harmonization; memory clinics; mild cognitive impairment; neurocognitive disorder; social cognition.

PubMed Disclaimer

Conflict of interest statement

Chiara Cerami has been granted for consultancy by Biogen Italy, Newel Health, LinkForMed, Ethos srl. Stefano F. Cappa has received speaker honoraria from Biogen, Roche and Nutricia and is member of the Scientific Advisory Board of Brain Control. Cristina Festari has received funding through her institution from the Alzheimer's Association and Italian Ministry of Health. Giancarlo Logroscino has served as investigator for clinical trials sponsored by Biogen Pharmaceuticals, Axovant, Alector, Denali, Roche, Eisai, Genentech, Amylyx, Piam Farmaceutici SpA and has been granted for speech and consultancy by EISAI, Roche, Lilly, Piam Farmaceutici Spa, Biogen. Jordi Matias‐Guiu has been granted for speech and consultancy by Almirall, Alter, Fujirebio, Esteve, KRKA and Schwabbe, Araclon, Eisai, and Schwabbe and is supported by grants from Instituto de Salud Carlos III and Fundacion Conocimiento Madrid. Fabricio Ferreira de Oliveira has been granted for consultancy by Gerson Lehrman Group, Atheneum Partners, Guidepoint, Lionbridge. He is supported by FAPESP—The State of São Paulo Research Foundation (Grant No. #2015/10109‐5) and is a board member of AAN Global Strategies Subcommittee, Awards Committee of the International Parkinson and Movement Society, ISTAART PIA Biofluid Based Biomarkers working group, ISTAART PIA Neuropsychiatric Syndromes and ESF Committee of Experts. Leonardo Sacco has served as investigator for clinical trials sponsored by Biogen and was member of the Advisory Board of Roche and Eisai. Marc Sollberger has been granted for speech and consultancy by Lilly, Eisai, OM Pharma. Katheen Welsh‐Bohmer is a consultant to WCG, Senaptec, Jigsawdio. She serves on the U.S. POINTER data safety monitoring board and is unpaid board member for the nonprofit Dementia Alliance of NC (DANC). She is also funded through US Federal Grants (NIA/NIH), NC DHHS state funds, and private foundational support (National Philanthropic Trust/Gates to the Alzheimer's Data Discovery Initiative ADDI). The other authors do not declare any conflict of interest.

Figures

FIGURE 1
FIGURE 1
Roadmap of the SIGNATURE Initiative according to the different project phases.
FIGURE 2
FIGURE 2
Coverage of the routine neuropsychological assessment in the respondents' practice. On the left, the percentage of respondents who assess or not (YES/NO) all DSM‐5 core cognitive domains in major (a) and mild (b) NCDs. On the right, the percentage of coverage of individual core cognitive domains in respondents who assess all core cognitive domains.
FIGURE 3
FIGURE 3
Average scores of perceived relevance of socio‐cognitive assessment for different syndromes. ADD, Alzheimer's disease dementia; aMCI, amnestic mild cognitive impairment; APD, atypical parkinsonisms; bvFTD, behavioural variant of frontotemporal dementia; naMCI, non amnestic mild cognitive impairment; NDD, non‐degenerative dementias; PDD, Parkinson's disease dementia; PPA, primary progressive aphasia.
FIGURE 4
FIGURE 4
Percentage of agreement for main obstacles in the use of socio‐cognitive testing in clinics.
See this image and copyright information in PMC

References

    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders. American Psychiatric Publishing. 10.1176/appi.books.9780890425596 - DOI
    1. Argaud, S. , Vérin, M. , Sauleau, P. , & Grandjean, D. (2018). Facial emotion recognition in Parkinson's disease: A review and new hypotheses. Movement Disorders, 33, 554–567. 10.1002/mds.27305 - DOI - PMC - PubMed
    1. Baron‐Cohen, S. , Wheelwright, S. , Hill, J. , Raste, Y. , & Plumb, I. (2001). The “Reading the mind in the eyes” test revised version: A study with normal adults, and adults with Asperger syndrome or high‐functioning autism. Journal of Child Psychology and Psychiatry, 42, 241–251. - PubMed
    1. Beach, T. G. , Monsell, S. E. , Phillips, L. E. , & Kukull, W. (2012). Accuracy of the clinical diagnosis of Alzheimer disease at National Institute on Aging Alzheimer disease centers, 2005–2010. Journal of Neuropathology and Experimental Neurology, 71, 266–273. 10.1097/NEN.0b013e31824b211b - DOI - PMC - PubMed
    1. Bertoux, M. , Cassagnaud, P. , Lebouvier, T. , Lebert, F. , Sarazin, M. , le Ber, I. , Dubois, B. , NeuroCEB Brain Bank , Auriacombe, S. , Hannequin, D. , Wallon, D. , Ceccaldi, M. , Maurage, C. A. , Deramecourt, V. , & Pasquier, F. (2020). Does amnesia specifically predict Alzheimer's pathology? A neuropathological study. Neurobiology of Aging, 95, 123–130. 10.1016/j.neurobiolaging.2020.07.011 - DOI - PubMed