The TIE-93: a Facial Emotion Recognition Test Adapted for Culturally, Linguistically, and Educationally Diverse Alzheimer’s Dementia Patients in France

OBJECTIVE: Emotion recognition tests are essential for differential diagnostics when assessing patients with Alzheimer's disease (AD) dementia. However, there remains a lack of emotion recognition tests appropriate for culturally and educationally diverse populations. The aim of this study was to develop an emotion recognition test (the TIE-93) appropriate for these populations. We then examined whether the TIE-93 could reduce emotion recognition performance differences between populations with a native French versus a culturally and educationally diverse background (participants who had immigrated to France). This was assessed by comparing performance between controls of each cultural group. We also assessed the effect of demographic variables on TIE-93 test performance and whether performance in an AD patient group was consistent with the research literature. METHODS: Fifty-seven patients with AD dementia and 240 healthy controls, from native French and culturally and educationally diverse backgrounds, were included in the study. The TIE-93 is composed of eight panels with photos of actors displaying six basic emotions. Participants were asked to identify which of the six facial expressions displayed matched an oral description of a context. RESULTS: When comparing French and culturally and educationally diverse controls, Quade's ANCOVA revealed that there remained an effect of culture and education on TIE-93 test performance. Nonetheless, while controlling for years of education, age, sex, and cultural group, patients with AD dementia scored significantly more poorly than controls, specifically for most negative emotions. CONCLUSION: The TIE-93 represents a first step toward developing appropriate emotion recognition tests for culturally and educationally diverse populations.