SOCIAL NORMS AND AGING: EFFECTS OF GENDER AND COGNITION

Abstract

Social cognition is one of the cognitive domains potentially impaired in the neurocognitive disorders, and is typically affected in disorders affecting frontal lobe functions, including several dementias. Appreciation of normative social behavior is one aspect of social cognition. The Social Norms Questionnaire (SNQ22) asks individuals about the appropriateness of specific behaviors in 22 hypothetical scenarios. Errors are related either to breaking with relevant social norms or over-adhering to norms. In the clinical setting, break-norms errors are considered specific to frontotemporal dementia (FTD) while over-adherence is seen in other neurodegenerative disorders and can also be related to anxiety or inattention. Population-based and normative data are not available for older adults. We administered the SNQ22 to 745 adults aged 65+ years within a population-based study, and examined the distribution of total and error scores by demographics, other cognitive measures, and Clinical Dementia Rating (CDR). Total SNQ22 scores and both error scores had extremely skewed distributions. Women and young-old individuals performed significantly better than men and older individuals on total score and over-adherence; women also made significantly fewer break-norms errors. No race or education effects were observed. Worse total scores and more over-adherence errors were inversely associated with literacy, CDR, MMSE, attention, memory, language, visuospatial, and executive functions. Break-norms errors were rare and not associated with any of the above (P<0.01). In a 65+ aged population-based study, data on the SNQ22 showed that most participants performed well, validating the normative nature of the scale; break-norms errors typical of FTD were rare. Age and gender effects were found on total score and over-adherence errors, which were associated with higher CDR and worse scores in all cognitive domains. Social norms screening may add a useful social cognitive dimension to neuropsychological assessment of older adults.