Deficits in explicit theory of mind: a possible early indicator of pathological aging

Traditionally, the evaluation and intervention of cognitive abilities in aging have focused on intellectual cognition, particularly executive functions such as working memory, attention, and processing speed. In contrast, social cognition—crucial for effective daily social functioning, such as following conversations, participating in group interactions, or understanding complex social situations—has received considerably less attention. Scientific evidence suggests that brain and cognitive functioning follow different trajectories in normal and pathological aging.The present study aimed to examine how age and the presence of pathological cognitive impairment predict deficits in the ability to attribute mental states through verbal cues (explicit Theory of Mind, ToM), as well as to analyze differences in this ability between normative and pathological aging. Thirty older adults (aged 58–88) participated, divided into two age- and gender-matched groups: those with normative aging (n = 15) and those with pathological aging (n = 15). Explicit ToM was assessed using an extended version of the Faux Pas Test (Baron-Cohen et al., 1999), which evaluates not only the detection of faux pas but also the attribution of both cognitive and emotional mental states to different characters within complex social situations.Results showed that, among older adults, only the presence of pathological cognitive impairment—and not age—predicted deficits in explicit ToM. When analyzing groups separately, age was associated with improvements in explicit ToM only in normative aging; this effect disappeared in pathological aging, where participants showed marked difficulties in verbally reasoning about social scenarios. These findings may contribute to the early identification of pathological cognitive decline and support the refinement of neuropsychological assessment and intervention protocols for older adults with both normative and pathological aging profiles.