The Role of Chronic Illness in Theory of Mind Performance in Older Adults

Theory of Mind (ToM) reflects the ability to reason about mental states in order to understand and predict behavior. Research has identified links between increased pulse pressure, a measure of vascular health, and reduced ToM in older adults. Furthermore, previous findings suggest that cognitive ToM is particularly vulnerable to increased pulse pressure. However, to date, the relationships between other chronic vascular and nonvascular conditions and reduced ToM are unknown. We aimed to investigate the effects of vascular and nonvascular illness burden on cognitive and affective ToM in N = 86 older adults (59 females; 27 males, M = 72 years). While vascular illness burden emerged as a significant predictor of older adults’ ToM, nonvascular illness burden was not significantly associated with ToM. Further, executive functioning and semantic memory mediated the relationship between vascular illness burden and cognitive ToM. Our findings highlight the specific importance of considering vascular health as a risk factor for declines in ToM in later life, beyond pulse pressure. Further elucidation of the associations between health, neurocognition and ToM will be valuable in developing effective interventions for older adults given the high prevalence of vascular illness in later life.