ABSTRACT

Objective : This study systematically reviewed neuroimaging studies to examine associations between social cognitive decline and brain structural and functional changes in older adults with mild cognitive impairment (MCI).Methods : PubMed Central, EMBASE, and Web of Science were searched for studies published from 2010 to 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Two reviewers independently screened studies; disagreements were resolved by consensus or by a third reviewer. Eligible studies included older adults with MCI who performed social cognition tasks and reported neuroimaging outcomes. Evidence level and risk of bias were evaluated using established criteria and the Risk of Bias Assessment tool for Non-randomized Studies.Results : Six studies were included. Declines were observed in emotion recognition, theory of mind, empathy, and emotional interference. Neuroimaging findings showed changes in key social cognition-related regions, including the medial prefrontal cortex, temporoparietal junction, amygdala, anterior cingulate cortex, and superior temporal regions. These changes tended to be related to lower task accuracy and altered response characteristics.Conclusion : Social cognitive decline in MCI may be associated with specific brain changes. Neuroimaging-based assessment may support early detection and clinical intervention planning; however, findings require cautious interpretation due to heterogeneity and limited samples.