Abstract
The ability to decode others’ emotions from multisensory cues is central to social functioning. However, findings remain inconsistent regarding the extent to which this capacity is compromised in neurodegenerative diseases, leaving the underlying mechanisms unclear. This study aimed to delineate the shared and divergent patterns of multisensory emotion perception (MEP) deficits among clinically distinct populations of individuals with Alzheimer’s disease (AD), frontotemporal dementia (FTD), and mild cognitive impairment (MCI). We conducted a systematic review on 51 studies identified from Web of Science, MEDLINE, PubMed, PsycINFO and PsycARTICLES to synthesize research trends in this field between 2001 and 2025. We applied a hierarchical Bayesian meta-analysis (1,511 patients and 1,151 healthy controls) to quantify the deficits and their moderators. Meta-analytic results demonstrated a differential magnitude of MEP impairment across groups (FTD > AD > MCI), reflecting distinct socio-emotional vulnerabilities rather than a single disease continuum. Moderator analyses of 15 participant- and study-related factors showed that impairment magnitude was more strongly associated with age, sex, education, global cognitive functioning, publication year, and emotion category, and less strongly with region, paradigm, language, and modality. Sensitivity analyses indicated that these patterns remained robust to potential publication bias, though the results were less stable within the FTD cohort. We propose a Hierarchical Socio-Emotional Disintegration and Compensation Framework to explain the dynamic interplay between neurodegeneration-driven deficits and compensatory mechanisms. This framework advances mechanistic insight into the relationship between emotion and cognition, informing future clinical efforts to support the interpersonal well-being of aging populations.