A decline in the ability to identify fearful expression has been frequently reported in patients with Alzheimer’s
disease (AD). In patients with severe destruction of the bilateral amygdala, similar difficulties
have been reduced by using an explicit visual exploration strategy focusing on gaze. The current study
assessed the possibility of applying a similar strategy in AD patients to improve fear recognition. It also
assessed the possibility of improving fear recognition when a visual exploration strategy induced AD
patients to process the eyes region. Seventeen patients with mild AD and 34 healthy subjects (17 young
adults and 17 older adults) performed a classical task of emotional identification of faces expressing happiness,
anger, and fear in two conditions: The face appeared progressively from the eyes region to the
periphery (eyes region condition) or it appeared as a whole (global condition). Specific impairment in
identifying a fearful expression was shown in AD patients compared with older adult controls during
the global condition. Fear expression recognition was significantly improved in AD patients during the
eyes region condition, in which they performed similarly to older adult controls. Our results suggest that
using a different strategy of face exploration, starting first with processing of the eyes region, may compensate
for a fear recognition deficit in AD patients. Findings suggest that a part of this deficit could be
related to visuo-perceptual impairments. Additionally, these findings suggest that the decline of fearful
face recognition reported in both normal aging and in AD may result from impairment of non-amygdalar
processing in both groups and impairment of amygdalar-dependent processing in AD.