Symptoms of psychosis in patients with Alzheimer disease may be the expression of a pathological subtype associated with an accelerated cognitive and functional deterioration portending a hastened mortality.1 The proposed National Institute of Mental Health Research Domain Criteria initiative provides a framework for conceptualizing the common neurobiological underpinnings of symptom domains such as psychosis that transcend individual diagnostic categories to facilitate translational research.2 Gur et al3 suggest that highly implementable tasks measuring facial affective processing can be used to assay social cognitive integrity in psychotic disorders within the National Institute of Mental Health Research Domain Criteria framework. Although McLellan et al4 report that facial affective processing is degraded in Alzheimer disease, to our knowledge no published studies have investigated the association between this impairment and the psychotic phenotype. We report on facial affective processing performance in a longitudinal cohort of healthy elderly control individuals and participants with mild cognitive impairment (MCI) or Alzheimer disease at baseline, with and without symptoms of psychosis over the course of the study.https://blackwells.co.uk/bookshop/product/Evidence-Based-Assessment-in-ASD-Autism-Spectrum-Disorder-by-Kenneth-Aitken-author/9781849055291