AbstractObjectiveThis study compared the affective theory of mind (ToM) of people with mild and moderate Alzheimer's disease (AD) and healthy older adults and also investigated the relationship between affective ToM and cognitive and clinical functioning in AD people.MethodsThis cross‐sectional study included 156 older adults with AD and 40 healthy older adults. We used an experimental task involving reasoning processes in different contextual situations.ResultsThe affective ToM was impaired in AD groups compared with healthy group, with moderate AD group showing lower performance than mild AD group. The affective ToM task of mild AD group was significantly correlated with the Mini‐Mental State Examination (MMSE) and education years. Linear regression showed only education years as a predictor of ToM task performance. The neuropsychiatric symptoms and functionality were not correlated with the affective ToM.ConclusionsOur findings demonstrated that people with mild and moderate AD presented impairments in affective ToM that can be explained by the difficulties to infer emotion from reasoning processes. In addition, the education years variable proved to be an affective ToM performance's predictor for the mild AD group, but not for the moderate AD group, indicating that ToM abilities are affected differently in different stages of AD. Neuropsychiatric symptoms and functionality seem to have no influence on affective ToM impairments in people with AD.