Prevalence of Disorders of Executive Cognitive Functioning among the Elderly: Findings from the San Luis Valley Health and Aging Study

Grigsby, Jim; Kaye, Kathryn; Shetterly, Susan; Baxter, Judith; Morgenstern, Nora; Hamman, Richard F.

doi:10.1159/000065638

Cited by 41 publications

(26 citation statements)

References 31 publications

(56 reference statements)

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“…Moreover, an equally large fraction may have isolated ECF impairment and escape detection. This is consistent with the high frequency of ECF impairment in community samples [25,35] and represents an essentially unadressed cause of disabling cognitive impairment.…”

Section: Discussionsupporting

confidence: 85%

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Misclassification Is Likely in the Assessment of Mild Cognitive Impairment

Royall

Chiodo

Polk³

2004

Neuroepidemiology

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We estimated the relative frequency of isolated memory impairment versus isolated and comorbid impairment in executive control function (ECF). One hundred and ninety-three noninstitutionalized residents of a single Comprehensive Care Retirement Community (mean age 79.2 years) were investigated. The subjects were tested with multiple measures of memory and ECF. Test scores were standardized to minimize scaling effects. ‘Impairment’ was defined as performance ≤1.5 standard deviations below the mean for the entire sample (i.e., a z score ≤–1.5). Disability was estimated as the sum of self-reported activities of daily living and instrumental activities of daily living. The cognitive test performance was significantly associated with functional impairment, independently of age. ECF and memory measures were significantly intercorrelated. Both were significantly and independently associated with disability ratings. 6–10% of the subjects had memory impairment; 25–35% of the memory-impaired subjects had comorbid ECF impairments. An additional 4–7% of the subjects had isolated ECF impairment. A significant fraction of the cases otherwise meeting the criteria for ‘mild cognitive impairment’ may have comorbid ECF impairment. This raises the issue of whether they might be more properly classified as ‘demented’. In addition, isolated ECF impairment may affect almost as many persons as isolated memory impairment. Isolated ECF impairment is not consistent with the natural history of preclinical Alzheimer’s disease, suggests other conditions, and can be disabling, independently of age and/or memory loss.

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Section: Discussionsupporting

confidence: 85%

“…At baseline, 38% of the FHS sample failed these measures at these thresholds [10]. This is similar to the only published population-based prevalence study of ECF impairment in community-dwelling elderly persons (i.e., 33.3%) [25].…”

Section: Discussionsupporting

confidence: 80%

Misclassification Is Likely in the Assessment of Mild Cognitive Impairment

Royall

Chiodo

Polk³

2004

Neuroepidemiology

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“…Behavioral Self-Regulation: The primary measure of ECF used in the study was the Behavioral Dyscontrol Scale (BDS; Grigsby, Kaye, & Robbins, 1992;Kaye, Grigsby, Robbins, & Korzun, 1990), an extensively-validated measure of the capacity for behavioral self-regulation involving intentional control of simple voluntary motor behavior (Diesfeldt, 2004;Ecklund-Johnson, Miller, & Sweet, 2004;Grigsby et al, 2002b;Grigsby, Kaye, Baxter, Shetterly, & Hamman, 1998;Grigsby, Kaye, Eilertsen, & Kramer, 2000;Grigsby et al, 1992;Kaye et al, 1990). Based on the work of Luria (1966Luria ( , 1980 and Fuster (1997Fuster ( , 2000, the BDS was developed to measure the capacity to use intentions to guide the performance of goal-directed, purposeful activity.…”

Section: Methodsmentioning

confidence: 99%

The primary cognitive deficit among males with fragile X-associated tremor/ataxia syndrome (FXTAS) is a dysexecutive syndrome

Brega

Goodrich

Bennett

et al. 2008

Journal of Clinical and Experimental Neuropsychology

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Fragile X-associated tremor/ataxia syndrome (FXTAS) is a neurodegenerative disorder associated with a premutation trinucleotide repeat expansion in the fragile X mental retardation 1 gene (FMR1). Symptoms include gait ataxia, action tremor, and cognitive impairment. The objectives of the study were to clarify the nature of the dysexecutive syndrome observed in FXTAS and to assess the contribution of executive impairment to deficits in nonexecutive cognitive functions. Compared to controls, men with FXTAS demonstrated significant executive impairment, which was found to mediate group differences in most other cognitive abilities. Asymptomatic premutation carriers performed similarly to controls on all but two measures of executive functioning. These findings suggest that the impairment of non-executive cognitive skills in FXTAS is in large part secondary to executive dysfunction.

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“…While some authors find education to be a variable that affects the age-related decline in executive functioning, with low education exacerbating age effects and high education associated with more successful aging, (Van der Elst et al 2006;Grigsby et al 2002), others find education to be a poor predictor of executive performance (Manly et al 2005;Hashimoto et al 2006). Plumet et al (2005) utilized a sorting task (MCST) and found that distractive errors were exhibited at the same rate in participants over the age of 70, regardless of level of education attained.…”

Section: Executive Functions In the Aging Populationmentioning

confidence: 99%

The Elusive Nature of Executive Functions: A Review of our Current Understanding

2007

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Executive functions include abilities of goal formation, planning, carrying out goal-directed plans, and effective performance. This article aims at reviewing some of the current knowledge surrounding executive functioning and presenting the contrasting views regarding this concept. The neural substrates of the executive system are examined as well as the evolution of executive functioning, from development to decline. There is clear evidence of the vulnerability of executive functions to the effects of age over lifespan. The first executive function to emerge in children is the ability to inhibit overlearned behavior and the last to appear is verbal fluency. Inhibition of irrelevant information seems to decline earlier than set shifting and verbal fluency during senescence. The sequential progression and decline of these functions has been paralleled with the anatomical changes of the frontal lobe and its connections with other brain areas. Generalization of the results presented here are limited due to methodological differences across studies. Analysis of these differences is presented and suggestions for future research are offered.

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Prevalence of Disorders of Executive Cognitive Functioning among the Elderly: Findings from the San Luis Valley Health and Aging Study

Cited by 41 publications

References 31 publications

Misclassification Is Likely in the Assessment of Mild Cognitive Impairment

Misclassification Is Likely in the Assessment of Mild Cognitive Impairment

The primary cognitive deficit among males with fragile X-associated tremor/ataxia syndrome (FXTAS) is a dysexecutive syndrome

The Elusive Nature of Executive Functions: A Review of our Current Understanding

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