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Patterns of executive dysfunction in amnestic mild cognitive impairment

Published online by Cambridge University Press:  11 April 2013

Nai-Ching Chen
Affiliation:
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Chiung-Chih Chang
Affiliation:
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan Department of Biological Science, National Sun Yat-sen University, Kaohsiung, Taiwan
Ker-Neng Lin
Affiliation:
Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Psychology, Soo-Chow University, Taipei, Taiwan
Chi-Wei Huang
Affiliation:
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan Department of Biological Science, National Sun Yat-sen University, Kaohsiung, Taiwan
Wen-Neng Chang
Affiliation:
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Ya-Ting Chang
Affiliation:
Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Ching Chen
Affiliation:
Department of Psychiatry, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan
Yen-Chi Yeh
Affiliation:
Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan Division of Neurology, Department of Internal Medicine, Far-Eastern Memorial Hospital, Taipei, Taiwan
Pei-Ning Wang*
Affiliation:
Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
*
Correspondence should be addressed to: Pei-Ning Wang, MD, Department of Neurology, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City 11217, Taiwan, Republic of China. Phone: +886-2-28757578; Fax: +886-2-28738696. Email: pnwang@vghtpe.gov.tw.

Abstract

Background: Executive dysfunction is not uncommon in patients with amnestic mild cognitive impairment (aMCI). This study aimed to investigate the applicability of executive function tests (EFTs) in aMCI as an aid in establishing the diagnosis of multi-domain MCI.

Methods: One hundred and twenty (120) aMCI patients, 126 Alzheimer's disease (AD) patients, and 100 normal controls were enrolled. The EFTs evaluated included the trail making test, digit backward span, Stroop color–word test, and design fluency and category fluency tests.

Results: Of the aMCI participants, 66% exhibited impairment in at least one EFT. Among the five selected EFTs, the category fluency test was the most discriminative in detecting executive dysfunction between patients with aMCI (standardized β = 0.264) or AD (standardized β = 0.361) with the controls, followed by the Stroop test. The performance of aMCI patients with two or more impaired EFTs was significantly different from those of controls but not from those of AD patients.

Conclusion: In the clinical setting, aMCI patients who fail in two or more EFTs may represent a unique population with multi-domain MCI that require close follow-up.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

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