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Dysexecutive Functioning in Mild Cognitive Impairment: Derailment in Temporal Gradients

Published online by Cambridge University Press:  07 October 2011

Joel Eppig
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Denene Wambach
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Christine Nieves
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Catherine C. Price
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
Melissa Lamar
Department of Psychiatry, University of Illinois, Chicago, Illinois
Lisa Delano-Wood
Department of Psychiatry, University of California San Diego, School of Medicine, San Diego, California and the Psychology Service, Veterans Administration San Diego Healthcare System, San Diego, California
Tania Giovannetti
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Brianne M. Bettcher
Department of Neurology, The Lahey Clinic, Burlington, Massachusetts
Dana L. Penney
Department of Neurology, The Lahey Clinic, Burlington, Massachusetts
Rod Swenson
Department of Neuroscience, University of North Dakota Medical School, Fargo, North Dakota
Carol Lippa
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Anahid Kabasakalian
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Mark W. Bondi
Department of Psychiatry, University of California San Diego, School of Medicine, San Diego, California and the Psychology Service, Veterans Administration San Diego Healthcare System, San Diego, California
David J. Libon*
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Correspondence and reprint requests to: David J. Libon, Drexel University, College of Medicine, 245 North 15th Street, 7th Floor, Philadelphia, PA 19102. E-mail:


Libon et al. (2010) provided evidence for three statistically determined clusters of patients with mild cognitive impairment (MCI): amnesic (aMCI), dysexecutive (dMCI), and mixed (mxMCI). The current study further examined dysexecutive impairment in MCI using the framework of Fuster's (1997) derailed temporal gradients, that is, declining performance on executive tests over time or test epoch. Temporal gradients were operationally defined by calculating the slope of aggregate letter fluency output across 15-s epochs and accuracy indices for initial, middle, and latter triads from the Wechsler Memory Scale-Mental Control subtest (Boston Revision). For letter fluency, slope was steeper for dMCI compared to aMCI and NC groups. Between-group Mental Control analyses for triad 1 revealed worse dMCI performance than NC participants. On triad 2, dMCI scored lower than aMCI and NCs; on triad 3, mxMCI performed worse versus NCs. Within-group Mental Control analyses yielded equal performance across all triads for aMCI and NC participants. mxMCI scored lower on triad 1 compared to triads 2 and 3. dMCI participants also performed worse on triad 1 compared to triads 2 and 3, but scored higher on triad 3 versus triad 2. These data suggest impaired temporal gradients may provide a useful heuristic for understanding dysexecutive impairment in MCI. (JINS, 2012, 18, 20–28)

Research Articles
Copyright © The International Neuropsychological Society 2011

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