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Specific Measures of Executive Function Predict Cognitive Decline in Older Adults

Published online by Cambridge University Press:  24 November 2011

Lindsay R. Clark ,
Dawn M. Schiehser ,
Gali H. Weissberger ,
David P. Salmon ,
Dean C. Delis  and
Mark W. Bondi
Lindsay R. Clark
Affiliation:
San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
Dawn M. Schiehser
Affiliation:
Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, California Department of Veterans Affairs San Diego Healthcare System, San Diego, California
Gali H. Weissberger
Affiliation:
San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
David P. Salmon
Affiliation:
Department of Neurosciences, University of California San Diego, School of Medicine, La Jolla, California
Dean C. Delis
Affiliation:
Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, California Department of Veterans Affairs San Diego Healthcare System, San Diego, California
Mark W. Bondi*
Affiliation:
Department of Psychiatry, University of California San Diego, School of Medicine, La Jolla, California Department of Veterans Affairs San Diego Healthcare System, San Diego, California
*
Correspondence and reprint requests to: Mark W. Bondi, ABPP/CN, VA San Diego Healthcare System (116B), 3350 La Jolla Village Drive, San Diego, CA 92161. E-mail: mbondi@ucsd.edu
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Abstract

Decline in executive function has been noted in the prodromal stage of Alzheimer's disease (AD) and may presage more global cognitive declines. In this prospective longitudinal study, five measures of executive function were used to predict subsequent global cognitive decline in initially nondemented older adults. Of 71 participants, 15 demonstrated significant decline over a 1-year period on the Dementia Rating Scale (Mattis, 1988) and the remaining participants remained stable. In the year before decline, the decline group performed significantly worse than the no-decline group on two measures of executive function: the Color-Word Interference Test (CWIT; inhibition/switching condition) and Verbal Fluency (VF; switching condition). In contrast, decliners and non-decliners performed similarly on measures of spatial fluency (Design Fluency switching condition), spatial planning (Tower Test), and number-letter switching (Trail Making Test switching condition). Furthermore, the CWIT inhibition-switching measure significantly improved the prediction of decline and no-decline group classification beyond that of learning and memory measures. These findings suggest that some executive function measures requiring inhibition and switching provide predictive utility of subsequent global cognitive decline independent of episodic memory and may further facilitate early detection of dementia. (JINS, 2012, 18, 118–127)

Keywords

Executive functionsGlobal cognitionSwitchingProdromal Alzheimer's diseaseMild cognitive impairmentPrediction
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 1 , January 2012 , pp. 118 - 127
Copyright
Copyright © The International Neuropsychological Society 2011

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