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Executive functioning mediates the link between other neuropsychological domains and daily functioning: a Project FRONTIER study

Published online by Cambridge University Press:  19 July 2010

Sid E. O'Bryant ,
Jed Falkowski ,
Valerie Hobson ,
Leigh Johnson ,
James Hall ,
Gregory W. Schrimsher ,
Ohmar Win ,
Bichthy Ngo  and
Andrew Dentino
Sid E. O'Bryant*
Affiliation:
F. Marie Hall Institute for Rural and Community Health, Texas Tech Health Sciences Center, Lubbock, TX, U.S.A. Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
Jed Falkowski
Affiliation:
West Texas A and M University, Canyon, TX, U.S.A.
Valerie Hobson
Affiliation:
Department of Psychology, Texas Tech University, Lubbock, TX, U.S.A.
Leigh Johnson
Affiliation:
Laura W. Bush Institute for Women's Health, Texas Tech University Health Sciences Center, Amarillo, TX, U.S.A. Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, U.S.A.
James Hall
Affiliation:
Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Sciences Center, Fort Worth, TX, U.S.A. Department of Psychiatry and Neuroscience, University of North Texas Health Sciences Center, Fort Worth, TX, U.S.A.
Gregory W. Schrimsher
Affiliation:
Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, TX, U.S.A.
Ohmar Win
Affiliation:
Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, U.S.A.
Bichthy Ngo
Affiliation:
Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, U.S.A.
Andrew Dentino
Affiliation:
Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, U.S.A. Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, U.S.A. Division of Geriatric and Palliative Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, U.S.A.
*
Correspondence should be addressed to: Sid. E. O'Bryant, F. Marie Hall Institute for Rural and Community Health, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 6232, Lubbock, TX, 79430-6232, U.S.A.. Phone: +1 806-743-1338. Fax: +1 806-743-4510. Email: sid.obryant@ttuhsc.edu.
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Abstract

Background: The purpose of this study was to examine the mediating impact of executive functioning on the link between other neuropsychological domain scores and informant-based rating of functional status.

Methods: Data on 181 participants were analyzed from an ongoing epidemiological study of rural health, Project FRONTIER (mean age = 64.6 ± 13.8 years, 69% women, 42% Mexican American). Executive functioning was assessed by the EXIT25 and other neuropsychological domains were assessed via the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Informant-based rating of functional status was assessed via the Clinical Dementia Rating Scale sum of boxes scores (CDR SB).

Results: RBANS Index scores were each significantly (p < 0.05) related to CDR SB scores and EXIT25 scores. EXIT25 score was a significant partial mediator of the link between four RBANS indices (Immediate Memory, Attention, Visuospatial/Construction, Delayed Memory) and CDR SB scores, and a complete mediator of the fifth index (Language).

Conclusion: Executive functioning is a mediator of the link between other neuropsychological domains and daily functioning. Neuropsychological assessments that do not measure executive functioning will provide only a partial clinical picture with adults and elders.

Keywords

executive functioningcognitionruralfunctional status

Information

Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 1 , February 2011 , pp. 107 - 113
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Aron, A. R. (2008). Progress in executive-function research: from tasks to functions to regions to networks. Current Directions in Psychological Science, 17, 124–129.Google Scholar
Bell-McGinty, S., Podell, K., Franzen, M., Baird, A. D. and Williams, M. J. (2002). Standard measures of executive function in predicting instrumental activities of daily living in older adults. International Journal of Geriatric Psychiatry, 17, 828–834.CrossRefGoogle ScholarPubMed
Berg, L., McKeel, D. W. Jr., Miller, J. P., Baty, J. and Morris, J. C. (1993). Neuropathological indexes of Alzheimer's disease in demented and nondemented persons aged 80 years and older. Archives of Neurology, 50, 349–358.CrossRefGoogle ScholarPubMed
Burke, W. J. et al. (1988). Reliability of the Washington University Clinical Dementia Rating. Archives of Neurology, 45, 31–32.CrossRefGoogle ScholarPubMed
Cahn-Weiner, D. A., Malloy, P. F., Boyle, P. A., Marran, M. and Salloway, S. (2000). Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals. Clinical Neuropsychologist, 14, 187–195.CrossRefGoogle ScholarPubMed
Chui, H. C., Victoroff, J. I., Margolin, D., Jagust, W., Shankle, R. and Katzman, R. (1992). Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. Neurology, 42, 473–480.Google Scholar
Crook, T. et al. (1986). Age-associated memory impairment: proposed diagnostic criteria and measures of clinical change. Report of a National Institute of Mental Health Work Group. Developmental Neuropsychology, 2, 261–276.CrossRefGoogle Scholar
Duff, K., Humphreys, J. D., O'Bryant, S. E., Mold, J. W., Scheffer, R. B. and Sutker, P. B. (2008). Utility of the RBANS in detecting cognitive impairment associated with Alzheimer's disease: sensitivity, specificity, and positive and negative predictive powers. Archives of Clinical Neuropsychology, 23, 603–612.Google Scholar
Farias, S. et al. (2008). Longitudinal changes in memory and executive functioning are associated with longitudinal changes in instrumental activities of daily living in older adults. Clinical Neuropsychologist, 23, 446–461.CrossRefGoogle Scholar
Freilich, B. M. and Hyer, L. A. (2007). Relation of the Repeatable Battery for Assessment of Neuropsychological Status to measures of daily functioning in dementia. Psychological Reports, 101, 119–129.CrossRefGoogle ScholarPubMed
Hobson, V. L., Hall, J. R., Humphreys-Clark, J. D., Schrimsher, G. W. and O'Bryant, S. E. (2010). Identifying functional impairment with scores from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). International Journal of Geriatric Psychiatry, 25, 525–530.Google Scholar
McKhann, D. et al. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group. Neurology, 34, 939–944.Google Scholar
Mitchell, M. and Miller, L. S. (2008). Prediction of functional status in older adults: the ecological validity of four Delis-Kaplan Executive Function System tests. Journal of Clinical and Experimental Neuropsychology, 30, 683–690.CrossRefGoogle ScholarPubMed
Morris, J. C. (1997). Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. International Psychogeriatrics, 1, 173–176.Google Scholar
Morris, J. C. et al. (1997). Clinical dementia rating training and reliability in multicenter studies: the Alzheimer's Disease Cooperative Study experience. Neurology, 48, 1508–1510.Google Scholar
O'Bryant, S. E. et al. (2009). The Cochran County Aging Study: methodology and descriptive statistics. Texas Public Health Journal, 61, 5–7.Google Scholar
Peterson, R. C. (ed.) (2003). Mild Cognitive Impairment: Aging to Alzheimer's Disease, New York: Oxford University Press.Google Scholar
Randolph, C. (1998). Repeatable Battery for the Assessment of Neuropsychological Status, San Antonio, TX: The Psychological Coporation.Google ScholarPubMed
Royall, D., Mahurin, R. K. and Gray, K. (1992). Bedside assessment of executive cognitive impairment: the Executive Interview (EXIT). Journal of the American Geriatrics Society, 40, 1221–1226.CrossRefGoogle Scholar
Royall, D. R., Palmer, R., Chiodo, L. K. and Polk, M. J. (2004). Declining executive control in normal aging predicts change in functional status: the Freedom House Study. Journal of the American Geriatrics Society, 52, 346–352.CrossRefGoogle ScholarPubMed
Royall, D. R., Palmer, R., Chiodo, L. K. and Polk, M. J. (2005). Executive control mediates memory's association with change in instrumental activities of daily living: the Freedom House Study. Journal of the American Geriatrics Society, 53, 11–17.Google Scholar
Royall, D. R., Lauterbach, E. C., Kaufer, D., Malloy, P., Coburn, K. L. and Black, K. J. (2007). The cognitive correlates of functional status: a review from the Committee on Research of the American Neuropsychiatric Association. Journal of Neuropsychiatry and Clinical Neurosciences, 19, 249–265.CrossRefGoogle Scholar
Sobel, M. (1982). Asymptotic intervals for indirect effects in structural equations models. In Leinhart, S. (ed.), Sociological Methodology. San Francisco, CA: Jossey-Bass.Google Scholar
Tabachnick, B. G. and Fidell, L. S. (2001). Using Multivariate Statistics, Needham Heights, MA: Allyn and Bacon.Google Scholar
Upper Midwest Rural Health Research Center (2009). Rural Issues Related to Comparative Effectiveness Research and Dissemination. Available at: http://www.uppermidwestrhrc.org/pdf/policybrief_effectiveness.pdfGoogle Scholar
U.S. Census Bureau (2004). American Fact Finder. U.S. Department of Commerce. Available at http://www.census.gov; last accessed 205.Google Scholar
Whelihan, W. M., Dicarlo, M. A. and Paul, R. H. (2005). The relationship of neuropsychological functioning to driving competence in older persons with early cognitive decline. Archives of Clinical Neuropsychology, 20, 217–228.Google Scholar