Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 52
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Aretouli, Eleni and Brandt, Jason 2010. Everyday functioning in mild cognitive impairment and its relationship with executive cognition. International Journal of Geriatric Psychiatry, Vol. 25, Issue. 3, p. 224.

    Han, Areum Parker, Kathy and McDowd, Joan M. 2016. Occupational Therapy with Aging Adults.

    Woodard, John L. 2010. Handbook of Assessment in Clinical Gerontology.

    2009. Current awareness in geriatric psychiatry. International Journal of Geriatric Psychiatry, Vol. 24, Issue. 5, p. i.

    Tarnanas, Ioannis Tsolakis, Apostolis and Tsolaki, Magda 2015. Handbook of Research on Innovations in the Diagnosis and Treatment of Dementia.

    Forlenza, Orestes V Diniz, Breno S and Gattaz, Wagner F 2010. Diagnosis and biomarkers of predementia in Alzheimer's disease. BMC Medicine, Vol. 8, Issue. 1,

    Sewell, Margaret C. Vigario, Andrew and Sano, Mary 2010. Brocklehurst's Textbook of Geriatric Medicine and Gerontology.

    Park, Lovingly Quitania and Busson, Britt 2015. Psychosocial Studies of the Individual's Changing Perspectives in Alzheimer's Disease.

    Park, Lovingly Quitania Gross, Alden L. McLaren, Donald G. Pa, Judy Johnson, Julene K. Mitchell, Meghan and Manly, Jennifer J. 2012. Confirmatory factor analysis of the ADNI neuropsychological battery. Brain Imaging and Behavior, Vol. 6, Issue. 4, p. 528.

    Gure, T. R. Kabeto, M. U. Plassman, B. L. Piette, J. D. and Langa, K. M. 2010. Differences in Functional Impairment Across Subtypes of Dementia. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol. 65A, Issue. 4, p. 434.

    Nascimento, Carla Manuela Crispim Ayan, Carlos Cancela, Jose Maria Gobbi, Lilian Teresa Bucken Gobbi, Sebastião and Stella, Florindo 2014. Effect of a multimodal exercise program on sleep disturbances and instrumental activities of daily living performance on Parkinson's and Alzheimer's disease patients. Geriatrics & Gerontology International, Vol. 14, Issue. 2, p. 259.

    Young, Yuchi Kalamaras, John Kelly, Lindsay Hornick, David and Yucel, Recai 2015. Is Aging in Place Delaying Nursing Home Admission?. Journal of the American Medical Directors Association, Vol. 16, Issue. 10, p. 900.e1.

    Overdorp, Eduard J. Kessels, Roy P. C. Claassen, Jurgen A. and Oosterman, Joukje M. 2016. The Combined Effect of Neuropsychological and Neuropathological Deficits on Instrumental Activities of Daily Living in Older Adults: a Systematic Review. Neuropsychology Review, Vol. 26, Issue. 1, p. 92.

    Sequeira, Shwetha S. Eggermont, Laura H. P. Silliman, Rebecca A. Bickmore, Timothy W. Henault, Lori E. Winter, Michael R. Nelson, Kerrie and Paasche-Orlow, Michael K. 2013. Limited Health Literacy and Decline in Executive Function in Older Adults. Journal of Health Communication, Vol. 18, Issue. sup1, p. 143.

    Malinowsky, Camilla Almkvist, Ove Nygård, Louise and Kottorp, Anders 2012. Individual variability and environmental characteristics influence older adults' abilities to manage everyday technology. International Psychogeriatrics, Vol. 24, Issue. 03, p. 484.

    Martyr, Anthony and Clare, Linda 2012. Executive Function and Activities of Daily Living in Alzheimer’s Disease: A Correlational Meta-Analysis. Dementia and Geriatric Cognitive Disorders, Vol. 33, Issue. 2-3, p. 189.

    Marshall, Gad A Amariglio, Rebecca E Sperling, Reisa A and Rentz, Dorene M 2012. Activities of daily living: where do they fit in the diagnosis of Alzheimer’s disease?. Neurodegenerative Disease Management, Vol. 2, Issue. 5, p. 483.

    Burnett, Jason Dyer, Carmel B. and Naik, Aanand D. 2009. Convergent Validation of the Kohlman Evaluation of Living Skills as a Screening Tool of Older Adults' Ability to Live Safely and Independently in the Community. Archives of Physical Medicine and Rehabilitation, Vol. 90, Issue. 11, p. 1948.

    Marshall, Gad A. Rentz, Dorene M. Frey, Meghan T. Locascio, Joseph J. Johnson, Keith A. and Sperling, Reisa A. 2011. Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease. Alzheimer's & Dementia, Vol. 7, Issue. 3, p. 300.

    Johns, Erin K. Phillips, Natalie A. Belleville, Sylvie Goupil, Diane Babins, Lennie Kelner, Nora Ska, Bernadette Gilbert, Brigitte Massoud, Fadi de Boysson, Chloé Duncan, Hilary D. and Chertkow, Howard 2012. The Profile of Executive Functioning in Amnestic Mild Cognitive Impairment: Disproportionate Deficits in Inhibitory Control. Journal of the International Neuropsychological Society, Vol. 18, Issue. 03, p. 541.


Executive dysfunction correlates with impaired functional status in older adults with varying degrees of cognitive impairment

  • F. S. Pereira (a1), M. S. Yassuda (a1) (a2), A. M. Oliveira (a1) and O. V. Forlenza (a1)
  • DOI:
  • Published online: 01 December 2008

Background: Previous studies have reported an association between executive dysfunction and the ability to perform activities of daily living (ADL)s among older adults. This study aims to examine the association between executive functions and functional status in a cross-section of older adults with varying degrees of cognitive impairment.

Methods: 89 individuals (mean age 73.8 years) were recruited at a memory clinic in São Paulo, Brazil. Subjects underwent evaluation, and were allocated into three diagnostic groups according to cognitive status: normal controls (NC, n = 32), mild cognitive impairment (MCI, n = 31) and mild Alzheimer's disease (AD, n = 26). Executive functions were assessed with the 25-item Executive Interview (EXIT25), and functional status was measured with the Direct Assessment of Functional Status test (DAFS-R).

Results: Significantly different total DAFS-R scores were observed across the three diagnostic groups. Patients with AD performed significantly worse in EXIT25 compared with subjects without dementia, and no significant differences were detected between NC and MCI patients. We found a robust negative correlation between the DAFS-R and the EXIT25 scores (r =–0.872, p < 0.001). Linear regression analyses suggested a significant influence of the EXIT-25 and the CAMCOG on the DAFS-R scores.

Conclusion: Executive dysfunction and decline in general measures of cognitive functioning are associated with a lower ability to undertake instrumental ADLs. MCI patients showed worse functional status than NC subjects. MCI patients may show subtle changes in functional status that may only be captured by objective measures of ADLs.

Corresponding author
Correspondence should be addressed to: Dr. Orestes V. Forlenza, Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Rua Dr. Ovídio Pires de Campos, 785, 3rd floor, 05403-010 – São Paulo, S.P., Brazil. Phone: +55 11 3069–7924; Fax: +55 11 3085-5412. Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

S. Argüelles , D. A. Loewenstein , C. Eisdorfer and T. Argüelles (2001). Caregivers’ judgments of the functional abilities of the Alzheimer's disease patient: impact of caregivers’ depression and perceived burden. Journal of Geriatric Psychiatry and Neurology, 14, 9198.

L. Backman , S. Jones , A. K. Berger , E. J. Laukka and B. J. Small (2004). Multiple deficits during the transition to Alzheimer's disease. Journal of Internal Medicine, 256, 195204.

S. Bell-McGinty , K. Podell , M. Franzen , A. D. Baird and M. J. Williams (2002). Standard measures of executive function in predicting instrumental activities of daily living in older adults. International Journal of Geriatric Psychiatry, 17, 828834.

G. Binetti , E. Magni , A. Padovani , S. F. Cappa , A. Bianchetti and M. Trabucchi (1996). Executive dysfunction in early Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 60, 9193.

G. Blessed , B. E. Tomlinson and M. Roth (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797811.

D. A. Cahn-Weiner , P. F. Malloy , P. A. Boyle , M. Marran and S. Salloway (2000). Prediction of functional status from neuropsychological tests in community-dwelling elderly individuals. Clinical Neuropsychologist, 14, 187195.

D. A. Cahn-Weiner , P. A. Boyle and P. F. Malloy (2002). Tests of executive function predict instrumental activities of daily living in community-dwelling elderly individuals. Applied Neuropsychology, 9, 187191.

B. H. DeBettignies , R. K. Mahurin and F. J. Pirozzolo (1990). Insight for impairment in independent living skills in Alzheimer's disease and multi-infarct dementia. Journal of Clinical and Experimental Neuropsychology, 12, 355363.

B. S. O. Diniz (2007). Clinical and neuropsychological characterization of community-dwelling elderly patients assessed at a university based memory clinic. International Conference on Prevention of Dementia. Alzheimer's and Dementia, 3 (Suppl.), S138.

S. T. Farias , D. Mungas , B. Reed , D. Harvey , D. Cahn-Weiner and C. DeCarli (2006). MCI is associated with deficits in everyday functioning. Alzheimer Disease and Associated Disorders, 20, 217223.

M. F. Folstein , S. E. Folstein and P. R. McHugh (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.

P. Fuld (1980). Guaranteed stimulus processing in the evaluation of memory and learning. Cortex, 16, 255271.

V. C. Hachinski (1975). Cerebral blood flow in dementia. Archives of Neurology, 32, 632637.

M. Hamilton (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 5662.

R. Lindeboom , M. Vermeulen , R. Holman and R. J. De Hann (2003). Activities of daily living instruments: optimizing scales for neurologic assessment. Neurology, 60, 738742.

D. A. Loewenstein (2001). Caregivers’ judgments of the functional abilities of the Alzheimer's disease patient: a comparison of proxy reports and objective measures. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 56, 7884.

D. A. Loewenstein (2006). Cognitive profiles on Alzheimers disease and mild cognitive impairment on different etiologies. Dementia and Geriatric Cognitive Disorders, 21, 309315.

U. M. Mann , E. Mohr , M. Gearing and T. N. Chase (1992). Heterogeneity in Alzheimer's disease: progression rate segregated by distinct neuropsychological and cerebral metabolic profiles. Journal of Neurology, Neurosurgery and Psychiatry, 55, 956959.

G. McKhann , D. Drachman , M. Folstein , R. Katzman , D. Price and E. M. Stadlan (1984). Clinical diagnosis of Alzheimer disease: Report of NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Service Task Force on Alzheimer Disease. Neurology, 34, 939944.

K. Peres , V. Chrysostome , C. Fabrigoule , J. M. Orgogozo , J. F. Dartigues and P. Barberger-Gateau (2006). Restriction in complex activities of daily living in MCI. Impact on outcome. Neurology, 67, 461466.

R. Perneczky (2006). Complex activities of daily living in mild cognitive impairment: conceptual and diagnostic issues. Age and Ageing, 35, 240245.

R. J. Perry and J. R. Hodges (2000). Relationship between functional and neuropsychological performance in early Alzheimer disease. Alzheimer Disease and Associated Disorders, 14, 110.

R. C. Petersen (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183194.

R. C. Petersen and S. Negash (2008). Mild cognitive impairment: an overview. CNS Spectrums, 13, 4553.

R. C. Petersen , G. E. Smith , S. C. Waring , R. J. Ivnik , E. G. Tangalos and E. Kokmen (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303308.

M. Roth (1986). CAMDEX: a standardized instrument for the diagnosis of mental disorders in the elderly with special reference to early detection of dementia. British Journal of Psychiatry, 149, 698709.

D. R. Royall , R. K. Mahurin and K. Gray (1992). Bedside assessment of executive cognitive impairment: the Executive Interview (EXIT25). Journal of the American Geriatrics Society, 40, 12211226.

D. R. Royall , R. Palmer , L. K. Chiodo and J. M. Polk (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, 1117.

D. R. Royall , E. C. Lauterbach , D. Kaufer , P. Malloy , K. L. Coburn and K. J. Black (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, 249265.

L. Rozzini (2007).Conversion of amnestic Mild Cognitive Impairment to dementia of Alzheimer type is independent of memory deterioration. International Journal of Geriatric Psychiatry, 22, 12171222.

T. Sunderland (1989). Clock drawing in Alzheimer's disease: a novel measure of disease severity. Journal of the American Geriatrics Society, 37, 725729.

M. H. Tabert (2006). Neuropsychological prediction of conversion to Alzheimer disease in patients with mild cognitive impairment. Archives of General Psychiatry, 63, 916.

L. Teri , E. B. Larson and B. V. Reifler (1988). Behavioral disturbance in dementia of the Alzheimer's type. Journal of the American Geriatrics Society, 36, 16.

S. A. van Hooren , M. P. Van Boxtel , S. A. Valentijn , H. Bosma , R. W. Ponds and J. Jolles (2005). Influence of cognitive functioning on functional status in an older population: 3- and 6-year follow-up of the Maastricht Aging Study. International Journal of Geriatric Psychiatry, 20, 883888.

M. S. Yassuda (2006). Preliminary analyses of the psychometric characteristics of the Rivermead Behavioral Memory Test (RBMT) as an early detection instrument for AD in Brazil, paper presented at Alzheimer's Association 10th International Conference on AD and Related Disorders. Alzheimer's and Dementia, 2 (Suppl.), S387.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
Please enter your name
Please enter a valid email address
Who would you like to send this to? *