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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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