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Ecological assessment of executive functions in mild cognitive impairment and mild Alzheimer’s disease

Published online by Cambridge University Press:  01 September 2009

ANA ESPINOSA
Affiliation:
Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
MONTSERRAT ALEGRET*
Affiliation:
Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
MERCÈ BOADA
Affiliation:
Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain Neurology Department, Hospital Universitari Vall d’Hebron. Universitat Autònoma de Barcelona, Barcelona, Spain
GEORGINA VINYES
Affiliation:
Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
SERGI VALERO
Affiliation:
Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain Psychiatry Department, Hospital Universitari Vall d’Hebron. Universitat Autònoma de Barcelona, Barcelona, Spain
PABLO MARTÍNEZ-LAGE
Affiliation:
Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
JORDI PEÑA-CASANOVA
Affiliation:
Section of Behavioral Neurology, Hospital del Mar, Barcelona & Municipal Institute of Medical Research, Barcelona, Spain
JAMES T BECKER
Affiliation:
Departments of Neurology, Psychiatry, and Psychology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
BARBARA A. WILSON
Affiliation:
MRC Cognition and Brain Sciences Unit, Cambridge, England
LLUÍS TÁRRAGA
Affiliation:
Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
*
*Correspondence and reprint requests to: Montserrat Alegret, Ph.D. Fundació ACE. Institut Català de Neurociències Aplicades, C/ Marquès de Sentmenat, 35-37, 08014 Barcelona, Spain. E-mail: malegret@fundacioace.com

Abstract

Although memory deficits are typically the earliest and most profound symptoms of Alzheimer’s disease (AD) and mild cognitive impairment (MCI), there is increasing recognition of subtle executive dysfunctions in these patients. The purpose of the present study was to determine the sensitivity of the Behavioral Assessment of the Dysexecutive Syndrome (BADS), and to detect early specific signs of the dysexecutive syndrome in the transition from normal cognition to dementia. The BADS was administered to 50 MCI subjects, 50 mild AD patients, and 50 normal controls. Statistically significant differences were found among the three groups with the AD patients performing most poorly, and the MCI subjects performing between controls and AD patients. The Rule Shift Cards and the Action Program subtests were the most highly discriminative between MCI and controls; the Zoo Map and Modified Six Elements between MCI and AD; and the Action Program, Zoo Map, and Modified Six Elements between AD and controls. These results demonstrate that the BADS is clinically useful in discriminating between normal cognition and progressive neurodegenerative conditions. Furthermore, these data confirm the presence of a dysexecutive syndrome even in mildly impaired elderly subjects. (JINS, 2009, 15, 751–757.)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2009

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References

REFERENCES

Alegret, M., Boada-Rovira, M., Vinyes-Junqué, G., Valero, S., Espinosa, A., Hernández, I., et al. . (2009). Detection of visuoperceptual déficits in preclinical and mild Alzheimer’s disease. Journal of Clinical and Experimental Neuropsychology, 14, 18.Google Scholar
Allain, P., Chaudet, H., Nicoleau, S., Etcharry-Bouyx, F., Barré, J., Dubas, F., et al. . (2007). A study of action planning in patients with Alzheimer’s disease using the zoo map test. Revue Neurologique (Paris), 163, 222230.CrossRefGoogle ScholarPubMed
Amieva, H., Lafont, S., Auriacombe, S., Le Carret, N., Dartigues, J.F., Orgogozo, J.M., et al. . (2002). Inhibitory breakdown and dementia of the Alzheimer type: A general phenomenon? Journal of Clinical and Experimental Neuropsychology, 24, 503516.CrossRefGoogle ScholarPubMed
Amieva, H., Lafont, S., Auriacombe, S., Rainville, C., Orgogozo, J.M., Dartigues, J.F., et al. . (1998). Analysis of error types in the trail making test evidences an inhibitory deficit in dementia of Alzheimer type. Journal of Clinical and Experimental Neuropsychology, 20, 280285.CrossRefGoogle Scholar
Amieva, H., Lafont, S., Rouch-Leroyer, I., Rainville, C., Dartigues, J.F., Orgogozo, J.M., et al. . (2004). Evidencing inhibitory deficits in Alzheimer’s disease through interference effects and shifting disabilities in the Stroop test. Archives of Clinical Neuropsychology, 19, 791803.CrossRefGoogle ScholarPubMed
Amieva, H., Phillips, L., & Della Sala, S. (2003). Behavioral dysexecutive symptoms in normal aging. Brain and Cognition, 53, 129132.CrossRefGoogle ScholarPubMed
Ardila, A., Ostrosky-Solis, F., Rosselli, M., & Gómez, C. (2000). Age-related cognitive decline during normal aging: The complex effect of education. Archives of Clinical Neuropsychology, 15, 495513.Google ScholarPubMed
Ardila, A., & Rosselli, M. (1989). Neuropsychological characteristics of normal aging. Developmental Neuropsychology, 5, 307320.CrossRefGoogle Scholar
Bäckman, L., Jones, S., Berger, A.K., Laukka, E.J., & Small, B.J. (2005). Cognitive impairment in preclinical Alzheimer’s disease. A meta-analysis. Neuropsychology, 19, 520531.CrossRefGoogle ScholarPubMed
Baddeley, A.D., Bressi, S., Della Sala, S., Logie, R., & Spinnler, H. (1991a). The decline of working memory in Alzheimer’s disease. A longitudinal study. Brain, 114, 25212542.CrossRefGoogle ScholarPubMed
Baddeley, A., Della Sala, S., & Spinnler, H. (1991b). The two-component hypothesis of memory deficit in Alzheimer’s disease. Journal of Clinical and Experimental Neuropsychology, 13, 372380.CrossRefGoogle ScholarPubMed
Baddeley, A., Logie, R., Bressi, S., Della Sala, S., & Spinnler, H. (1986). Dementia and working memory. The Quarterly Journal of Experimental Psychology, 38, 603618.CrossRefGoogle ScholarPubMed
Becker, J.T. (1988). Working memory and secondary memory deficits in Alzheimer’s disease. Journal of Clinical and Experimental Neuropsychology, 10, 739753.CrossRefGoogle ScholarPubMed
Becker, J.T., Lopez, O., & Wess, J. (1992). Material-specific memory loss in probable Alzheimer’s disease. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 11771181.CrossRefGoogle ScholarPubMed
Beversdorf, D.Q., Ferguson, J.L., Hillier, A., Sharma, U.K., Nagaraja, H.N., Bornstein, R.A., et al. . (2007). Problem solving ability in patients with mild cognitive impairment. Cognitive and Behavioral Neurology, 20, 4447.CrossRefGoogle ScholarPubMed
Boeve, B., McCormick, J., Smith, G., Ferman, T., Rummans, T., & Carpenter, T. (2003). Mild cognitive impairment in the oldest old. Neurology, 60, 477480.CrossRefGoogle ScholarPubMed
Bozoki, A., Giordani, B., Heidebrink, J.L., Berent, S., & Foster, N.L. (2001). Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss. Archives of Neurology, 58, 411416.CrossRefGoogle ScholarPubMed
Brugger, P., Monsch, A.U., Salmon, D.P., & Butters, N. (1996). Random number generation in dementia of the Alzheimer type: A test of frontal executive functions. Neuropsychologia, 34, 97103.CrossRefGoogle ScholarPubMed
Burgess, P.W., Alderman, N., Forbes, C., Costello, A., Coates, L.M., Dawson, D.R., et al. . (2006). The case for the development and use of “ecologically valid” measures of executive function in experimental and clinical neuropsychology. Journal of International Neuropsychological Society, 12, 194209.CrossRefGoogle ScholarPubMed
Carlson, M.C., Fried, L.P., Xue, Q.L., Bandeen-Roche, K., Zeger, S.L., & Brandt, J. (1999). Association between executive attention and physical functional performance in community-dwelling older women. Journal of Gerontology: Psychological Sciences, 54(Suppl. 5), 262270.CrossRefGoogle ScholarPubMed
Daigneault, S., Braun, C.M.J., & Whitaker, H.A. (1992). Early effects of normal aging in perseverative and non-perseverative prefrontal measures. Developmental Neuropsychology, 8, 99114.CrossRefGoogle Scholar
De Jager, C.A., Hogervorst, E., Combrinck, M., & Budge, M.M. (2004). Sensitivity and specificity of neuropsychological tests for mild cognitive impairment and Alzheimer’s disease. Psychological Medicine, 34, 761762.Google Scholar
Estevez-González, A., Kulisevsky, J., Boltes, A., Otermin, P., & García-Sánchez, C. (2003). Rey verbal learning test is a useful tool for differential diagnosis in the preclinical phase of Alzheimer’s disease: Comparison with mild cognitive impairment and normal aging. International Journal of Geriatric Psychiatry, 18, 10211028.CrossRefGoogle ScholarPubMed
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle Scholar
Grigsby, J., Kaye, K., Baxter, J., Shetterly, S.M., & Hamman, R.F. (1998). Executive cognitive abilities and functional status among community-dwelling older persons in the San Luis Valley Health and Aging Study. Journal of the American Geriatric Society, 46, 590596.CrossRefGoogle Scholar
Grundman, M., Petersen, R.C., Ferris, S.H., Thomas, R.G., Aisen, P.S., Bennett, D.A., et al. . (2004). Mild cognitive impairment can be distinguished from Alzheimer’s disease and normal aging for clinical trials. Archives of Neurology, 61, 5966.CrossRefGoogle ScholarPubMed
Hughes, C.P., Berg, L., Danziger, W.L., Coben, L.A., & Martin, R.L. (1982). A new clinical scale for the staging of dementia. The British Journal of Psychiatry, 140, 566572.CrossRefGoogle ScholarPubMed
Levine, B. (2000). Self-regulation and autonoetic consciousness. In Tulving, E. (Ed.), Memory, consciousness, and the brain (pp. 200214). Philadelphia: Psychology Press.Google Scholar
Lezak, M.D., Howieson, D.B., & Loring, D.W. (2004). Neuropsychological assessment. New York: Oxford University Press.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Morris, J.C., Storandt, M., Miller, P., McKeel, R.W., Price, J.L., Rubin, E.H., et al. . (2001). Mild cognitive impairment represents early-stage Alzheimer’s disease. Archives of Neurology, 58, 397405.CrossRefGoogle Scholar
Moulin, C.J., James, N., Freeman, J.E., & Jones, R.W. (2004). Deficient Acquisition and consolidation: Intertrial free recall performance in Alzheimer’s disease. Journal of Clinical and Experimental Neuropsychology, 26, 110.CrossRefGoogle ScholarPubMed
Nordlund, A., Rolstad, S., Hellström, P., Sjögren, M., Hansen, S., & Wallin, A. (2005). The Goteborg MCI study: Mild cognitive impairment is a heterogeneous condition. Journal of Neurology, Neurosurgery, and Psychiatry, 76, 14851490.CrossRefGoogle ScholarPubMed
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., & Kokmen, E. (1999). Mild cognitive impairment. Clinical characterization and outcome. Archives of Neurology, 56, 303308.CrossRefGoogle ScholarPubMed
Piquard, A., Derouesné, C., Lacomblez, L., & Siéroff, E. (2004). Planning and activities of daily living in Alzheimer’s disease and frontotemporal dementia. Psychologie & Neuropsychiatrie du Vieillissement, 2, 147156.Google ScholarPubMed
Rainville, C., Amieva, H., Lafont, S., Dartigues, J.F., Orgogozo, J.M., & Fabrigoule, C. (2002). Executive function deficits in patients with dementia of the Alzheimer’s type. A study with a Tower of London task. Archives of Clinical Neuropsychology, 17, 513530.CrossRefGoogle ScholarPubMed
Ritchie, K., Artero, S., & Touchon, J. (2001). Classification criteria for mild cognitive impairment. A population-based validation study. Neurology, 56, 3742.CrossRefGoogle ScholarPubMed
Rozzini, L., Chilovi, B.V., Conti, M., Bertoletti, E., Delrio, I., Trabucchi, M., et al. . (2007). Conversion of amnestic mild cognitive impairment to dementia of Alzheimer type is independent to memory deterioration. International Journal of Geriatric Psychiatry, 22, 12171222.CrossRefGoogle ScholarPubMed
Shallice, T., & Burgess, P. (1991). Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727741.CrossRefGoogle ScholarPubMed
Sherod, M.G., Griffith, H.R., Copeland, J., Belue, K., Krzywanski, S., Zamrini, E.Y., et al. . (2009). Neurocognitive predictors of financial capacity across the dementia spectrum: Normal aging, mild cognitive impairment, and Alzheimer’s disease. Journal of the International Neuropsychological Society, 15, 258267.CrossRefGoogle ScholarPubMed
Traykov, L., Raoux, N., Latour, F., Gallo, L., Hanon, O., Baudic, S., et al. . (2007). Executive functions deficit in mild cognitive impairment. Cognitive and Behavioral Neurology, 20, 219224.CrossRefGoogle ScholarPubMed
Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., & Evans, J.J. (1996). The behavioural assessment of the dysexecutive syndrome. Bury St Edmunds: Thames Valley Company.Google Scholar