Bedside Assessment of Executive Cognitive Impairment: The Executive Interview

Royall, Donald R.; Mahurin, Roderick K.; Gray, Kevin F.

doi:10.1111/j.1532-5415.1992.tb03646.x

Cited by 560 publications

(427 citation statements)

References 33 publications

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“…the Stroop test [14]. Other studies found that apathy was significantly associated with executive dysfunctions, evaluated with the Executive Interview [61] and category and letter fluency [45] (In this study patients were treated with Levodopa and their average disease duration was 4.3 years). Dujardin and colleagues [44] evaluated cognitive functions in nondemented PD patients (Average disease duration was 9.4 years and they were treated with Levodopa).…”

Section: Apathymentioning

confidence: 84%

Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: A systematic review

Alzahrani

Venneri

2015

Journal of the Neurological Sciences

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Section: Apathymentioning

confidence: 84%

Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: A systematic review

Alzahrani

Venneri

2015

Journal of the Neurological Sciences

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“…While the EXIT was originally developed as a measure of executive functions (28), we also considered the EXIT items from the perspective of Miller & Cohen’s later conceptualization of cognitive control, namely, the ‘active maintenance of patterns of activity in the prefrontal cortex that represent goals and the means to achieve them by way of bias signals that promote task-appropriate responding’ (32). Eight of the 25 EXIT items assess the ability to inhibit an automatic behavior, and three items capture error detection or conflict monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…We assessed a spectrum of executive functions with the Executive Interview (EXIT) (28) (range 0–50). The 25 items comprising this screening test are administered in rapid succession with minimal instructions and elicit automatic behaviors and disinhibition and also include modifications of well-known “frontal lobe” tests (number/letter sequencing, Stroop, fluency tests, go/no-go tests, and Luria’s hand sequences).…”

Section: Methodsmentioning

confidence: 99%

Impaired Executive Function in Contemplated and Attempted Suicide in Late Life

Gujral

Dombrovski

Butters

et al. 2014

The American Journal of Geriatric Psychiatry

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Objective Executive deficits may play an important role in late-life suicide. Yet, current evidence in this area is inconclusive and does not indicate whether these deficits are broadly associated with suicidal ideation or specific to suicidal behavior. This study examined global cognition and specifically executive function impairments as correlates of suicidal ideation and suicidal behavior in depressed older adults, with the goal of extending an earlier preliminary study. Design Case-control study. Setting University-affiliated psychiatric hospital. Participants All were aged 60+: 83 depressed suicide attempters, 43 depressed individuals having suicidal ideation with a specific plan, 54 non-suicidal depressed participants, and 48 older adults with no history of psychiatric disorders. Measurements Global cognitive function - Dementia Rating Scale (DRS), Executive function - Executive Interview (EXIT). Results Both suicide attempters and suicide ideators performed worse than the two comparison groups on the EXIT, with no difference between suicide attempters and suicide ideators. On the DRS total score, as well as on Memory and Attention subscales, suicide attempters and ideators and non-suicidal depressed subjects performed similarly and were impaired relative to with non-psychiatric control subjects. Controlling for education, substance use disorders, and medication exposure did not affect group differences in performance on either the EXIT or DRS. Conclusions Executive deficits, captured with a brief instrument, are associated broadly with suicidal ideation in older depressed adults but do not appear to directly facilitate suicidal behavior. Our data are consistent with the idea that different vulnerabilities may operate at different stages in the suicidal process.

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“…In brief, participants were 70 and older, diagnosed via Structured Clinical Interview for DSM-IV (First et al, 1995) with current non-psychotic, nonbipolar major depressive disorder (single-episode or recurrent), a 17-item Hamilton Depression Rating Scale (Hamilton, 1960) of 15 or higher, and a Mini Mental State Examination (MMSE) (Folstein et al, 1975) score of 17 or higher. Cognitive function was assessed with the Dementia Rating Scale (Mattis, 2004) and the Executive Interview (Royall et al, 1992). Subjects included in this study had a Mini Mental State Examination of 24 or above.…”

Section: Methodsmentioning

confidence: 99%

Gray Matter Changes in Late Life Depression—a Structural MRI Analysis

Andreescu

Butters

Begley

et al. 2007

Neuropsychopharmacol

127

120

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Multiple brain morphometric changes have been reported in late-life depression (LLD), mostly in studies comparing volumes of circumscribed brain areas. The aim of our study is to characterize the volumetric changes of multiple gray matter regions in relation to age of onset/duration of illness. We predicted that the association of gray matter volumes with total duration of illness and age of onset would differ depending on whether the region was susceptible to the toxic effects of chronic exposure to cortisol or to the vascular/ neurodegenerative changes accompanying prodromal dementia. Seventy-one elderly depressed subjects were studied along with thirtytwo comparison subjects. High-resolution T1-weighted brain MRIs were processed using an automated labeling pathway technique. To protect against type-I error, we combined the right and left hemisphere volume data. We sampled 24 regions of interest (ROIs). We used the primary visual cortex volume to normalize for individual variations in brain size. LLD Subjects had smaller volumes than nondepressed subjects in 17 of the 24 examined ROIs. Shorter duration of illness and later age of onset was correlated with smaller volumes of parahippocampal area and parietal inferior area. A later age of onset was also correlated with smaller volumes of several frontal and temporal areas, cingulum, and putamen. Our findings support a dementia prodrome model more strongly than a toxic stress model in this group of subjects. However, it remains likely that both processes as well as other factors contribute to the heterogeneity of volumetric brain changes in LLD.

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Bedside Assessment of Executive Cognitive Impairment: The Executive Interview

Abstract: These preliminary findings suggest that the EXIT is a valid and reliable instrument for the assessment of executive impairment at the bedside. It correlates well with level of care and problem behavior. It discriminates residents at earlier stages of cognitive impairment than the MMSE.

Cited by 560 publications

References 33 publications

Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: A systematic review

Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: A systematic review

Impaired Executive Function in Contemplated and Attempted Suicide in Late Life

Gray Matter Changes in Late Life Depression—a Structural MRI Analysis

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