Declining Executive Control in Normal Aging Predicts Change in Functional Status: The Freedom House Study

Royall, Donald R.; Palmer, Raymond F.; Chiodo, Laura K.; Polk, Marsha J.

doi:10.1111/j.1532-5415.2004.52104.x

Cited by 290 publications

(239 citation statements)

References 37 publications

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“…It also provides evidence that an EF battery of tests can be administered to this population in their homes based on the number of subjects who were willing to complete these measures as previously reported. Consistent with the ED literature, this study found that individuals with high MMSE scores may test positive for scores consistent ED [12] . As previously mentioned, the MMSE is a global screen for cognition (i.e.…”

supporting

confidence: 76%

Assessing dimensions of executive function in community-dwelling older adults with self-neglect

Pickens

Ostwald²,

Pace³

et al. 2013

Clinical Nursing Studies

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Purpose: Self-neglect (SN) is the inability to maintain self-care needs. It is thought that older adults who have impaired executive function (EF) develop the inability to self-care and to protect themselves. The specific aims were to determine the feasibility of using multiple EF measures and assess the different dimensions of EF with community-dwelling elders with SN. Results: Older adults with SN were more likely to fail the CLOX1 and D-KEFS, while passing the other cognitive measures. The low D-KEFS scores indicate difficulties in generating new concepts, inhibiting previous conceptual thoughts, or initiating novel ideas. Methods Conclusions:Results from this study provide support that individuals with SN will complete a battery of EF tests and that they exhibit the following impairments consistent with executive dysfunction: "concept generation", "planning, inhibition", and "spatial working memory". Utilizing only one EF measure in individuals with intact cognition may result in unidentification of individuals with executive dysfunction, thus delaying necessary treatment. Future studies should attempt to determine different etiologies of executive dysfunction and determine if early treatment can prevent or reverse SN.

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supporting

confidence: 76%

Assessing dimensions of executive function in community-dwelling older adults with self-neglect

Pickens

Ostwald²,

Pace³

et al. 2013

Clinical Nursing Studies

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“…Alternately, cognition has been measured between dialysis treatments using a battery of neuropsychiatric tests (5) which, although very sensitive measures, are infeasible for adminstration by clinicians during the dialysis treatment. By using the EXIT25 in addition to the MMSE, we were able to capture executive dysfunction, a facet of cognition associated with the ability to independently perform instrumental activities of daily living (26). The high rate of completion of the SPPB, a test of physical performance that has been shown to be predictive of mortality and nursing home placement (27), stands in contrast to prior studies utilizing alternative physical performance measures, which had substantially higher rates of incomplete assessments (28,29).…”

Section: Discussionmentioning

confidence: 59%

Relationship between Conditions Addressed by Hemodialysis Guidelines and Non-ESRD-Specific Conditions Affecting Quality of Life

Leinau

Murphy

Bradley

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: Persons with ESRD identify non-disease-specific conditions as negatively affecting their quality of life. It is unknown how these non-ESRD-specific conditions correlate with each other and with ESRD-specific conditions such as anemia, renal osteodystrophy, dialysis access, and dialysis adequacy. The objectives of this study were to determine the prevalence and inter-relatedness of selected conditions among persons receiving hemodialysis and to analyze the relationship between non-ESRD-specific and ESRD-specific conditions. Design, setting, participants, & measurements: This was an observational cohort study of persons with ESRD that included standardized assessments for pain, fatigue, depression, cognitive impairment, and impaired physical performance. The study was conducted at three dialysis clinics in one urban geographic area. Of the 134 persons who met exclusion criteria, 25 declined participation, yielding a sample size of 109.Results: Pain was present in >81% of participants, fatigue and impaired physical performance in >60% participants, and cognitive impairment and depression in >25% of participants. Pain, fatigue, and depression were highly correlated, but had no correlation with use of a catheter for access, hemoglobin (Hgb), intact parathyroid hormone (iPTH), phosphorous, or Kt/V values outside of the range of guidelines. There was a modest correlation between cognitive function and both Hgb and iPTH.Conclusions: Non-ESRD-specific conditions such as fatigue, pain, and depression are as prevalent as ESRD-specific conditions, and the magnitude of the correlations between the non-ESRD-specific conditions is greater than the correlations between non-ESRD-specific and ESRD-specific conditions. Current guidelines may be failing to address a substantial component of the disease burden for persons with ESRD.

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“…First, executive dysfunction may play a particularly important role in the progression of disability. For example, Royall (Royall, 2006;Royall et al, 2004, Royall et al,2005 argues for the central role of executive dysfunction in causing functional disability and in the conversion of MCI to dementia. Perhaps executive functions, because of their role in regulating and coordinating other mental functions, organizing behavior and generating responses, play a central role in a variety of everyday activities.…”

Section: Discussionmentioning

confidence: 99%

Cognitive and neuroimaging predictors of instrumental activities of daily living

Cahn-Weiner

Farias

Julián

et al. 2007

J. Inter. Neuropsych. Soc.

187

167

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Impaired ability to conduct daily activities is a diagnostic criterion for dementia and a determinant of healthcare services utilization and caregiver burden. What predicts decline in instrumental activities of daily living (IADLs) is not well understood. This study examined measures of episodic memory, executive function, and MRI brain volumes in relation to baseline IADLs and as predictors of rate of IADL change. Participants were 124 elderly persons with cognitive function between normal and moderate dementia both with and without significant small vessel cerebrovascular disease. Random effects modeling showed that baseline memory and executive function (EXEC) were associated with baseline IADL scores, but only EXEC was independently associated with rate of change in IADLs. Whereas hippocampal and cortical gray matter volumes were significantly associated with baseline IADL scores, only hippocampal volume was associated with IADL change. In a model including cognitive and neuroimaging predictors, only EXEC independently predicted rate of decline in IADL scores. These findings indicate that greater executive dysfunction at initial assessment is associated with more rapid decline in IADLs. Perhaps executive function is particularly important with respect to maintaining IADLs. Alternatively, executive dysfunction may be a sentinel event indicating widespread cortical involvement and poor prognosis.

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Declining Executive Control in Normal Aging Predicts Change in Functional Status: The Freedom House Study

Cited by 290 publications

References 37 publications

Assessing dimensions of executive function in community-dwelling older adults with self-neglect

Assessing dimensions of executive function in community-dwelling older adults with self-neglect

Relationship between Conditions Addressed by Hemodialysis Guidelines and Non-ESRD-Specific Conditions Affecting Quality of Life

Cognitive and neuroimaging predictors of instrumental activities of daily living

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