Executive function deficit in early Alzheimer's disease and their relations with episodic memory

INSERM/UPVM Unite 421, Faculté de Médecine, 8 rue du Général Sarrail, 94010 Créteil Cedex, France.
Archives of Clinical Neuropsychology (Impact Factor: 1.99). 02/2006; 21(1):15-21. DOI: 10.1016/j.acn.2005.07.002
Source: PubMed


Previous research suggests that patients with Alzheimer's disease (AD) are impaired on executive function early in the course of disease, but negative findings were reported. To evaluate the performance on executive tasks in early AD and to determine the involvement of memory on the outcome of executive tasks. Thirty-six AD patients were divided into two subgroups on the basis of the MMSE: very mild and mild. The comparison with 17 normal controls shows that very mild AD patients had deficits on visuospatial short-term memory, episodic memory, flexibility and self-monitoring abilities, concept formation and reasoning. The mild AD patients showed additional deficits on the Similarities test. Episodic memory and executive deficits occur in the very early stage of AD and precede impairment in constructional praxis, language and sustained attention. With the progression of the disease, additional deficit is observed in abstract thinking. In mild AD, memory failure is also related to executive impairment.

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Available from: Latchezar Dintchov Traykov, Dec 17, 2013
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    • "Frontal executive dysfunctions very often occur in Alzheimer's disease (AD), resulting in cognitive and behavioral abnormalities [1] since early stages of the illness [2]. Among dysexecutive behavioral disorders, AD patients very often show loss of motivation, diminished social and cognitive initiative, lack of interest, and reduced emotional responses, that are encompassed within the term Apathy [3] [4]. "
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    ABSTRACT: Background: Apathy and depression are behavioral manifestations that may occur often in Alzheimer's disease (AD) patients. AD patients may also show Closing-in (CI) phenomenon, in graphic copying tasks. Recent evidence would suggest that apathetic symptoms are related to frontal dysfunctions in AD patients, whereas the cognitive bases of depressive symptoms in AD are still unclear. Recent studies demonstrated that frontal dysfunctions are also involved in the genesis of CI in AD patients. Objective: Since frontal dysfunctions are thought to be more strongly related to apathetic than depressive symptoms, here we tested the hypothesis that CI is significantly associated with apathy in AD patients. Methods: Forty-four AD patients were enrolled for this study. All patients completed a neuropsychological evaluation of visuo-spatial, frontal/executive, visuo-constructional, and memory skills. Moreover, graphic copying tasks were employed to detect CI, and behavioral scales to assess apathetic and depressive symptoms. Results: CI and apathetic and depressed symptoms occurred in more than half of the present AD sample, but regression models revealed that the number of CI was significantly related to apathy only. The number of CI was also significantly correlated with severity of apathetic but not of depressive symptoms. Conclusion: The present study demonstrated that CI and apathy are correlated with each other in mild to moderate AD, likely because they share common pathogenic mechanisms related to frontal/executive dysfunctions.
    Journal of Alzheimer's disease: JAD 08/2014; 43(3). DOI:10.3233/JAD-141257 · 4.15 Impact Factor
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    • "Healthy aging is associated with decrements in EF [11], particularly in planning [12] [13] and inhibition [13] [14] [15] [16] [17]. EF are compromised in neurodegenerative and cerebrovascular disorders, such as Parkinson's disease [18] [19] [20], vascular dementia [21] [22], frontotemporal dementia (FTD) [21] [23], and Alzheimer's disease (AD) [24] [25] [26] [27] [28]. Concerning AD, breakdowns in EF are noticeable in the early course of the disease , possibly even before standard measures of global cognitive decline can distinguish between patients and controls [27] [28] [29]. "
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    ABSTRACT: Background. The Institute of Cognitive Neurology (INECO) Frontal Screening (IFS) is a brief neuropsychological tool recently devised for the evaluation of executive dysfunction in neurodegenerative conditions. Objective. In this study we present a cross-cultural validation of the IFS for the Portuguese population, provide normative values from a healthy sample, determine how age and education affect performance, and inspect its clinical utility in the context of Alzheimer’s disease (AD). A comparison with the Frontal Assessment Battery (FAB) was undertaken, and correlations with other well-established executive functions measures were examined. Methods. The normative sample included 204 participants varying widely in age (20 – 85 years) and education (3 – 21 years). The clinical sample (n = 21) was compared with a sample of age- and education-matched controls (n = 21). Healthy participants completed the IFS and the Mini-Mental State Examination (MMSE). In addition to these, the patients (and matched controls) completed the FAB and a battery of other executive tests. Results. IFS scores were positively affected by education and MMSE, and negatively affected by age. Patients underperformed controls on the IFS, and correlations were found with the Clock Drawing Test, Stroop test, and the Zoo Map and Rule Shift Card tests of The Behavioural Assessment of the Dysexecutive Syndrome. A cut-off of 17 optimally differentiated patients from controls. Whilst 88% of the IFS sub-tests discriminated patients from controls, only 67% of the FAB sub-tests did so. Conclusion. Age and education should be taken into account when interpreting performance on the IFS. The IFS is useful to detect executive dysfunction in AD, showing good discriminant and concurrent validities.
    Journal of Alzheimer's disease: JAD 04/2014; 42:261-273. DOI:10.3233/JAD-132348 · 4.15 Impact Factor
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    • "For example, a correlational study revealed that episodic memory in older people with vascular risk factors uniquely predicts the performance on the Trail Making Task (Oosterman et al., 2010). Similarly, a strong association between episodic memory impairment and impaired performance on executive function tasks was reported in Alzheimer patients (Baudic et al., 2006). Recent studies also indicate that the medial temporal lobes, brain regions that are crucially involved in episodic memory performance, also are important for executive function performance. "
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    ABSTRACT: This study tested the hypothesis that part of the age-related decline in performance on executive function tasks is due to a decline in episodic memory. For this, we developed a rule induction task in which we manipulated the involvement of episodic memory and executive control processes; age effects and neuropsychological predictors of task performance were investigated. Twenty-six younger (mean age, 24.0; range, 19-35 years) and 27 community-dwelling older adults (mean age, 67.5; range, 50-91 years) participated. The neuropsychological predictors consisted of the performance on tests of episodic memory, working memory, switching, inhibition and flexibility. Performance of the older adults was worse for the learning and memorization of simple rules, as well as for the more demanding executive control condition requiring the manipulation of informational content. Episodic memory was the only predictor of performance on the simple learning and memorization task condition whereas an increase in rule induction complexity additionally engaged working memory processes. Together, these findings indicate that part of the age-related decline on rule induction tests may be the result of a decline in episodic memory. Further studies are needed that examine the role of episodic memory in other executive function tasks in aging. (JINS, 2014, 20, 1-9).
    Journal of the International Neuropsychological Society 02/2014; 20(03):1-9. DOI:10.1017/S1355617713001446 · 2.96 Impact Factor
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