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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    • "This decline in responding to different semantic cues has been attributed to semantic as well as attention deficits. With semantic memory largely still intact in early dementia (Nestor et al., 2006), the decline in attention is more likely to play a vital role within semantic cueing due to its early deterioration (Baudic et al., 2006). Therefore, the important benefit which cues can provide in aiding (long-term) memory retrieval appears lost early on in dementia, so that addressing attention may offer a pathway into potentially improving on this deficit. "
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    ABSTRACT: Objectives: Early dementia is marked by cognitive and functional impairments, and although studies indicate an association between these, detailed analyses exploring this relationship are rare. It is crucial to understand how specific cognitive deficits underlie functional deficits to develop successful cognitive interventions. This paper reviews the evidence of impairment in everyday functioning and in working, long-term and prospective memory in early dementia. Findings are evaluated with respect to the relationship between cognitive and functional impairments. Methods: From the literature searches, 17 studies on everyday functioning and 40 studies on memory were obtained. Studies were only included if patients had an official diagnosis and were in the early stages of dementia. Results: Complex instrumental activities of daily living were subject to greater impairment than basic activities of daily living. In particular, early dementia patients struggle with finance tasks; a deficit linked to impaired working memory. Regarding cognition, long-term memory is the earliest form of memory to decline as is well recognised. Evidence also indicates deficits in working and prospective memory, with inconsistent evidence about impairments of the former. A major limitation of the literature is a lack of studies assessing individual everyday activities and the associated error patterns that might occur. Conclusion: This review critically assesses the status of translational research for everyday activities in early dementia, an area with critical implications for cognitive-based rehabilitation. Further research is required into the detailed assessment of individual everyday activity and specific memory deficits, in order to effectively map cognitive functions onto functional performance.
    Aging and Mental Health 01/2015; 19(10). DOI:10.1080/13607863.2014.1003282 · 1.75 Impact Factor
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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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