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

Alexandrovska University Hospital, Ulpia Serdica, Sofia-Capital, Bulgaria
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
    • "Alzheimer's disease (AD) is a progressive neurodegenerative disorder that is mainly characterized by episodic memory disorder, visuospatial impairment, attentional impairment, and executive dysfunction [1, 2] . During the course of this disease, various neuropsychiatric symptoms (NPSs) of dementia emerge, including delusions, depression, behavioral disturbances, agitation, sleep disturbances, and eating problems, which in turn increase burden of stress and direct costs of care among caregivers3456. "
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    ABSTRACT: Background: The Neuropsychiatric Inventory (NPI) comprises 12 items, which were conventionally determined by psychopathological symptoms of patients with dementia. The clinical rating scales with structured questionnaires have been useful to evaluate neuropsychiatric symptoms (NPSs) of patients with dementia over the past twenty year. Objective: The aim of this study was to classify the conventional NPSs in patients with Alzheimer's disease (AD) requiring antipsychotic treatment for their NPSs into distinct clusters to simplify assessment of these numerous symptoms. Methods: Twelve items scores (product of severity and frequency of each symptom) in the NPI taken from the baseline visit were classified into subgroups by principle component analysis using data from 421 outpatients with AD enrolled in the Clinical Antipsychotic Trials of Intervention Effectiveness-Alzheimer's Disease (CATIE-AD) Phase 1. Chi square tests were conducted to examine the co-occurrence of the subgroups. Results: We found four distinct clusters: Aggressiveness (agitation and irritabilities), apathy and eating problems (apathy and appetite/eating disturbance), psychosis (delusions and hallucinations), and emotion and disinhibition (depression, euphoria, and disinhibition). Anxiety, aberrant motor behavior, and sleep disturbance were not included by these clusters. Apathy and eating problems, and emotion and disinhibition co-occurred (p = 0.002), whereas aggressiveness and psychosis occurred independent of the other clusters. Conclusions: Four distinct category clusters were identified from NPSs in patients with AD requiring antipsychotic treatment. Future studies should investigate psychosocial backgrounds or risk factors of each distinct cluster, in addition to their longitudinal course over treatment intervention.
    No preview · Article · Feb 2016 · Journal of Alzheimer's disease: JAD
    • "In addition, AD patients show semantic memory deficits (Verma and Howard, 2012) that lead to poor performance in naming and/or semantic fluency tasks, for example. Moreover, early AD is often associated with executive dysfunction (Backman et al., 2005;Baudic et al., 2006;Chen et al., 2001;Clark et al., 2012) including deficits in various executive sub-domains, such as abstract thinking or cognitive flexibility (Clark et al., 2012;Gibbons et al., 2012). Collectively, mnemonic and executive deficits manifest during early stages of AD. "
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    ABSTRACT: Memory and executive deficits are important cognitive markers of Alzheimer's disease (AD). Moreover, in the past decade, cerebrospinal fluid (CSF) biomarkers have been increasingly utilized in clinical practice. Both cognitive and CSF markers can be used to differentiate between AD patients and healthy seniors with high diagnostic accuracy. However, the extent to which performance on specific mnemonic or executive tasks enables reliable estimations of the concentrations of different CSF markers and their ratios remains unclear.
    No preview · Article · Nov 2015 · Experimental gerontology
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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.
    Full-text · Article · Aug 2014 · Journal of Alzheimer's disease: JAD
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