The frequency of executive cognitive impairment in elderly rehabilitation inpatients

The aim of this study was to determine the frequency of executive cognitive dysfunction in a sample of elderly patients in 2 rehabilitation wards in Wellington, New Zealand. All patients in 2 wards over a 2-month period were approached and invited to complete a brief neuropsychological battery. Sixty-two patients volunteered, of whom 52 completed at least 3 of the 4 measures of executive functioning. The frequency of executive dysfunction in the resulting sample of 52 was determined. Impaired executive function was defined as impaired performance on at least 2 executive function tests. The authors administered the Hayling-Brixton tests, the verbal fluency test, the Trail-Making Test, the Mini-Mental State Examination (MMSE), and the Geriatric Depression Scale. Patients' behavior was rated for executive problems on the Dysexecutive Questionnaire by themselves and by a nurse. The frequency of executive impairment was high at 13 out of 52 patients (25%). Only 1 of these 13 patients with executive difficulties was impaired according to their MMSE score. Screening for executive impairment among older rehabilitation inpatients is a necessary part of their medical management and rehabilitation. This should involve more than just administering the MMSE at admission. Several brief methods for screening for executive impairment are now available.