Executive functioning mediates the link between other neuropsychological domains and daily functioning: a Project
Sid E O'Bryant1, Jed Falkowski, Valerie Hobson
1F. Marie Hall Institute for Rural and Community Health, Texas Tech Health Sciences Center, Lubbock, TX 79430-6232, USA. sid.obryant@ttuhsc.edu
International Psychogeriatrics
|July 20, 2010
Summary
Executive functioning significantly mediates the relationship between neuropsychological domains and daily functional status in adults and elders. Comprehensive assessments require evaluating executive function for a complete clinical picture.
Area of Science:
- Neuropsychology
- Gerontology
- Epidemiology
Background:
- Understanding factors influencing functional status in aging populations is crucial.
- Previous research has not fully elucidated the role of executive functioning in daily life outcomes.
Purpose of the Study:
- To investigate the mediating role of executive functioning in the relationship between various neuropsychological domains and informant-rated functional status.
- To determine if executive functioning explains the link between cognitive abilities and real-world functioning.
Main Methods:
- Analysis of data from 181 participants in the rural health epidemiological study, Project FRONTIER.
- Assessment of executive functioning using the EXIT25 and other neuropsychological domains via the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).
- Functional status evaluated using the Clinical Dementia Rating Scale sum of boxes (CDR SB).
Main Results:
- All RBANS Index scores were significantly associated with CDR SB and EXIT25 scores (p < 0.05).
- The EXIT25 score partially mediated the association between four RBANS indices (Immediate Memory, Attention, Visuospatial/Construction, Delayed Memory) and CDR SB.
- Executive functioning completely mediated the link between the RBANS Language index and CDR SB scores.
Conclusions:
- Executive functioning acts as a significant mediator between other neuropsychological domains and an individual's daily functioning.
- Neuropsychological evaluations omitting executive functioning assessments provide an incomplete understanding of cognitive and functional status in adults and older adults.
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