Executive function deficits in persons with mild cognitive impairment: a study with a Tower of London task

This study assessed executive functions in persons with mild cognitive impairment (MCI) using the Tower of London (TOL). A second objective was to study the impact of three types of problem selected according to the presence or absence of a "trigger." A trigger (T) is an incitation to the participant, at the first move, to move a ball to its final position according to the model. A positive trigger (T+) is helpful, while a negative trigger (T-) creates an obstruction. Some problems have no trigger (N). This study includes 81 participants with MCI. After follow-up, one year later, two subgroups were distinguished: (a) 51 (63%) participants did not convert or decline (stable MCI); (b) 30 (37%) participants showed significant decline or progressed to dementia (decliner MCI). Persons with MCI were compared to an older adult group matched with respect to sex, age, and education. For the successes, there was a significant group difference between the three types of problem. The post hoc analysis showed that T+ took significantly less time than N or T-. There were significantly more successes for T+ than N, and these two types of problem had more success than T-. For "total number of moves," there was no significant difference between the groups. In post hoc analysis, T- involved more moves than N or T+. In qualitative analysis, T- MCI decliners produced significantly more rule breakings than the stable MCI and controls. A dysfunction in self-monitoring is a characteristic feature of persons with MCI.