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Executive impairment among the functionally dependent: comparisons between schizophrenic and elderly subjects

D R Royall1, R K Mahurin, J E True

  • 1Department of Psychiatry, University of Texas Health Science Center at San Antonio 78284-7792.

The American Journal of Psychiatry
|December 1, 1993
PubMed
Summary

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The Executive Interview effectively measures executive deficits, which worsen with increasing care needs. This pattern is consistent across different conditions, including schizophrenia and Alzheimer's disease, highlighting its broad applicability.

Area of Science:

  • Neuropsychology
  • Gerontology
  • Psychiatry

Background:

  • Executive deficits are traditionally linked to frontal lobe damage and are significant in conditions like schizophrenia and Alzheimer's disease.
  • A validated tool is needed to accurately measure these executive deficits across diverse patient populations and functional impairments.

Purpose of the Study:

  • To introduce and validate the Executive Interview, a brief (15-minute) 25-item assessment tool for executive deficits.
  • To evaluate the Executive Interview's sensitivity and specificity in distinguishing cognitive impairment across different care levels and patient groups.

Main Methods:

  • The Executive Interview and Mini-Mental State Examination were administered to 40 schizophrenic patients and 104 elderly individuals across three care levels.
  • Statistical analyses controlled for age, gender, education, and medication to assess cognitive impairment and tool performance.

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Main Results:

  • Cognitive impairment, measured by both instruments, increased with the level of care required.
  • The Executive Interview independently discriminated between care levels and was more sensitive to cognitive impairment than the Mini-Mental State Examination.
  • Schizophrenic patients exhibited executive impairment comparable to elderly individuals at similar care levels, despite demographic differences.

Conclusions:

  • Executive dyscontrol severity correlates with the need for increased care and supervision, independent of age or specific disease.
  • The Executive Interview demonstrates potential for identifying distinct patient subgroups based on disease-specific patterns of executive dysfunction.