Title | Characteristics of Alzheimer's Disease Patients with Severe Executive Disorders. |
Publication Type | Journal Article |
Year of Publication | 2016 |
Authors | Godefroy, O, Bakchine, S, Verny, M, Delabrousse-Mayoux, J-P, Roussel, M, Pere, J-J |
Corporate Authors | REFLEX study group: |
Journal | J Alzheimers Dis |
Volume | 51 |
Issue | 3 |
Pagination | 815-25 |
Date Published | 2016 |
ISSN | 1875-8908 |
Keywords | Activities of Daily Living, Aged, Alzheimer Disease, Caregivers, Cost of Illness, Executive Function, Female, Humans, Male, Mental Status Schedule, Neuropsychological Tests, Prevalence, Severity of Illness Index, Treatment Outcome |
Abstract | BACKGROUND: Executive dysfunctions in Alzheimer's disease (AD) have been assessed using variable batteries and/or in selected populations. OBJECTIVE: The primary objective of this observational study was to determine the prevalence and severity of executive dysfunction in AD patients using a previously validated battery. The secondary objective was to determine the characteristics including treatment outcomes of AD patients with severe executive dysfunction. METHODS: The study included AD patients with mild-to-moderate dementia aged 60 or over, consulting in various clinical settings including memory clinics and requiring the introduction of an antidementia drug. Executive dysfunction was examined using a validated, shortened executive battery. RESULTS: 381 patients were included. Executive dysfunctions were observed in 88.2% of the patients (95% CI: 84.9-91.4) and were severe (defined as ≥2/3 impaired scores) in 80.4% (95% CI: 76.9-84.8). Global hypoactivity with apathy was more frequent (p = 0.0001) than impairment in executive function tests. The 308 patients with severe executive dysfunction were older (p = 0.003) and had more severe dementia (p = 0.0001). Similarly, in the subset of 257 patients with mild dementia, individuals with severe executive dysfunction were older (p = 0.003) and had more severe dementia. Global hypoactivity was independently associated with difficulties in IADL and a higher caregiver burden (p = 0.0001 for both). The severity of executive dysfunction did not significantly influence the patients' outcomes at 6 months. CONCLUSIONS: Executive dysfunction is a very common disorder in a representative population of patients with mild-to-moderate AD. It was independently correlated with impaired autonomy and increased caregiver burden but did not significantly influence treatment outcomes. |
DOI | 10.3233/JAD-150971 |
Alternate Journal | J. Alzheimers Dis. |
PubMed ID | 26890770 |