Olivier Godefroy1, Serge Bakchine2, Marc Verny3, Jean-Philippe Delabrousse-Mayoux4, Martine Roussel1, Jean-Jacques Pere5. 1. Department of Neurology and Laboratory of Functional Neurosciences University Hospital of Amiens, Amiens, France. 2. Department of Neurology, University Hospital of Reims, Reims, France. 3. Geriatric Center, CMRR, Pitié-Salpêtrière University Hospital (AP-HP and UPMC) and DHU FAST, Paris, France. 4. Office of Neurology, Bergerac, France. 5. Novartis Pharma SAS, Paris, France.
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.
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 ADpatients using a previously validated battery. The secondary objective was to determine the characteristics including treatment outcomes of ADpatients with severe executive dysfunction. METHODS: The study included ADpatients 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.
Authors: Roos J Jutten; John Harrison; Frank Jan de Jong; André Aleman; Craig W Ritchie; Philip Scheltens; Sietske A M Sikkes Journal: Alzheimers Dement (N Y) Date: 2017-02-09
Authors: Ole Kristian Drange; Olav Bjerkehagen Smeland; Alexey A Shadrin; Per Ivar Finseth; Aree Witoelar; Oleksandr Frei; Yunpeng Wang; Sahar Hassani; Srdjan Djurovic; Anders M Dale; Ole A Andreassen Journal: Front Neurosci Date: 2019-03-13 Impact factor: 4.677