Yael Goverover1,2, Joan Toglia3, John DeLuca2,4. 1. Department of Occupational Therapy, New York University, New York, NY, USA. 2. Kessler Foundation, West Orange, NJ, USA. 3. School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, USA. 4. Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA.
Abstract
Deficits in executive functioning are detrimental to employment, daily functioning and quality of life, however their precise nature in multiple sclerosis (MS) remains underspecified. The aims of this study were to: (1) describe the executive processes affected in MS, using a top-down (Weekly Calendar Planning Activity; WCPA) and bottom-up (Delis-Kaplan Executive Function System; DKEFS) assessment tools; (2) explore relationships between performance on the WCPA and DKEFS with a test of everyday functional performance, Actual RealityTM (AR). Methods: Sixty two participants with MS with and without cognitive impairments (n = 21 and 41, respectively) and 38 Healthy Controls (HC) completed the WCPA, two selected subtests of the DKEFS, and AR. Results: The MS group with cognitive impairments performed worse compared with the MS with no cognitive impairments and HC on both the WCPA and DKEFS. Better scores on the DKEFS were associated with better performance of the WCPA. WCPA was a significant predictor of three of the four AR variables. The DKEFS was a significant predictor of time to perform the AR. The results support the use of the WCPA as an assessment of executive functions in persons with MS. It embodies processes such as environmental monitoring, planning and problem solving, and self-regulation.
Deficits in executive functioning are detrimental to employment, daily functioning and quality of life, however their precise nature in multiple sclerosis (MS) remains underspecified. The aims of this study were to: (1) describe the executive processes affected in MS, using a top-down (Weekly Calendar Planning Activity; WCPA) and bottom-up (Delis-Kaplan Executive Function System; DKEFS) assessment tools; (2) explore relationships between performance on the WCPA and DKEFS with a test of everyday functional performance, Actual RealityTM (AR). Methods: Sixty two participants with MS with and without cognitive impairments (n = 21 and 41, respectively) and 38 Healthy Controls (HC) completed the WCPA, two selected subtests of the DKEFS, and AR. Results: The MS group with cognitive impairments performed worse compared with the MS with no cognitive impairments and HC on both the WCPA and DKEFS. Better scores on the DKEFS were associated with better performance of the WCPA. WCPA was a significant predictor of three of the four AR variables. The DKEFS was a significant predictor of time to perform the AR. The results support the use of the WCPA as an assessment of executive functions in persons with MS. It embodies processes such as environmental monitoring, planning and problem solving, and self-regulation.
Entities:
Keywords:
Activities of daily living; assessment; executive functions; multiple sclerosis