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J Alzheimers Dis. 2016;51(3):815-25. doi: 10.3233/JAD-150971.

Characteristics of Alzheimer's Disease Patients with Severe Executive Disorders.

Author information

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.

KEYWORDS:

Alzheimer’s disease; apathy; cognitive disorders; control function; executive function; treatment

PMID:
26890770
DOI:
10.3233/JAD-150971
[Indexed for MEDLINE]

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