Executive dysfunction in Alzheimer disease.
BACKGROUND
Executive dysfunction (EDF) is common in Alzheimer disease (AD); however, its relationship to other symptoms is difficult to assess in patients with AD.


OBJECTIVE
To determine the prevalence of EDF and study its relationship to cognitive, functional, and neuropsychiatric symptoms in patients with AD.


METHODS
A retrospective analysis of data from participants in the English Instruments Protocol of the Alzheimer's Disease Cooperative Study. Subjects were drawn from a sample of patients evaluated at tertiary referral centers.


RESULTS
A total of 64% of AD patients were classified as having EDF. Patients with EDF performed worse on tests of cognition (P <.001), dementia severity (P <.001), and activities of daily living (P =.01) and had more frequent symptoms of psychosis (P =.03) with greater emergence during the 12-month interval (P =.03) compared with patients with normal executive function. Less than 30% of the variance in executive function performance was explained by cognitive measures.


CONCLUSIONS
These findings support the assessment of executive function in persons with AD and the importance of frontal lobe dysfunction in AD.
Swanberg
Margaret M
MM
Department of Neurology, David Geffen School of Medicine at UCLA, 90095-1769, USA.
Tractenberg
Rochelle E
RE
Mohs
Richard
R
Thal
Leon J
LJ
Cummings
Jeffrey L
JL
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D004193:Discrimination Learning / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D009483:Neuropsychological Tests; D011340:Problem Solving / Q000502:physiology; D011594:Psychometrics / Q000706:statistics & numerical data; D012016:Reference Values; D012189:Retrospective Studies; D013223:Statistics as Topic