Executive functioning mediates the link between other neuropsychological domains and daily functioning: a Project FRONTIER study.
BACKGROUND
The purpose of this study was to examine the mediating impact of executive functioning on the link between other neuropsychological domain scores and informant-based rating of functional status.


METHODS
Data on 181 participants were analyzed from an ongoing epidemiological study of rural health, Project FRONTIER (mean age = 64.6 ± 13.8 years, 69% women, 42% Mexican American). Executive functioning was assessed by the EXIT25 and other neuropsychological domains were assessed via the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Informant-based rating of functional status was assessed via the Clinical Dementia Rating Scale sum of boxes scores (CDR SB).


RESULTS
RBANS Index scores were each significantly (p < 0.05) related to CDR SB scores and EXIT25 scores. EXIT25 score was a significant partial mediator of the link between four RBANS indices (Immediate Memory, Attention, Visuospatial/Construction, Delayed Memory) and CDR SB scores, and a complete mediator of the fifth index (Language).


CONCLUSIONS
Executive functioning is a mediator of the link between other neuropsychological domains and daily functioning. Neuropsychological assessments that do not measure executive functioning will provide only a partial clinical picture with adults and elders.
O'Bryant
Sid E
SE
F. Marie Hall Institute for Rural and Community Health, Texas Tech Health Sciences Center, Lubbock, TX 79430-6232, USA. sid.obryant@ttuhsc.edu
Falkowski
Jed
J
Hobson
Valerie
V
Johnson
Leigh
L
Hall
James
J
Schrimsher
Gregory W
GW
Win
Ohmar
O
Ngo
Bichthy
B
Dentino
Andrew
A
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D056344:Executive Function; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012424:Rural Population; D013028:Space Perception; D014796:Visual Perception