title: Characteristics of Alzheimer's Disease Patients with Severe Executive Disorders.
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.
authors.affiliation: Department of Neurology and Laboratory of Functional Neurosciences University Hospital of Amiens, Amiens, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Godefroy
authors.affiliation: Department of Neurology, University Hospital of Reims, Reims, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Bakchine
authors.affiliation: Geriatric Center, CMRR, Pitié-Salpêtrière University Hospital (AP-HP and UPMC) and DHU FAST, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Verny
authors.affiliation: Office of Neurology, Bergerac, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Delabrousse-Mayoux
authors.affiliation: Department of Neurology and Laboratory of Functional Neurosciences University Hospital of Amiens, Amiens, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Roussel
authors.affiliation: Novartis Pharma SAS, Paris, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Pere
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D017028:Caregivers / Q000523:psychology; D017281:Cost of Illness; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D015995:Prevalence; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Alzheimer’s disease; apathy; cognitive disorders; control function; executive function; treatment