评估执行功能要素作为日常生活工具性活动(IADL)的预测指标。

Evaluating elements of executive functioning as predictors of instrumental activities of daily living (IADLs).

作者信息

Jefferson Angela L, Paul Robert H, Ozonoff Al, Cohen Ronald A

机构信息

Department of Psychiatry & Human Behavior, Brown Medical School, Providence, RI, USA.

出版信息

Arch Clin Neuropsychol. 2006 May;21(4):311-20. doi: 10.1016/j.acn.2006.03.007.

Abstract

OBJECTIVE

Executive functioning has been repeatedly linked to the integrity of instrumental activities of daily living (IADL). The present study examined the association of multiple executive functioning elements (i.e., working memory, generation, inhibition, planning, and sequencing) to IADLs among an older adult cohort at risk for future cognitive and functional decline.

METHODS

Seventy-two participants with prevalent but stable cardiovascular disease completed a neuropsychological protocol assessing multiple elements of executive functioning, including COWA, PASAT, DKEFS Color-Word Interference Test, DKEFS Trail-Making Test, DKEFS Tower Test, and Ruff Figural Fluency Test. Reliable informants completed a measure of IADLs.

RESULTS

Stepwise logistic regression selected a model involving a single significant predictor, a measure of inhibition (i.e., DKEFS Color-Word Interference Test), which had a significant regression coefficient. Subsequent correlation analyses confirmed an association between the inhibition measure and multiple IADL items. Inter-item comparisons among the IADLs revealed significant differences, such that telephone use and laundry were significantly more intact than most other IADLs while shopping and housekeeping were most compromised.

CONCLUSIONS

Our data suggest that inhibition, also known as susceptibility to interference, is most strongly related to IADL impairment among patients at risk for future cognitive and functional decline.

摘要

目的

执行功能已多次被证明与日常生活工具性活动(IADL)的完整性相关。本研究在一组有未来认知和功能衰退风险的老年人群中,考察了多个执行功能要素(即工作记忆、生成、抑制、计划和排序)与IADL之间的关联。

方法

72名患有常见但稳定心血管疾病的参与者完成了一项神经心理学测试,评估执行功能的多个要素,包括COWA、PASAT、DKEFS颜色-词语干扰测试、DKEFS连线测试、DKEFS塔测试和鲁夫图形流畅性测试。可靠的信息提供者完成了一项IADL测量。

结果

逐步逻辑回归选择了一个包含单一显著预测因子的模型,即一项抑制测量指标(即DKEFS颜色-词语干扰测试),其具有显著的回归系数。随后的相关分析证实了该抑制测量指标与多个IADL项目之间的关联。IADL项目间的比较显示出显著差异,电话使用和洗衣的功能完整性显著高于大多数其他IADL,而购物和家务管理受损最为严重。

结论

我们的数据表明,抑制,也称为干扰易感性,在有未来认知和功能衰退风险的患者中与IADL损害的相关性最强。

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