Grigsby J, Kaye K, Baxter J, Shetterly S M, Hamman R F
University of Colorado Health Sciences Center, Center for Health Services Research, Denver 80222, USA.
J Am Geriatr Soc. 1998 May;46(5):590-6. doi: 10.1111/j.1532-5415.1998.tb01075.x.
The purpose of this study was to evaluate the contribution of the executive cognitive functions to self-reported and observed performance of activities of daily living and instrumental activities of daily living.
These data were collected as part of a cross-sectional survey of community-dwelling older persons, using statistical sampling, in a two-county area of southern Colorado.
Participants were interviewed and administered measures of general cognition, depression, executive functioning, and performance of self-care and instrumental activities, either in their homes or at the study clinic.
A total of 1158 community-dwelling persons between the ages of 60 and 99 participated. Of these, 657 were female, 501 were male, 637 were Hispanic, and 521 were non-Hispanic whites.
Subjects were administered the Mini-Mental State Exam (MMSE), a measure of executive functioning (the Behavioral Dyscontrol Scale), the Center for Epidemiologic Studies Depression scale (CES-D), and the Structured Assessment of Independent Living Skills (SAILS, a measure of observed performance of daily tasks). They also were interviewed regarding their reported ADL and IADL status using measures from the Longitudinal Study on Aging.
Both general mental status and executive functioning demonstrated statistically significant univariate associations with all seven functional status measures (both self-report and observed performance). In a series of ordinary least squares regression models, executive functioning was a predictor for self-reported ADLs and observed performance of complex IADL tasks such as managing money and medications. Mental status did not predict self-reported functioning but was a predictor of observed performance. Depression was a significant variable for self-report measures but not for observed performance. Executive functioning and general mental status demonstrated some degree of independence from one another.
Executive functioning is an important determinant of functional status for both self-reported and observed ADLs and IADLs and should be assessed routinely when evaluating the mental status and functional abilities of older people. These results replicate and extend previous research on executive functioning among older persons by examining these factors in a large bi-ethnic community sample.
本研究旨在评估执行认知功能对自我报告的以及观察到的日常生活活动和工具性日常生活活动表现的贡献。
这些数据是作为对科罗拉多州南部两县地区社区居住老年人的横断面调查的一部分收集的，采用统计抽样方法。
参与者在其家中或研究诊所接受访谈，并接受一般认知、抑郁、执行功能以及自我护理和工具性活动表现的测量。
共有1158名年龄在60至99岁之间的社区居住者参与。其中，657名是女性，501名是男性，637名是西班牙裔，521名是非西班牙裔白人。
受试者接受了简易精神状态检查表（MMSE）、一项执行功能测量（行为失控量表）、流行病学研究中心抑郁量表（CES-D）以及独立生活技能结构化评估（SAILS，一项对日常任务观察表现的测量）。他们还使用来自老龄化纵向研究的测量方法就其报告的日常生活活动和工具性日常生活活动状况接受了访谈。
一般精神状态和执行功能在统计学上均与所有七项功能状态测量（自我报告和观察到的表现）显示出显著的单变量关联。在一系列普通最小二乘回归模型中，执行功能是自我报告的日常生活活动以及观察到的诸如理财和用药等复杂工具性日常生活活动任务表现的预测指标。精神状态不能预测自我报告的功能，但却是观察到的表现的预测指标。抑郁对于自我报告测量是一个显著变量，但对于观察到的表现则不是。执行功能和一般精神状态彼此表现出一定程度的独立性。
执行功能是自我报告的以及观察到的日常生活活动和工具性日常生活活动功能状态的重要决定因素，在评估老年人的精神状态和功能能力时应常规进行评估。这些结果通过在一个大型双族裔社区样本中研究这些因素，重复并扩展了先前关于老年人执行功能的研究。
