Role of executive functions in the conversion from mild cognitive impairment to dementia

Almudena Junquera Fernández, Estefania García-Zamora, Javier Olazarán-Rodriguez, Mario A. Parra Rodriguez, Sara Fernández Guinea

Research output: Contribution to journalArticle

Abstract

Background: Recent researches pointed to executive dysfunction as a potential early predictor of the progression Mild Cognitive Impairment (MCI) dementia in clinical syndrome (ACS). Such cognitive impairments account for functional impairments in instrumental activities of daily living (IADL). Objective: The present study analyse the contributions of executive functions to predict MCI dementia progression in ACS. Methods: We assessed 145 participants, 51 cognitively unimpaired and 94 MCI. The latter were divided using the traditional, memory-based MCI classification (single domain amnestic, multidomain amnestic and non-amnestic). Eight tests assessing executive functions were administered at baseline and at 1-year follow-up, together with cognitive screening tools and IADL measures. MCI patients were reclassified based on the outcomes from a K-mean cluster analysis which identified three groups. A simple lineal regression model was used to examine whether the classification based on executive functioning could more accurately predict progression to dementia a year later. Results: Clusters based on executive function deficits explained a significant proportion of the variance linked to MCI dementia conversion, even after controlling for the severity of MCI at baseline (F(1, 68) = 116.25, p=0.000, R2=0.63). Classical memory-based MCI classification failed to predict such a conversion (F(1, 68) = 5.09, p=0.955, R2=0.07). Switching, categories generation and planning were the executive functions that best distinguished between MCI converters and stable. Conclusion: MCI with a dysexecutive phenotype significantly predicts conversion to dementia in ACS a year later. Switching abilities and verbal fluency (categories) must be evaluated in MCI patients to assess risk of future dementia.
Original languageEnglish
Number of pages37
JournalJournal of Alzheimer's Disease
Publication statusAccepted/In press - 17 Jun 2020

Keywords

  • activities of daily living
  • alzheimer disease
  • cognitive dysfunction
  • executive function
  • longitudinal studies

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    Junquera Fernández, A., García-Zamora, E., Olazarán-Rodriguez, J., Parra Rodriguez, M. A., & Fernández Guinea, S. (Accepted/In press). Role of executive functions in the conversion from mild cognitive impairment to dementia. Journal of Alzheimer's Disease.