Executive Functions in the Elderly with Mild Cognitive Impairment

Aging and Mental Health
10 Apr, 2019 ,

Angela Guarino et al assessed executive functions (EFs) in patients with mild cognitive impairment (MCI), specifically inhibition (motor and cognitive), conflict control and cognitive flexibility. For this review, eligibility criteria were use of specific paradigms for EFs assessment (“Wisconsin Card Sorting Test,” “Stroop Task,” “Go/No-Go Task,” “Flanker Task”), age over 65, and studies published in English. The four experimental tasks studied were supported as being applicable and are identified as being valuable for research, diagnosis and therapeutic needs that may help to determine the EFs profile that can impact daily life in the elderly. Standard assessment of MCI generally does not determine EFs. However, EF evaluation may enhance MCI knowledge and aid in diagnosis and treatment

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Background: Mild Cognitive Impairment (MCI) is a syndrome characterised by mild cognitive decline, on one or more domains, but which does not compromise daily functions. Several studies have investigated the relationship between MCI and deficit in executive functions (EFs) but, unlike robust evidence in the mnestic domain, the nature of executive deficits in the MCI population remains uncertain.

Objectives: This systematic review aims to evaluate EFs in patients with MCI, considering inhibition (motor and cognitive), conflict control and cognitive flexibility.

Method: The databases used for the search were PUBMED, PsycINFO, PsycARTICLES and MEDLINE. Eligibility criteria: use of specific paradigms for EFs assessment (‘Wisconsin Card Sorting Test’, ‘Stroop Task’, ‘Go/No-Go Task’, ‘Flanker Task’); age over 65, studies published in English. Exclusion criteria: presence of dementia; psychiatric disorders; stroke; cranial trauma; inclusion of participants with MCI in groups with healthy elderly or those with dementia.

Results: Fifty-five studies were selected, namely: Stroop Task (N = 30), WCST (N = 14), Go/No-Go (N = 9), Flanker Task (N = 2). Results have shown in people with MCI deficits in all the EFs considered.

Conclusions: The results of this review support the applicability of the four experimental tasks examined for the study of EFs in people with MCI. These paradigms are useful in research, diagnosis and therapeutic purposes, allowing obtaining an articulated EFs profile that can compromise the daily life in elderly. These EFs are not generally evaluated by standard assessment of MCI, but their evaluation can lead to a better knowledge of MCI and help in the diagnosis and treatment.