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Neuropsychological correlates of instrumental activities of daily living in neurocognitive disorders: a possible role for executive dysfunction and mood changes

Published online by Cambridge University Press:  23 May 2018

Martina Amanzio ,
Sara Palermo Open the ORCID record for Sara Palermo [Opens in a new window] ,
Milena Zucca ,
Rosalba Rosato ,
Elisa Rubino ,
Daniela Leotta ,
Massimo Bartoli  and
Innocenzo Rainero
Martina Amanzio
Affiliation:
Department of Psychology, University of Turin, Via Verdi 10, 10123 Turin, Italy European Innovation Partnership on Active and Healthy Ageing, Bruxelles, Belgium
Sara Palermo*
Affiliation:
Department of Psychology, University of Turin, Via Verdi 10, 10123 Turin, Italy
Milena Zucca
Affiliation:
Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
Rosalba Rosato
Affiliation:
Department of Psychology, University of Turin, Via Verdi 10, 10123 Turin, Italy Unit of Cancer Epidemiology, Città della Salute e della Scienza Hospital and CPO Piemonte, Turin, Italy
Elisa Rubino
Affiliation:
Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
Daniela Leotta
Affiliation:
Martini Hospital, Neurology Division, Via Tofane 71, 10100 Turin, Italy
Massimo Bartoli
Affiliation:
Department of Psychology, University of Turin, Via Verdi 10, 10123 Turin, Italy
Innocenzo Rainero
Affiliation:
Department of Neuroscience, University of Turin, Via Cherasco 15, 10126 Turin, Italy
*
Correspondence should be addressed to: Sara Palermo, Department of Psychology, University of Turin, Via Verdi 10, Turin 10124, Italy. E-mail: sara.palermo@unito.it.
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Abstract

Since baseline executive dysfunction predicts worsening Instrumental Activities of Daily Living (i-ADL) over time and progression to Alzheimer's Disease (AD), we aimed to analyze the role of neuropsychological variables to outline which factors can contribute to functional impairment. Specific attention to executive functions (EFs) has been given.

A total of 144 subjects complaining of different cognitive deficits – ranging from “MCI likely due to AD” to “mild AD patients” – underwent an overall neuropsychological assessment. The Behavioral Assessment of the Dysexecutive Syndrome was used to analyze EFs. We conducted multiple linear regression analyses to study whether the level of independent living skills – assessed with the Lawton-scale – could be associated with cognitive and behavioral measurements.

We found a significant association between i-ADL and specific EFs measured by Rule Shift Cards (p = 0.04) and Modified Six Elements (p = 0.02). Moreover, considering i-ADL scores, we observed an involvement of mood changes and a reduced awareness of deficits in terms of Hamilton Depression Rating Scale (p = 0.02) and Awareness of Deficit Questionnaire – Dementia scale (p < 0.0001), respectively.

Our results suggest the importance of considering the association between a reduction in i-ADL and executive dysfunction in patients who have AD etiopathology, for which the ability to inhibit a response, self-monitoring, set-shifting and mood deflection play a key role. Besides, no straightforward associations between i-ADL scores and global cognition, memory, language comprehension, attention, and perspective taking abilities were found.

Keywords

IADLmild cognitive impairmentAlzheimer's diseaseexecutive dysfunction
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 12: Issue Theme: Positive Psychiatry , December 2018 , pp. 1871 - 1881
Copyright
Copyright © International Psychogeriatric Association 2018 

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