Cognitive deficits associated with an aging population have been the focus of clinical research interest as an increasing number of people survive into older age. These research interests have determined that there is a need to accurately detect the onset of cognitive changes that show the beginning of a dementia syndrome and to differentiate among disorders with distinct etiologies and sites of pathology. Impairment in executive functions has been recognized as one cognitive feature in which changes and deficits have been reported in various types of neurodegenerative disorders. Mild cognitive impairment is often viewed as a transitional stage between normal aging and Alzheimer’s disease (AD), frontotemporal lobe dementia (FTD), and Lewy body dementia (LBD). Neuropsychological evaluations can assist in detecting the onset of cognitive executive functioning changes and decline in the early stages of dementia disorders. The purpose of this study was to determine if there is a change in executive functioning profiles in subjects who initially have no dementia but later receive a diagnosis of neurodegenerative disorders of Alzheimer’s, frontotemporal lobe, and Lewy body dementias. Possible early executive functioning indicators might be found that could then be used to identify at-risk individuals before a formal diagnosis is made. Strategic interventions could then be provided to lessen the effects of these disorders. Early intervention allows more time for individuals to gain access to strategies and plan for changes that may occur throughout the process of these disorders. It also provides information for further study. The aim of this study was to test the hypothesis that once a subject has been diagnosed with dementia a detectable change has occurred in executive functioning measures. Participants were 34 persons between the ages of 61-89 who had been given a series of neuropsychological tests of executive functioning. Individuals who met criteria for AD, LBD, and FTD disorders were included in this sample, and their scores from baseline evaluation to initial diagnosis of AD, LBD, and FTD were analyzed to determine changes in executive functioning measures. The executive functioning tests included verbal associative fluency retrieval of animal and vegetable exemplars, Trail Making Part B, and Digit Span Backward from the Wechsler Memory Scale-Revised (WMR-R). Analysis included changes in executive functioning measures when the diagnosis of AD, LBD, or FTD was made after a change from the initial diagnosis of no dementia. The results of this study are that patients performed similarly across different measures, with the exception of the Trails B subtest, which indicated a significant difference. This subtest difference emerged between the initial evaluation and the first diagnosis of AD, LBD, or FTD.
|Advisor:||Hawkins, Raymond C., II|
|Commitee:||Cornelius, Allen , Holland, Daniel , Eslinger, Paul|
|School:||Fielding Graduate University|
|Department:||The School of Psychology|
|School Location:||United States -- California|
|Source:||DAI-B 82/9(E), Dissertation Abstracts International|
|Subjects:||Clinical psychology, Neurosciences|
|Keywords:||Alzheimer’s Disease, Dementia, Executive functioning, FrontoTemporal Dementia, Lewy Body Dementia, Working memory|
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