Assessing the integrity of executive functioning in chronic aphasia

Abstract

ABSTRACT Background Executive functioning (EF) deficits can commonly co-occur with language impairments in aphasia. Despite recognizing the role of EF in language and aphasia treatment outcomes, the integrity of EF in aphasia remains to be comprehensively studied. Aims The present study aimed to comprehensively examine the integrity of EF skills in individuals with different types and severities of aphasia. Accordingly, we sought to compare the performances of persons with aphasia (PWA) and healthy controls on a broad range of verbal and nonverbal EF skills using an extensive battery of assessments. To fully understand the nature of deficits in the aphasia population, we aimed to evaluate EF performances both quantitatively and qualitatively in addition to examining group- and individual-level differences. Method Persons with aphasia (PWA) and age- and education-matched healthy controls (HC) completed a battery of verbal and nonverbal EF assessments. Between-group comparisons were carried out using quantitative and qualitative EF task scores. Additionally, we conducted individual-level analyses to examine performances within the aphasia group. The influence of aphasia severity and type on EF task performances were also evaluated. Results PWA differed significantly from HC on most EF measures. Individual-level analyses revealed marked variability in performances within the aphasia group indicating that most but not all PWA demonstrated EF deficits. PWA performed significantly more poorly than HC on both verbal and nonverbal measures with greater difficulty on verbal EF tasks. No consistent relationship was found between aphasia variables and EF task performances. Conclusion Our findings indicate that many PWA demonstrate domain-general EF deficits that are not necessarily related to the degree of their language impairments. The present study emphasizes the importance of evaluating EF more routinely in clinical practice to improve rehabilitation success for PWA.