D-KEFS Color Word Interference Test Research Articles

Convergent and Predictive Validity of the Mini MoCA and Considerations for Use among Older Adults

The Mini MoCA is a cognitive screening instrument designed for quick administration that can be completed via telephone. The Mini MoCA has not received the same level of research attention as the original MoCA, and no articles have explored its validity and feasibility of use with older adults using the officially published administration/scoring protocol. This study examined the convergent and predictive validity of the Mini MoCA among community-dwelling older adults (N=68, M age=74.5 years) and identified considerations for use as a telephone cognitive screener. Correlations examined the Mini MoCA’s convergent validity with a measure of general cognitive functioning (RBANS). A significant positive correlation was found (r = .34), such that higher Mini MoCA scores were associated with higher overall scores on the RBANS. Additionally, the Mini MoCA was uncorrelated with measures of problem-solving ability and inhibition (M-WCST, D-KEFS Color-Word Interference Test) providing evidence for discriminant validity. Multiple regression analyses revealed total Mini MoCA scores predicted RBANS total scores when accounting for demographic variables. Overall, the current study provides preliminary support for the Mini MoCA as a valid screening measure of general cognitive functioning among older adults. However, several barriers to valid administration of the Mini MoCA arose that warrant attention.

21 Toxic Wounds are Associated with Cognitive Decrements in Women Veterans of the 1991 Gulf War

Objective:Gulf War Illness (GWI) is a debilitating multi-symptom condition that affects nearly a third of 1990-91 Gulf War (GW) veterans. Symptoms include chronic pain, debilitating fatigue, gastrointestinal issues, and cognitive decrements. Prior studies have documented reduced cognitive functioning in this affected population, particularly in the areas of memory, attention and response inhibition. To date, research has focused on cognitive functioning in male and female veterans together. Very limited research has reported on GW women's cognitive functioning separately mostly due to scarcity of data on women veterans. In this study, we had the unique opportunity to utilize a newly combined neuropsychological test dataset from women GW veterans in the Boston, Biorepository and Integrative Network (BBRAIN) for GWI. The aim was to compare neuropsychological outcomes with toxicant exposures in women veterans with and without GWI.Participants and Methods:Cognitive data from the BBRAIN biorepository was used for this study. The sample consisted of 62 women veterans who were deployed to the Persian Gulf War from 1990-91. Neuropsychological test scores included the Conners Continuous Performance Test Third Edition (CPT3), Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference, and the California Verbal Learning Test Second Edition (CVLT-II). War-related exposure to chemical weapons, anti-nerve gas pills and pesticides were measured by a self-reported survey. For analysis, war-related exposure was classified into three groups: controls with 0-6 days of exposure; cases with 0-6 days of exposure and cases with 7 or more days of exposure. Multiple linear regression modeling was used to measure differences in neuropsychological scores across the three groups by each war-related exposure.Results:After adjusting for age, education and other exposures, an increase in duration of exposure to pesticides was significantly associated with worse CPT3 commission errors, fewer words correct in the CVLT-II trials 1-5, and an increase in self-corrected errors on DKEFS Color-Word Interference Test Trials 1, 2 and 4 (p<0.05). More days reported hearing chemical alarms and seeing smoke from oil well fires was significantly associated with fewer words correct on all CVLT-II trials, and more self-corrected errors on Color-Word Interference Trials 2 and 4 (p<0.05). An increase in exposure duration to pyridostigmine bromide anti-nerve gas pills was associated with fewer words correct on the CVLT-II learning Trials 1-5 and short delay recall and an increase in self-corrected errors on Color-Word Interference Trials 2, 3, and 4 (p<0.05). When associations were adjusted for PTSD, all significant associations stayed constant (p<0.05).Conclusions:In this study, women veterans with GWI who had higher levels of exposure to pesticides, oil well fires and who took more antinerve gas pills during the war are showing increased learning difficulties and more deficits in attention and response inhibition. Future research should examine if similar patterns of neuropsychological symptoms are also present in male GW veterans with higher war-time related toxicant exposures.

B - 59 Testing the Cognitive Model of Pathological Worry as an Explanation for Increased Worry among the Oldest Old.

Based on past research demonstrating increased worry among the oldest old compared to younger older adults, this study tested an existing cognitive model of worry to determine whether differences in executive functioning during aging contribute to increased worry among the oldest old. 97 community-dwelling older adults (M age = 74.49; range = 60-89years) completed self-report questionnaires including the Penn State Worry Questionnaire, Geriatric Anxiety Scale, and Cognitive Problems and Strategies Assessment, and were individually evaluated with neurocognitive measures including the RBANS, DKEFS Color-Word Interference Test, and Modified Wisconsin Card Sorting Test. Two-way ANOVAs revealed no significant differences in worry based on age group (i.e., 60s, 70s, and 80s; F[2, 85] = 1.31, p = 0.28) or gender (F[1, 85] = 3.22, p = 0.08). Further, response inhibition and problem-solving did not predict anxiety or worry severity in multiple regression analyses. Lower education was the only consistent predictor of both anxiety and worry when accounting for cognitive performance, age, and gender. However, subjective cognitive functioning also predicted worry among older adults, independent of objective performance. No age differences in worry or anxiety severity were found. Also, no evidence was found to support age-differences in executive functioning as a contributor to worry presentation in late life. The cognitive model of worry may only be applicable to pathological worry or executive decline among the sample was not pronounced enough to impact anxiety. Overall, this study demonstrates that the cognitive model of worry is not supported in healthy, community-dwelling older adults. However, limitations included limited demographic diversity, small sample size, and limited measurement of executive functioning.

A-141 Vindicated by Awareness: Acting with Awareness May Compensate for Inhibitory Deficits in ADHD Symptom Burden

Abstract Objective To understand the role of trait mindfulness acting-with-awareness in the relationship between inhibitory control and ADHD symptom burden. Method We conducted a cross-sectional study with 103 adults, aged 18 to 86, mean age = 46, mean education = 15 years, 46% male. Participants were recruited in North Western Oregon counties. Eligible individuals were aged >18, fluent in English, and with normal global cognition (Montreal Cognitive Assessment, MoCA>22). The presence of ADHD diagnoses/symptoms was not required. Participants were administered the Adult Investigator Symptom Rating Scale (AISRS), the Five Facet Mindfulness Questionnaire (FFMQ) Acting with Awareness, and the DKEFS Color-Word Interference Test (CWIT). We examined the contribution of CWIT (time/sec), acting-with-awareness (AA), and their interaction in age-adjusted multiple regression predicting AISRS total score. Results Descriptives for the measures of interest were AISRS (M = 19.21, SD = 12.72), CWIT (M = 55.66, SD = 15.27), and FFMQ-AA (M = 25.10, SD = 7.17). Both CWIT and FFMQ-AA predicted AISRS when analyzed independently (B = 0.274, p = 0.14, R2 = 0.13 and B = -0.633, p < 0.001, R2 = 0.45). In the combined model, FFMQ-AA (B = -1.06, p = 0.000) but not CWIT predicted AISRS, R2 = 0.47. The interaction was not significant, p = 0.55. Conclusion AA is a powerful predictor of ADHD symptom burden: it accounts for almost half of the variance, and removes any contribution from inhibitory control. Our finding suggests that trait mindfulness has a more important role in shaping ADHD than cognition.

Does cognitive training improve attention/working memory in persons with MS? A pilot study using the Cogmed Working Memory Training program

BackgroundCognitive deficits, especially in attention, are common in persons with MS (PwMS) and are associated with clinically meaningful outcomes, such as work disability and lower quality of life (QOL). In this study, we aimed to determine whether Cogmed Working Memory Training (CWMT) improves attention/working memory in PwMS displaying impairment in these domains. MethodsThis single blind, randomized controlled, pilot study compared the effects of CWMT, a five-week evidenced-based computer-assisted training program that is supported by weekly meetings with a coach, to standard medical care (treatment as usual). We recruited PwMS from one MS center (London (ON) Canada), aged 18-64, with an Expanded Disability Status Scale (EDSS) score of ≤ 7.0, and a visual acuity (corrected) of at least 20/70. Potential subjects had to demonstrate impaired attention on at least two of three measures (Paced Auditory Serial Addition Test [PASAT], Symbol Digit Modalities Test [SDMT], and/or DKEFS Color-Word Interference Test); these measures also served as the primary study outcomes. Subjects were randomized to either the CWMT or treatment as usual. Secondary cognitive outcomes included other measures of attention, memory, as well as a self-reported cognitive function measure. Self-reported measures of mood (depression and anxiety), pain, and QOL were also included as other secondary outcomes. Subjects received assessments at baseline, post-treatment, and 6-month follow-up, or an equivalent time period for the treatment as usual group. The two groups were compared at baseline on background measures using independent samples t-tests, Chi-Square tests, and Mann-Whitney U tests. To analyze primary and secondary outcomes, a non-parametric approach was used due the small sample size and that many of our outcomes did not meet assumptions for parametric analyses. Friedman's test was conducted followed by post hoc pairwise comparisons within each group using Wilcoxon Signed-Rank tests with Bonferroni corrected post hoc contrasts, which allowed us to examine for differences between time points. ResultsOf 30 subjects, 15 were assigned to CWMT. Significant training effects were noted in 1 of 3 primary attentional outcomes (DKEFS Color-Word Interference Test), 2 of 3 secondary attentional outcomes (Letter-Number Sequencing, Digit Span), and 1 mood scale (Hospital Anxiety and Depression scale (HADS) - Depression Subscale), ps < .025. No significant changes were observed in the treatment as usual group. ConclusionThis pilot study demonstrates that cognitive training with CWMT has the potential to improve attention/working memory in PwMS, as well as a potential positive effect on mood, in PwMS. Further exploration of this intervention in PwMS with attention/working memory impairment is warranted.

A-057 Deficits in Inhibitory Control Are Associated with Social and Emotional Difficulties Among Children with Congenital Heart Defects

Abstract Objective Research has suggested that children with congenital heart defects (CHD) may experience socioemotional maladjustment because of their often-seen executive dysfunction. However, preliminary work has largely used behavioral ratings of executive functioning. Our study used cognitive assessments of inhibitory control, an executive function key for emotional regulation and social initiative. Method We prospectively recruited 46 6-to-16 year olds with CHD (M = 11.65 years, SD = 3.11; 74% male) and 95 healthy controls (M = 12.09 years, SD = 2.87; 54% male). Children completed face-to-face and computerized tests of inhibitory control (D-KEFS Color-Word Interference Test; NIH Toolbox Flanker Inhibitory Control and Attention Test). Children and their parents also filled out scales assessing emotional and social functioning (Pediatric Quality of Life Inventory [PedsQL]; Harter Self Perception Profile [SPP]). Results Using regression, controlled for age, children with CHD had greater parent-rated emotional distress than healthy peers (p &amp;lt; .001). Poorer inhibition was associated with greater distress for children with CHD but not (or less so) healthy peers (p &amp;lt; .05). Children across groups rated their emotional functioning similarly; a face-to-face test of inhibition (but not a computerized test) was related with greater emotional health for both groups (p &amp;lt; .05). Children with CHD had poorer parent-rated social functioning than healthy peers on the PedsQL (p &amp;lt; .005) but not the SPP; there were no significant differences for self-reports. Inhibition was associated with social skills only in select models (p &amp;lt; .05). Conclusions Similar to past research, families reported more maladjustment than children. Regardless, poor inhibition emerged as one potential contributor to socioemotional maladjustment among children with CHD. Interventions targeting executive dysfunction may support socioemotional development.

Perinatal complications and executive dysfunction in early-onset schizophrenia

BackgroundThe present study examined the association between perinatal obstetric complications and executive dysfunction in early-onset schizophrenia (EOS), compared to healthy controls. Higher incidences of obstetric complications and more severe executive dysfunctions characterize EOS. Research shows extensive brain maturation in newborns, suggesting them to be particularly vulnerable for perinatal insults. Executive function is mainly mediated by the prefrontal cortex, an area that matures last during pregnancy. Thus, exposure to perinatal complications may influence executive dysfunction in EOS.MethodsThe participants were 19 EOS patients and 54 healthy controls. Executive function was assessed with the D-KEFS Color Word Interference Test and the Wisconsin Card Sorting Test. Information on perinatal obstetric complications and Apgar 5-min scores were obtained from the Norwegian Medical Birth Registry. Associations between perinatal conditions and executive function were studied using stepwise regression analyses.ResultsPerinatal complications, and especially shorter gestational lengths, were significantly associated with significant executive dysfunctions in EOS. Perinatal complications did not affect executive function among healthy controls. A significant relationship between lower Apgar 5-min scores and executive dysfunction was found among both EOS patients and healthy controls.ConclusionsExposure to perinatal complications, and particularly a shorter gestational length, was associated with increased executive dysfunction in EOS. Exposed healthy controls did not exhibit similar executive difficulties, suggesting that the EOS patients seemed especially vulnerable for executive deficits due to perinatal insults. The findings indicate that EOS youths learn more slowly and experience more difficulty with problem-solving, which carry important implications for clinical practice. Lower Apgar 5-min scores were associated with executive dysfunction in both groups. Low Apgar score at 5 min may therefore be an important early indicator of executive difficulties among adolescents, independent of diagnosis.

Utility of the D-KEFS Color Word Interference Test as an embedded measure of performance validity

Objective: The D-KEFS Color Word Interference Test (CWIT) is among the most commonly administered measures of verbally mediated processing speed and executive functioning. Previous research suggests that this test may also be sensitive to performance invalidity. We sought to develop new embedded measures of performance invalidity based on multi-condition performance on the CWIT and to evaluate previously proposed embedded measures for performance invalidity on this test.Method: Newly developed and previously proposed embedded measures were evaluated in three samples: a traumatic brain injury (TBI) sample (N = 224) classified into psychometrically-defined performance-valid and performance-invalid subgroups; the D-KEFS normative sample (N = 1,735); and a Parkinson’s disease sample (N = 166). To explore the resilience of CWIT cutoffs to the effects of age and neurocognitive impairment, the D-KEFS normative sample was stratified into age groups of 8–19, 20–69, and 70–89 and the Parkinson’s disease sample into normal cognition, mild cognitive impairment, and dementia groups.Results: Our newly developed embedded measures derived from within the TBI sample were largely resilient to the effects of age and neurocognitive impairment other than dementia. Overall, a cutoff of ≤18 on the sum of age-corrected scaled scores on all four conditions exhibited the strongest classification accuracy. In contrast, previously proposed cutoffs (Erdodi et al., 2018) produced unacceptable false-positive rates within the TBI sample and generally a high rate of potential false positives in the normative age and clinical groups.Conclusion: Scoring ≤18 on the sum of all conditions on the CWIT appears to be an optimal cutoff for performance invalidity detection in non-demented samples.

S197. OBSTETRIC COMPLICATIONS, NEUROCOGNITION, AND SCHIZOPHRENIA

BackgroundSchizophrenia is a disorder with a heterogeneous genetic and neurobiological background that influences early brain development. The symptoms is the behavioural outcome of deviations in early neurodevelopment, including prenatal insults such as obstetric complications (OC). OC have been linked to an increased risk for schizophrenia in offspring, especially in early-onset schizophrenia (EOS). Extensive cognitive deficits occur in EOS, whereof executive function is one of the best documented. Cognitive dysfunction reflects underlying abnormalities in the brain neurodevelopment, and is considered to be an intermediate variable between OC and schizophrenia. Our research group (Teigset et al, 2016) is the only study that has investigated the relationship between OC and cognition in EOS. This study aimed to examine the frequency of OC in EOS compared to controls, and also investigate the relationship between OC and neurocognitive dysfunction. In the present presentation we will focus upon executive function and report the findings when comparing the same sample of patients and controls as in the Teigset et al study.MethodsNineteen EOS patients and 53 healthy controls were tested with the MATRICS Consensus Cognitive Battery(MCCB), and two tests for assessment of executive functioning. The selected subtests for measuring executive function were the D-KEFS Color Word Interference Test (Stroop) and the Wisconsin Card Sorting Test. WCST assesses perseverative responses and failure to maintain set, and the Stroop assesses time in seconds for completing the Inhibition and Switching conditions. The cognitive measures were combined with data from the Norwegian Birth Registry (NMBR). Information on OC was collected from the NMBR containing information about all births in Norway, including information about maternal health before and during pregnancy, and any complications arising during pregnancy or birth. The registry includes information about medication during pregnancy, labor interventions, birth complications, maternal complications after birth, whether this was a live birth, any diagnoses in the child or evidence of congenital abnormalities.ResultsGroup differences in OC were studied with Student’s t-tests and Chi-square tests. The association between OC and cognitive function were studied using linear regression analyses. The results indicated no group differences in OC in EOS and healthy controls. However, a shorter gestational length in the EOS group led to significant decreases in the overall neurocognitive composite score (MCCB), in processing speed and in the two executive function tasks.DiscussionOur findings indicate that a shorter gestational length did not increase the risk for developing EOS, but was significantly associated with the cognitive difficulties in this group. In particular, executive functioning were affected, a finding in line with those of Brown et al (2009), showing that prenatal infections were associated with impaired executive function. Interestingly, reductions in neurocognitive performance among those exposed to OC was less extensive in the healthy control group with the same labor-conditions, which may indicate a greater effect of OC on neuropsychological development in schizophrenia. In conclusion, gestational length does not increase the risk for developing EOS, but significantly affects the cognitive difficulties - particularly executive function - seen among cases.

C-83Effectiveness of the D-KEFS Color-Word Interference Test as a Measure of Negative Response Bias

C-83Effectiveness of the D-KEFS Color-Word Interference Test as a Measure of Negative Response Bias

Disruptive behavior disorders and indicators of disinhibition in adolescents: The BRIEF-SR, anti-saccade task, and D-KEFS color–word interference test

Disinhibition contributes to the development of disruptive behavior disorders (DBD) in adolescents. Self-reports and behavioral tasks are commonly used to assess disinhibition, each with their unique strengths and limitations. Accordingly, it is important to identify which measure, or combination thereof, is the most effective in predicting DBD symptoms. This study assessed the relationship between DBD (symptoms of ADHD/ODD/CD) and two behavioral disinhibition tasks: the anti-saccade task and the D-KEFS color–word interference test, as well as a self-report measure (the BRIEF-SR). The results indicated that the BRIEF-Inhibit scale accounted for the majority of the variance in the DBD sum score. The anti-saccade task and color–word interference test were also significantly associated with an increase in the number of DBD symptoms endorsed. These behavioral tasks accounted for 9% additional variance than the self-report alone. Therefore, combining self-report measures with behavioral disinhibition tasks may provide the most thorough assessment of adolescent DBD.

The reliability and validity of the Complex Task Performance Assessment: A performance-based assessment of executive function

The objective of this study was to evaluate the inter-rater reliability, test-retest reliability, concurrent validity, and discriminant validity of the Complex Task Performance Assessment (CTPA): an ecologically valid performance-based assessment of executive function. Community control participants (n = 20) and individuals with mild stroke (n = 14) participated in this study. All participants completed the CTPA and a battery of cognitive assessments at initial testing. The control participants completed the CTPA at two different times one week apart. The intra-class correlation coefficient (ICC) for inter-rater reliability for the total score on the CTPA was .991. The ICCs for all of the sub-scores of the CTPA were also high (.889–.977). The CTPA total score was significantly correlated to Condition 4 of the DKEFS Color-Word Interference Test (p = −.425), and the Wechsler Test of Adult Reading (p = −.493). Finally, there were significant differences between control subjects and individuals with mild stroke on the total score of the CTPA (p = .007) and all sub-scores except interpretation failures and total items incorrect. These results are also consistent with other current executive function performance-based assessments and indicate that the CTPA is a reliable and valid performance-based measure of executive function.

B-02 * Examining the Construct Validity of the BADS Key Search Test

Objective: The Key Search, a subtest within the Behavioral Assessment of Dysexecutive Syndrome battery, is purported to assess planning and problem solving. However, evidence supporting the interpretability of performance on the Key Search is limited. This study evaluated the construct validity of the Key Search in neurologically healthy adults. Method: A diverse sample of healthy adults (n = 101) was administered a comprehensive neuropsychological battery. Between-measure correlations and exploratory factor analysis (EFA) were used to evaluate construct validity of the Key Search's total score (TS) and total time (TT) measures. Results: Covariate analyses revealed small correlations between the Key Search TS, but not TT, and 3 of 10 executive functioning (EF) measures: the D-KEFS Trail Making Test, Switching Condition (r = .259, p = .009), Symbol Digit Modalities Test (r = .25, p = .013), and the D-KEFS Color-Word Interference Test, Inhibition/Switching (r = .217, p = .039). Discriminant analyses revealed no correlation between measures of non-verbal memory, visuospatial reasoning, or literacy (p > .05). An EFA of EF measures revealed a 3 component item structure (Eigenvalues > 1), accounting for 43% of the total variance. Key Search TS loaded on the executive control/working memory factor (Factor 1: .508). Key Search TT measure loaded minimally on the inhibitory control factor (Factor 2: .354). Neither loaded on the planning factor (Factor 2). Conclusion(s): Interpretability of the Key Search as a measure of planning and problem solving was not supported; however, the Key Search TS appears to measure other aspects of EF. Future studies should assess the Key Search's construct validity in clinical samples.

Building a neurocognitive profile of thought disorder in schizophrenia using a standardized test battery

A core symptom of schizophrenia is thought disorder (TD). The cognitive abilities of semantic processing and executive function are argued to be etiologically linked to TD. However, there has been no comprehensive investigation of neurocognition in TD to date. The neurocognitive profile of 58 schizophrenia patients and 48 healthy controls was examined using the MATRICS Consensus Cognitive Battery and the D-KEFS Color–Word Interference Test. TD patients performed more poorly than non-TD patients on the cognitive domains of Verbal Learning and Inhibition, reflective of semantic and executive function respectively, confirming their critical roles over and above other cognitive deficits in schizophrenia.

Cognitive, sensory, and psychosocial characteristics in patients with Bardet–Biedl syndrome

Forty-two patients with a clinical diagnosis of Bardet-Biedl syndrome ages 2-61 years were given a neuropsychological test battery to evaluate cognitive, sensory, and behavioral functioning. These tests included the Wechsler scales of intelligence, Rey Auditory Verbal Learning Test, Boston Naming Test, D-KEFS Verbal Fluency Test, D-KEFS Color-Word Interference Test, D-KEFS Sorting Test, Wide Range Achievement Test: Math and Reading Subtests, Purdue Pegboard, The University of Pennsylvania Smell Identification Test, Social Communication Questionnaire, Social Responsiveness Scale, and Behavior Assessment System for Children, Second Edition, Parent Rating Scale. On the age appropriate Wechsler scale, the mean Verbal Comprehension was 81 (n = 36), Working Memory was 81 (n = 36), Perceptual Reasoning was 78 (n = 24) and Full Scale IQ was 75 (n = 26). Memory for a word list (Rey Auditory Verbal Learning Test) was in the average range with a mean of 89 (n = 19). Fine motor speed was slow on the Purdue with mean scores 3-4 standard deviations below norms. All subjects were microsmic on the University of Pennsylvania Smell Identification Test. Of these 42 patients, only 6 were able to complete all auditory and visual tests; 52% were unable to complete the visual tests due to impaired vision. A wide range of behavioral issues were endorsed on questionnaires given to parents. Most had social skill deficits but no pattern of either externalizing or internalizing problems. We identify a characteristic neuro-behavioral profile in our cohort comprised of reduced IQ, impaired fine-motor function, and decreased olfaction.

Executive function tests in early‐onset psychosis: which one to choose?

People with schizophrenia exhibit executive functioning deficits, an area well investigated in the adult onset schizophrenia (AOS) group, but far less so in early-onset schizophrenia (EOS). Since EOS in general seems to exhibit poorer cognitive functions and is clinically more compromised than AOS, choice of efficient and sensitive assessment measures is not necessarily the same within the two groups. The MATRICS Consensus Cognitive Battery was developed for adults when studying treatment effects and uses Mazes (Neuropsychological Assessment Battery [NAB]) to assess executive functioning. We tested 31 adolescents with schizophrenia spectrum disorders and 66 healthy controls in order to examine how Mazes compares to two other commonly used tests to measure executive functioning, D-KEFS Color Word Interference Test (Stroop) and the Wisconsin Card Sorting Test (WCST). Significant discriminating power was found for all three measures. Patients performed 0.8-1.5 SD below controls with Stroop as the most sensitive measure, followed by Mazes and WCST. Mazes was selected by the MATRICS to assess treatment effects in AOS and is shown to be able. We find the instrument also able to separate adolescent patients from controls and thus, it appears a sensible choice in clinical settings. If a more elaborated neuropsychological evaluation of the executive functioning domain is needed, Stroop should be considered a complementary test.

P.1.g.034 Comparative analysis of the neurocognitive profile of patients with a first episode of paranoid schizophrenia and schizoaffective disorder

A core symptom of schizophrenia is thought disorder (TD). The cognitive abilities of semantic processing and executive function are argued to be etiologically linked to TD. However, there has been no comprehensive investigation of neurocognition in TD to date. The neurocognitive profile of 58 schizophrenia patients and 48 healthy controls was examined using the MATRICS Consensus Cognitive Battery and the D-KEFS Color–Word Interference Test. TD patients performed more poorly than non-TD patients on the cognitive domains of Verbal Learning and Inhibition, reflective of semantic and executive function respectively, confirming their critical roles over and above other cognitive deficits in schizophrenia.

Correlation of white matter changes with behavioral and psychological symptoms in Alzheimer's disease

Background: Because deficits in inhibition and cognitive-shifting have been noted in early Alzheimer’s disease (AD), the first goal of this study is to determine whether impairments in these domains are also present in the preclinical stages of AD. Neuroimaging studies suggest that the precuneus is active during cognitive-shifting processes and that decreased cerebral blood flow in this region may be a risk factor for AD. Therefore, the second goal of this study is to examine whether precuneus volume and thickness is associated with inhibition and cognitive shifting performance in subjects in the preclinical stages of AD. Methods: Thirty-nine cognitively normal (CN, mean MMSE: 29.5) older adults and 68 patients with single or multiple-domain mild cognitive impairment (MCI, mean MMSE: 27.7) were studied with the D-KEFS Color-Word Interference Test; CWIT; Delis et al., 2001). The Inhibition/Switching condition in the CWIT depends upon both inhibitory and cognitive-shifting abilities. Subjects also received structural magnetic resonance imaging on a 1.5 or 4 tesla scanner (scanner strength was included as a covariate in the analyses). Freesurfer was used to determine precuneus volume and thickness. Results: MCI patients performed comparably to CN in the less cognitively demanding conditions, but were slower on the Inhibition (p 1⁄4 0.01) and Inhibition/Switching (p 1⁄4 0.04) conditions and committed more uncorrected errors in the Inhibition/Switching condition (p 1⁄4 0.001). There was no significant group difference in precuneus volume or thickness (p > 0.2). However, both predicted time to complete the Inhibition/Switching condition (all subjects; thickness: b 1⁄4 0.36, p < 0.01; volume: b 1⁄4 0.33, p 1⁄4 0.02; MCI alone; thickness: b 1⁄4 0.34, p 1⁄4 0.04; volume: b 1⁄4 0.39, p 1⁄4 0.04). Finally, performance on the Inhibition/Switching condition was significantly correlated with global cognitive status (i.e., MMSE) among APOE-e4 positive (CN: r 1⁄4 060, p 1⁄4 0.04; MCI: r 1⁄4 0.59, p < 0.0001) but not among non-e4 subjects (CN: r 1⁄4 -0.04, p 1⁄4 0.9; MCI: r 1⁄4 0.02, p 1⁄4 0.9). Conclusions: These findings suggest that deficits in inhibition and cognitive-shifting are present during the preclinical stages of AD and can be predicted by the volume and thickness of the precuneus. Moreover, the association between these executive-function deficits and overall cognitive status in CN older adults positive for the APOE-e4 allele provides further support for the utility response inhibition and cognitive flexibility deficits as a possible preclinical marker of AD.

Is cognitive switching performance on the D-KEFS Color Word Interference Test predicted by frontal lobe volume?

Is cognitive switching performance on the D-KEFS Color Word Interference Test predicted by frontal lobe volume?

Evaluating elements of executive functioning as predictors of instrumental activities of daily living (IADLs)

OBJECTIVE Executive functioning has been repeatedly linked to the integrity of instrumental activities of daily living (IADL). The present study examined the association of multiple executive functioning elements (i.e., working memory, generation, inhibition, planning, and sequencing) to IADLs among an older adult cohort at risk for future cognitive and functional decline. METHODS Seventy-two participants with prevalent but stable cardiovascular disease completed a neuropsychological protocol assessing multiple elements of executive functioning, including COWA, PASAT, DKEFS Color-Word Interference Test, DKEFS Trail-Making Test, DKEFS Tower Test, and Ruff Figural Fluency Test. Reliable informants completed a measure of IADLs. RESULTS Stepwise logistic regression selected a model involving a single significant predictor, a measure of inhibition (i.e., DKEFS Color-Word Interference Test), which had a significant regression coefficient. Subsequent correlation analyses confirmed an association between the inhibition measure and multiple IADL items. Inter-item comparisons among the IADLs revealed significant differences, such that telephone use and laundry were significantly more intact than most other IADLs while shopping and housekeeping were most compromised. CONCLUSIONS Our data suggest that inhibition, also known as susceptibility to interference, is most strongly related to IADL impairment among patients at risk for future cognitive and functional decline.