Executive Function Test Performance Research Articles

Sociodemographic predictors and cross-cultural comparisons in tests performance from the Cambridge Neuropsychological Testing Automated Battery (CANTAB) among children aged 6-8 years from Montevideo, Uruguay.

Cross-culturally comparative data on measures of executive function (EF) are essential, but the 6-8-year group remains insufficiently described. This study examined the sociodemographic predictors of EF test performance employing the Cambridge Neuropsychological Testing Automated Battery (CANTAB). It also compared developmental trends in EF among children from Uruguay, the United States, and Mexico. EFs were assessed with the Intra-dimensional/Extra-dimensional shift, Spatial Span (SSP), and Stockings of Cambridge (SOC) tests from the CANTAB. The study sample consisted of 6-8-year-old children from the Salud Ambiental Montevideo (SAM) cohort in Uruguay. Differences between cohorts were examined, and we performed generalized linear regressions to assess the association between sociodemographic factors, and each EF domain. The final sample consisted of 525 participants (mean age in months 82.5 ± 6.0). Across all ages, SAM children had significantly lower performance in the SSP and SOC tasks compared to U.S. and Mexican children. On the Intra-dimensional/Extra-dimensional shift task, SAM children had similar scores to U.S. and Mexican children. Mother's intelligence quotient (IQ; β = 0.01; 95% CI [0.005, 0.02]), child's IQ (0.02 [0.02, 0.03]), the HOME total score (0.02 [0.01, 0.03]), as well as HOME subscales of accompaniment (0.13 [0.07, 0.20]), enrichment (0.11 [0.06,0.16]), and physical environment (0.07 [0.03, 0.10]) were positively associated with the span length (SSP task). Child's IQ (0.02 [0.01,0.03]) was positively associated with the number of problems solved on the SOC test. Uruguayan children perform lower in working memory and planning tests than U.S. children but similarly to Mexican children, while cognitive flexibility is consistent across all groups. Further, mother and child IQ, as well as the home environment, are important predictors of EF. These differences should be examined in the context of diverse cultural values and sociodemographic factors affecting CANTAB construct validity in this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Executive functioning in adults with attention deficit hyperactivity disorder: A systematic review

Introduction: Executive function deficits are associated with attention deficit hyperactivity disorder (ADHD) in both children and adults. The inattentive subtype is primary related to “cold” executive functions, while the hyperactive subtype is related to “warm” executive functions. Objective: To systematically review studies on executive functioning in adults with attention deficit hyperactivity disorder published during the last decade. Methodology: A documentary research was conducted, encompassing 33 articles retrieved from PubMed, Web of Science and EBSCO platforms. The analysis considered years and countries of publication, attention deficit hyperactivity disorder diagnostic criteria, participants, comorbidities, subtypes, medication use, assessment tools, and processes of executive functions evaluated. Results: It was evidenced that there is a high percentage of adults with attention deficit hyperactivity disorder who present a deficit or lower performance in executive function tests. However, the results varied depending on specific characteristics of the study and/or participants, which confirms the heterogeneity of the disorder. In addition, the main instruments for measuring executive functions and diagnostic criteria for adult attention deficit hyperactivity disorder were identified. Discussion: These results support the established links between attention deficit hyperactivity disorder , impaired executive functions, and major life activities found in the adult attention deficit hyperactivity disorder literature. However, some of the limitations were the poorly controlled variables such as comorbidities, attention deficit hyperactivity disorder subtypes that were not assessed, and usage of instruments that measure executive functions that can lead to reduced credibility of the results presented here. Conclusions: According to the results presented, there is a high percentage of adults with attention deficit hyperactivity disorder who present a deficit or lower performance in executive function tests, compared to both neurotypical adults and those with other psychiatric disorders. Further research is recommended to continue studies on the topic and to include other variables.

Effects of open-label transdermal nicotine antidepressant augmentation on affective symptoms and executive function in late-life depression

BackgroundLate-life depression (LLD) is characterized by a poor response to antidepressant medications and diminished cognitive performance, particularly in executive functioning. There is currently no accepted pharmacotherapy for LLD that effectively treats both mood and cognitive symptoms. This study investigated whether transdermal nicotine augmentation of standard antidepressant medications benefitted mood and cognitive symptoms in LLD. MethodsNonsmoking participants aged 60 years or older with unremitted LLD on stable SSRI or SNRI medications (N = 29) received transdermal nicotine patches up to a 21 mg daily dose over 12 weeks. Clinical measures assessed depression severity, secondary affective symptoms, and cognitive performance. Nicotine metabolite concentrations were obtained from blood samples. ResultsDepression severity significantly decreased over the trial, with a 76 % response rate and 59 % remission rate. Change in depression severity was positively associated with nicotine exposure. Participants also exhibited improvement in self-reported affective symptoms (apathy, insomnia, rumination, and generalized anxiety symptoms), negativity bias, and disability. Executive function test performance significantly improved, specifically in measures of cognitive control, as did subjective cognitive performance. Adverse events were generally mild, with 75 % of the sample tolerating the maximum dose. ConclusionThe current study extends our previous pilot open-label trial in LLD, supporting feasibility and tolerability of transdermal nicotine patches as antidepressant augmentation. Although preliminary, this open-label study supports the potential benefit of transdermal nicotine patches for both mood and cognitive symptoms of LLD. Further research, including definitive randomized, blinded trials, is warranted to confirm these findings and explore long-term risk and benefit. Trial registrationThe study was registered with clinicaltrials.gov (NCT04433767).

Cognitive impairment in Chinese adult patients with type III spinal muscular atrophy without disease-modifying treatment.

Spinal muscular atrophy (SMA) is a neurodegenerative disorder characterized by the degeneration of motor neurons in the spinal cord. It remains uncertain whether the cognitive performance of adult patients with SMA is impaired. The objective of this study was to assess the cognitive profile of adult Chinese patients with SMA and the association between clinical features and cognitive ability, particularly executive function. This cross-sectional study included 22 untreated adult patients with type III SMA and 20 healthy subjects. The following variables were assessed: general intelligence, memory, attention, language, executive function, depression, anxiety, and other demographic and clinical parameters. In addition, physical function was evaluated using the Hammersmith Functional Motor Scale Expanded (HFMSE), the Revised Upper Limb Module (RULM), and the 6-Minute Walk Test (6MWT). SMA patients had lower scores than healthy subjects in the Verbal Fluency Test, Stroop effect, Total Errors, Perseverative Responses, Perseverative Errors, and Non-perseverative Errors in the Wisconsin Card Sorting Test, showing impaired abilities of SMA patients in executive function. In the Attention Network Test (ANT), the results indicated that the SMA patients also had selective deficits in their executive control networks. Ambulant patients had better executive function test performance than non-ambulant ones. Compromised executive abilities in patients with SMA were correlated with a younger age at onset, poorer motor function, and higher levels of anxiety and depression. Our study presented the distribution of cognitive impairment in a Chinese cohort with SMA. Patients with type III SMA showed selective deficits in executive function, which may be associated with disease severity, physical impairment, depression and anxiety. Future cognitive studies, accounting for motor and emotional impairment, are needed to evaluate if executive impairment is driven by specific brain changes or by those confounding factors.

Exploring the relationship between frailty and executive dysfunction: the role of frontal white matter hyperintensities.

Frailty is a geriatric syndrome frequently associated with executive dysfunction and white matter hyperintensities (WMH). But the relation between executive dysfunction and brain changes is poorly understood in frail subjects. Our hypothesis is that frontal-WMH mediates the association between frailty and executive dysfunction. A convenience sample of 113 subjects older than 65 years without dementia was studied with neuropsychological test, a structured clinical interview, physical examination and brain MRI. They were classified as robust or pre-frail and frail using the frailty phenotype score (0-5). The frontal WMH (F-WMH) were manually graduated (0-6) using the "Age-Related White Matter Changes score" from FLAIR sequences at a 3 Tesla brain MRI. A mediation analysis was done for testing whether F-WMH could act as a link factor between frailty phenotype score and executive dysfunction. The group's mean age was 74 ± 6 years, subjects with higher frailty score had more depressive symptoms and worse performance in executive function tests. A regression analysis that explained 52% of the variability in executive functions, revealed a significant direct effect of frailty score (Standardized βcoeff [95% CI] -0.201, [-0.319, -0.049], and F-WMH (-0.152[-0.269, -0.009]) on executive functions, while the F-WMH showed a small partial mediation effect between frailty and executive functions (-0.0395, [-0.09, -0.004]). Frontal matter hyperintensities had a small mediation effect on the association between frailty and executive dysfunction, suggesting that other neuropathological and neurofunctional changes might also be associated with executive dysfunction in frail subjects.

Associations between gait performance and pain intensity, psychosocial factors, executive functions as well as prefrontal cortex activity in chronic low back pain patients: A cross-sectional fNIRS study.

Activities of daily living, such as walking, are impaired in chronic low back pain (CLBP) patients compared to healthy individuals. Thereby, pain intensity, psychosocial factors, cognitive functioning and prefrontal cortex (PFC) activity during walking might be related to gait performance during single and dual task walking (STW, DTW). However, to the best of our knowledge, these associations have not yet been explored in a large sample of CLBP patients. Gait kinematics (inertial measurement units) and PFC activity (functional near-infrared spectroscopy) during STW and DTW were measured in 108 CLBP patients (79 females, 29 males). Additionally, pain intensity, kinesiophobia, pain coping strategies, depression and executive functioning were quantified and correlation coefficients were calculated to determine the associations between parameters. The gait parameters showed small correlations with acute pain intensity, pain coping strategies and depression. Stride length and velocity during STW and DTW were (slightly to moderately) positively correlated with executive function test performance. Specific small to moderate correlations were found between the gait parameters and dorsolateral PFC activity during STW and DTW. Patients with higher acute pain intensity and better coping skills demonstrated slower and less variable gait, which might reflect a pain minimization strategy. Psychosocial factors seem to play no or only a minor role, while good executive functions might be a prerequisite for a better gait performance in CLBP patients. The specific associations between gait parameters and PFC activity during walking indicate that the availability and utilization of brain resources are crucial for a good gait performance.

Validity of the SKILLCOURT® technology for agility and cognitive performance assessment in healthy active adults

Background/ObjectivesAgility and cognitive abilities are typically assessed separately by different motor and cognitive tests. While many agility tests lack a reactive decision-making component, cognitive assessments are still mainly based on computer-based or paper-pencil tests with low ecological validity. This study is the first to validate the novel SKILLCOURT technology as an integrated assessment tool for agility and cognitive-motor performance. MethodsThirty-two healthy adults performed agility (Star Run), reactive agility (Random Star Run) and cognitive-motor (executive function test, 1-back decision making) performance assessments on the SKILLCOURT. Cognitive-motor tests included lower limb responses in a standing position to increase the ecological validity when compared to computer-based tests. Test results were compared to established motor and agility tests (countermovement jump, 10 m linear sprint, T-agility tests) as well as computer-based cognitive assessments (choice-reaction, Go-NoGo, task switching, memory span). Correlation and multiple regression analyses quantified the relation between SKILLCOURT performance and motor and cognitive outcomes. ResultsStar Run and Random Star Run tests were best predicted by linear sprint (r = 0.68, p < 0.001) and T-agility performance (r = 0.77, p < 0.001), respectively. The executive function test performance was well explained by computer-based assessments on choice reaction speed and cognitive flexibility (r = 0.64, p < 0.001). The 1-back test on the SKILLCOURT revealed moderate but significant correlations with the computer-based assessments (r = 0.47, p = 0.007). ConclusionThe results support the validity of the SKILLCOURT technology for agility and cognitive assessments in more ecologically valid cognitive-motor tasks. This technology provides a promising alternative to existing performance assessment tools.

Association between Sedentary Behavior and Cognitive Performance in Middle-Aged and Elderly Adults: Cross-Sectional Results from ELSA-Brasil.

This study aimed to verify the association between Sedentary Behavior (SB) and performance on cognitive function tests in middle-aged and elderly adults. This cross-sectional study included 6505 participants (55.2% women) of ELSA-Brasil, with a median age of 61 years. The different types of SB considered were sitting time and screen time. The scores obtained in the memory, language, and executive function tests were used to assess cognitive performance (CP). The association between SB and CP was assessed using linear regression. For men, sitting time was associated with better performance in memory, language, and executive function tests. Screen time on the weekend, showed a favorable association with performance in the executive function test. Occupational screen time on weekdays was positively associated with language test performance. For women, sitting time and occupational screen time were positively associated with performance on memory tests. SB was favorably associated with performance in language tests and executive function tests. SB seems to favor CP in this population without evident dementia and with a high level of education. The type of SB (mentally active or passive) and the schooling seem to be of particular interest for cognitive performance.

A Spanish Neuropsychological Battery Discriminates Between the Behavioral Variant of Frontotemporal Dementia and Primary Progressive Aphasia in a Colombian Sample.

The differential diagnosis among the behavioral variant of frontotemporal dementia FTD (bvFTD) and the linguist one primary progressive aphasia (PPA) is challenging. Presentations of dementia type or variants dominated by personality change or aphasia are frequently misinterpreted as psychiatric illness, stroke, or other conditions. Therefore, it is important to identify cognitive tests that can distinguish the distinct FTD variants to reduce misdiagnosis and best tailor interventions. We aim to examine the discriminative capacity of the most frequently used cognitive tests in their Spanish version for the context of dementia evaluation as well as the qualitative aspects of the neuropsychological performance such as the frequency and type of errors, perseverations, and false positives that can best discriminate between bvFTD and PPA. We also described mood and behavioral profiles of participants with mild to moderate probable bvFTD and PPA. A total of 55 subjects were included in this cross-sectional study: 20 with PPA and 35 with bvFTD. All participants underwent standard dementia screening that included a medical history and physical examination, brain MRI, a semistructured caregiver interview, and neuropsychological testing. We found that bvFTD patients had worse performance in executive function tests, and the PPA presented with the lower performance in language tests and the global score of Mini-Mental State Examination (MMSE). After running the linear discriminant model, we found three functions of cognitive test and subtests combination and three functions made by the Montreal Cognitive Assessment (MoCA) language subtest and performance errors that predicted group belonging. Those functions were more capable to classify bvFTD cases rather than PPA. In conclusion, our study supports that the combination of an individual test of executive function and language, MoCA's subtest, and performance errors as well have good accuracy to discriminate between bvFTD and PPA.

A - 20 Connectivity between Default Mode and Salience Networks is Associated with Decreased Attention and Inhibitory Control

Abstract Objective To determine the association of default mode (DMN) and salience (SAL) network connectivity to executive function test performance. We hypothesized that intranetwork connectivity of the DMN and SAL would be uncorrelated to executive function, whereas increased internetwork connectivity would be associated with lower executive function. Methods Twelve physically active and healthy young adults (7 females, 5 males; age: 23.41 ± 2.74 years) were recruited for this study. Participants completed resting-state functional magnetic resonance imaging and three executive function tests administered through the NIH Toolbox Cognitive Battery. Demographically-corrected T-scores were calculated from the Flanker Inhibitory Control and Attention Test (FICA), Dimensional Change Card Sort Test (DCCS), and Pattern Comparison Processing Speed Test (PCPS). The relationship between intra- and internetwork connectivity of the DMN and SAL networks and performance. Results Independently, the DMN and SAL networks demonstrated weak correlations to DCCS (SAL: r = 0.45, p = 0.14; DMN: r = 0.13, p = 0.69), FICA (SAL r = −0.10, p = 0.95; DMN: r = 0.31, p = 0.33), and PCPS (SAL r = 0.10, p = 0.79; DMN: r = 0.22, p = 0.50). However, connectivity between the SAL and DMN networks demonstrated a moderate correlation to FICA performance (r = −0.61, p = 0.02). Conclusions Greater connectivity between the DMN and SAL networks demonstrated the strongest association to attention and inhibitory control performance in physically active, young adults. This relationship suggests greater connectivity of task-negative networks to task-positive networks may interfere with ongoing processing of visuospatial attention and inhibition. Future studies should examine this relationship in athletes who sustain a head injury.

Executive function in individuals with clinically significant weight loss via behavioral intervention.

BackgroundExecutive function (EF) is associated with obesity development and self‐management. Individuals who demonstrate or self‐report poorer EF performance tend to have poorer short‐term outcomes in obesity treatment. There may be distinct behavioral self‐management strategies and EF domains related to initial weight loss as compared to weight loss maintenance.ObjectiveTo characterize EF in individuals who achieved clinically significant weight loss via behavioral intervention and examine potential differences in EF between those who maintained versus regained lost weight.MethodsParticipants who previously achieved ≥5% weight loss via lifestyle intervention were included (N = 44). “Maintainers” (n = 16) maintained this minimum level of weight loss for ≥1 year. “Regainers” (n = 28) regained some or all initially lost weight. Performance‐based EF, intelligence quotient, health literacy, depression, anxiety, binge eating, demographics, and medical/weight history were assessed using a cross‐sectional design. Descriptive statistics and age‐, gender‐, education‐adjusted reference ranges were used to characterize EF. Analyses of covariance were conducted to examine EF differences between maintainers and regainers.ResultsThe sample consisted primarily of females with obesity over age 50. Approximately half self‐identified as African–American. Decision‐making performance was better in maintainers than regainers (p = 0.003, partη2 = 0.19). There were no differences between maintainers and regainers in inhibitory control, verbal fluency, planning/organization, cognitive flexibility, or working memory (ps > 0.05, partη2s = 0.003–0.07). At least 75% of the sample demonstrated average‐above average EF test performance, indicated by scaled scores ≥13 or t‐scores > 60.ConclusionsMost individuals with obesity who achieved clinically significant weight loss via behavioral intervention had average to above average EF. Individuals who maintained (vs. regained) their lost weight performed better on tests of decision‐making.

Apathy in frontotemporal dementia is related to medial prefrontal atrophy and is independent of executive dysfunction

IntroductionApathy is the most common neuropsychiatric syndrome in behavioral variant frontotemporal dementia (bvFTD), and encompasses cognitive, behavioral and affective symptoms. The neural basis of apathy in bvFTD is not completely understood. Previous neuroimaging studies have poorly considered executive impairment and dementia severity as possible confounding factors. Herein we investigated the neural basis of apathy in bvFTD through structural neuroimaging taking into account these factors. MethodsWe included patients with probable bvFTD (n = 21) and cognitively healthy controls (HC, n = 22). Participants were matched for age, sex and schooling. All subjects underwent a thorough neuropsychological examination, including tests for executive functions and social cognition. Apathy was assessed with the Starkstein Apathy Scale (SAS). All subjects underwent 3T brain MRI. We investigated correlations between SAS scores and gray matter atrophy within the bvFTD group. Executive function (Frontal Assessment Battery) and disease severity were considered as covariates in neuroimaging analyses. ResultsCompared to HC, bvFTD patients had lower scores on global cognitive efficiency, executive functions and social cognition. All bvFTD had clinically relevant apathy (scores greater than 14 in the SAS). Performance in executive function tests did not correlate with apathy scores. The severity of apathy was negatively correlated with gray matter volumes in midline prefrontal regions, namely orbitofrontal cortex and both anterior and dorsal regions of cingulate cortex. ConclusionsApathy in bvFTD is related to a specific network of prefrontal cortical areas critically involved in effort-based behavior for rewards and appears to be independent of executive dysfunction.

Impact factor analysis of cerebrospinal fluid tap test response in patients of idiopathic normal pressure hydrocephalus

Objective To facilitate diagnosis and predict the outcome of shunting surgery in idiopathic normal pressure hydrocephalus (iNPH) and to explore the influence of clinical and neuroimaging factors on cerebrospinal fluid (CSF) tap test response in Han Chinese patients with iNPH. Methods Forty-three patients with possible clinical diagnosis of iNPH at neurology clinic and neurology inpatient at Department of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from March 2013 to January 2017 were recruited and underwent CSF tap test. Patients were categorized into CSF tap test responders (24 patients) and non-responders (19 patients) justified by two iNPH professional neurologists. The clinical parameters in those 2 groups including gender, age onset, duration, walking ability, neuropsychological testing result, clinical scores were analyzed. The neuroimaging parameters including Evan's index, callosum corpus angle, sign of disproportion of enlarged subarachnoid space and white matter lesion (WML) Fazekas rating score were also analyzed. Results The univariate analysis showed that compared with CSF tap test negative group, the proportion of males in the positive group was significantly higher (male ∶female 20 ∶4 vs. 9 ∶10, P=0.03), the duration of walking disturbance was longer [M (QR): 30(17) months vs. 12(20) months, P=0.04], Z score of executive function was lower [M(QR): -10.3(25.0) vs. -4.8(11.3), P=0.04], Fasekas score of paraventricular white matter lesions was higher[M (QR): 2.5 (1.0) vs. 1.0 (1.0), P=0.03]. However, those factors had no statistical correlation with the CSF tap test response by multivariate logistic regression analysis(all P>0.05). Conclusions Longer disease duration, worse walking ability, worse executive function test performance and prominent white matter lesions might be the impact factors of CSF tap test. Further research of large sample size is needed in the future. Key words: Hydrocephalus, normal pressure; Factor analysis, statistical; Idiopathic; Cere-brospinal fluid tap test

25-hydroxyvitamin D Levels are Associated with Cognitive Dysfunction in Type 2 Diabetes and the Metabolic Syndrome: A Preliminary Examination

Background: Type 2 diabetes (T2DM) and metabolic syndrome are linked to pathological changes in the brain and increased likelihood of cognitive impairment. Vitamin D insufficiency is commonly found in this population and is associated with cognitive dysfunction in other patient groups. The present study aims to demonstrate the presence of cognitive deficit in individuals with T2DM and metabolic syndrome, and determine if level of vitamin D is associated with cognitive deficit in this population. Methods: Twenty individuals with T2DM and metabolic syndrome (n = 20, aged 45 to 72) were recruited for this cross-sectional study from a subspecialty diabetes center. All completed computerized cognitive testing and clinical evaluation, including assessment of circulating vitamin D values. Pearson correlations determined the association between vitamin D value and test performance. Results: Cognitive dysfunction was prevalent, particularly in domains of executive function (e.g., Verbal Interference-Color Word, 47%) and attention (e.g., Working Memory Reaction Time, 50%; Digit Span, 30%). Lower vitamin D values were associated with poorer executive function test performance (Switching of Attention-Letters/Numbers, r = 0.64; Maze Errors, r = 0.47). Conclusions: Cognitive dysfunction was prevalent, and lower vitamin D values were associated with poorer executive function test performance. It is unclear if vitamin D directly affects cognition in this population, or if it serves as a proxy for another mechanism affecting cognition, such as poorer glycemic control or sedentary lifestyle. Prospective studies involving vitamin D supplementation may be of benefit in addressing the possible causal role of vitamin D in cognition for this population.

Meta-Analysis of the Relationship between Deep Brain Stimulation in Patients with Parkinson's Disease and Performance in Evaluation Tests for Executive Brain Functions.

Parkinson's disease (PD) is a neurodegenerative condition, which compromises the motor functions and causes the alteration of some executive brain functions. The presence of changes in cognitive symptoms in PD could be due to the procedure of deep brain stimulation (DBS). We searched in several databases for studies that compared performance in executive function tests before and after the DBS procedure in PE and then performed a meta-analysis. After the initial search, there were 15 articles that specifically evaluated the functions of verbal fluency, working memory, cognitive flexibility, abstract thinking, and inhibition. It was found that there were differences in the evaluation of the cognitive functions in terms of the protocols, which generated heterogeneity in the results of the meta-analysis. Likewise, a tendency to diminish functions like verbal fluency and inhibition was found, being this consistent with similar studies. In the other functions evaluated, no difference was found between pre- and postsurgery scores. Monitoring of this type of function is recommended after the procedure.

Impairment of the executive attention network in premenopausal women with hormone receptor-positive breast cancer treated with tamoxifen

Tamoxifen (TAM) is most commonly prescribed for patients with hormone-sensitive breast cancer and exerts agonistic/antagonistic effects on estrogen receptors throughout the body. Accumulating evidence has revealed that breast cancer patients receiving TAM manifest cognitive dysfunction. However, whether these patients have a global attention deficit or a more selective impairment of specific attention networks remains unknown. In the present study, we sought to explore the attention function of premenopausal women with hormone receptor-positive breast cancer treated with TAM using the attention network test (ANT). The subjects included breast cancer patients receiving TAM (TAM, N=43), breast cancer patients not receiving TAM (non-TAM, N=41), and matched healthy controls (HC, N=46). The subjects completed the ANT and neuropsychological tests, which measure three independent attention networks and executive function performance, respectively. Our results indicated that patients in the TAM group had significant deficits in their executive control component but not in the alerting or orienting components. Moreover, the patients showed poor executive function performance in the neuropsychological tests. Additionally, in the TAM group, significant correlations were found between the decreased efficiency of the executive control component and their reduced performance in executive function tests. This study demonstrates that premenopausal women with hormone receptor-positive breast cancer treated with TAM have impairment of the executive attention network and that this impairment was associated with differences in executive function performance.

Association of parent-child relationships and executive functioning in South Asian adolescents.

It is known that some environmental variables can significantly affect the development of executive functions (EF). The primary aim of this study was to analyze whether some family conditions, such as the adolescent's perception of the quality of parent-child relationships and the socioeconomic status (SES; assessed according to education, occupational status, and income) are significantly associated with EF test scores. There were 370 Pakistani participants ranging in age 13 to 19 years who were selected and then individually administered the following tests taken from the Delis-Kaplan Executive Function System (D-KEFS): Trail Making Test (TMT), Design Fluency Test (DFT), Color Word Interference Test (CWIT), and Card Sorting Test (CST). In addition, a Parent-Child Relationship Scale (PCRS) also was administered. Results showed that perceived "neglect" in the PCRS was negatively associated with the 4 EF test scores. Parents' education and SES were positively associated with 3 EF measures: DFT, CWIT, and CST. Further correlational analyses revealed that inhibition (as measured with the CWIT) and problem-solving ability (as measured with the CST) were significantly associated with the perceived parent-child relationships. Some gender differences also were observed: males outperformed females on TMT, DFT, and CST, while females outperformed males in the CWIT. It was concluded that perceived parent-child relationships, SES, and parents' education are significantly associated with executive function test performance during adolescents.

Does pain affect executive function in sickle cell disease?: Abstract G151 Table 1

Aims Research in populations with sickle cell anaemia (SCA) has consistently found differences from healthy controls on tests of executive function (EF), attributed to the elevated stroke risk. In older adults without SCA there is an association between pain and mental flexibility. The aims of this study were to investigate the executive function performance of a group of SCA children across a single test battery and the possibility that chronic pain impacts upon these skills. Methods Patients with SCA were recruited via their consultants at outpatients clinics. Sibling controls and other ethnically matched children were recruited via the community. The Weschler Abbreviated Scales of Intelligence (WASI): two-sub-test version was administered together with five of the nine available sub-tests of the Delis Kaplan Executive Function System (D-KEFS), representing a range of different skills: the trail-making, the design fluency, colour-word interference, sorting and tower tests. Composite scores were created for each of the DKEFS sub-tests. Current pain was measured using the Faces Pain Scale-Revised (FPS-R). Frequency of pain was measured via self-report of the number of pain episodes over the past year. A number of t-tests, followed by correlations, were then employed to compare performance across the two groups. Results Eight controls (3 male), mean age 11 y 3 m (9 y 8 m-14 y 8 m) and 14 (11 male) children with SCA, mean age 13 y 4 m (10 y 7 m-17 y 6 m) were recruited. There was a significant difference between the frequency of pain episodes in the SCA and control groups, t (20)=−2.56, p=0.019. T-tests showed no significant differences at the 95% confidence interval in FPS-R scores, any of the DKEFS sub-tests, or FSIQ. No significant correlations were found between either frequency of pain episodes or current pain, and any of the composite EF sub-test scores. Discussion We found no evidence of impaired performance by the SCA group on any of the EF sub-tests. The SCA group reported significantly more frequent pain episodes, and a wider range of pain levels on the day of testing but there was no association between current pain, or pain frequency, and EF test performance, perhaps explained by the subjective nature of pain, and differences in pain perception.

Leukoaraiosis Predicts Hidden Global Functioning Impairment in Nondisabled Older People: The LADIS (Leukoaraiosis and Disability in the Elderly) Study

To determine whether leukoaraiosis severity is independently associated with differences in global functioning in nondisabled elderly patients. Cross-sectional data analysis from an ongoing longitudinal multicenter and multinational study. The Leukoaraiosis and Disability Study, a collaboration aimed at assessing leukoaraiosis as an independent predictor of the transition to disability in older people. Six hundred thirty-nine nondisabled subjects (288 men, 351 women, mean age+/-standard deviation 74.1+/-5.0) with magnetic resonance imaging-detected leukoaraiosis of different severity and presenting with one of the following: mild cognitive or motor disturbances, minor cerebrovascular events, or mood alterations or in whom leukoaraiosis was incidentally identified. Centralized assessment of leukoaraiosis severity according to the three severity degrees of the Fazekas scale; Disability Assessment for Dementia (DAD) Scale for measurement of global functioning. At baseline, 44% of participants had a mild, 31% a moderate, and 25% a severe degree of leukoaraiosis. A significant trend toward declining performance on the DAD Scale was apparent with increasing leukoaraiosis score severity (total score=98.8, 98.6, 97.5, respectively, in the three leukoaraiosis categories, analysis of variance P=.002). Similar trends were obtained for basic (P=.01) and instrumental (P<.001) function items. The statistical significance of these differences was confirmed in a multiple linear regression analysis correcting for numerous factors known to influence disability in older people. Executive function test performance declined along with increasing leukoaraiosis severity and was significantly related to DAD total score. Even in nondisabled elderly patients, levels of functional ability are related to white matter lesion severity. Executive dysfunction may mediate this relationship.

Elevated body mass index is associated with executive dysfunction in otherwise healthy adults

There is growing evidence that obesity is linked to adverse neurocognitive outcome, including reduced cognitive functioning and Alzheimer disease. However, no study to date has determined whether the relationship between body mass index (BMI) and cognitive performance varies as a function of age. We examined attention and executive function in a cross-section of 408 healthy persons across the adult life span (20-82 years). Bivariate correlation showed that BMI was inversely related to performance on all cognitive tests. After controlling for possible confounding factors, overweight and obese adults (BMI > 25) exhibited poorer executive function test performance than normal weight adults (BMI, 18.5-24.9). No differences emerged in attention test performance, and there was no evidence of a BMI × age interaction for either cognitive domain. These results provide further evidence for the relationship between elevated BMI and reduced cognitive performance and suggest that this relationship does not vary with age. Further research is needed to identify the etiology of these deficits and whether they resolve after weight loss.