J Neuropsychiatry Clin Neurosci 10:426-432, November 1998
© 1998 American Psychiatric Press, Inc.
Executive Dysfunction in Alzheimer's Disease
Association With Neuropsychiatric Symptoms and Functional Impairment
Stephen T. Chen, M.D.,
David L. Sultzer, M.D.,
Charles H. Hinkin, Ph.D.,
Michael E. Mahler, M.D. and
Jeffrey L. Cummings, M.D.
Received September 15, 1997; revised November 10, 1997; accepted January 5, 1998. From the Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, and the Psychiatry Service, Veterans Affairs Medical Center–West Los Angeles, Los Angeles, California. Address correspondence to Dr. Chen, UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza C8-849, Los Angeles, CA 90024; e-mail: schen1{at}ucla.edu
Relationships between measures of executive skills and neuropsychiatric and functional status were examined in a group of 31 patients with Alzheimer's disease. Deficits in four executive skills tests were significantly associated with the Agitation/Disinhibition factor score and Total Neuropsychiatric score on the Neurobehavioral Rating Scale, as well as the Activities subscore on the Blessed Dementia Scale. The majority of these associations remained significant after covariance for Mini-Mental State Examination scores. Executive dysfunction is associated with clinically relevant neuropsychiatric symptoms and functional impairment in Alzheimer's disease. These associations may be independent of other cognitive deficits such as memory, language, and visuospatial skills, and may not be appreciated on routine clinical evaluations. Executive skills deficits, neuropsychiatric symptoms, and functional disability may emerge from shared neurobiological mechanisms.
Key Words: Alzheimer's Disease • Executive Function • Agitation
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