Executive dysfunction and apathy predict functional impairment in Alzheimer disease

Am J Geriatr Psychiatry. 2003 Mar-Apr;11(2):214-21.


Objective: The purpose of this study was to examine the extent to which executive cognitive dysfunction and frontally-mediated behavioral disturbances are associated with functional impairment in patients with mild-to-moderate Alzheimer disease (AD).

Methods: Patients with AD (N=45) completed the Mattis Dementia Rating Scale, and patients' caregivers completed the Frontal Systems Behavioral Inventory and a modified form of the Lawton and Brody Activities of Daily Living (ADLs) Questionnaire.

Results: Multiple-regression analyses revealed that executive cognitive dysfunction and apathy scores accounted for 44% of the variance in instrumental activities of daily living; executive cognitive dysfunction alone explained 17% of the variance in instrumental ADLs, and apathy scores explained an additional 27%. Executive dysfunction and frontal-behavioral impairment explained 28% of the variance in basic ADLs (BADLs), and, after accounting for executive dysfunction, apathy was the only symptom found to explain additional unique variance in BADLs.

Conclusion: These findings suggest that specific cognitive and behavioral symptoms are associated with functional impairment in patients with AD.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / epidemiology*
  • Alzheimer Disease / physiopathology
  • Caregivers
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology*
  • Female
  • Frontal Lobe / physiopathology
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology
  • Mood Disorders / diagnosis
  • Mood Disorders / epidemiology*
  • Neuropsychological Tests
  • Observer Variation
  • Predictive Value of Tests
  • Regression Analysis
  • Severity of Illness Index
  • Surveys and Questionnaires