The Frequency of Executive Cognitive Impairment in Elderly Rehabilitation Inpatients

Abstract

The aim of this study was to determine the frequency of executive cognitive dysfunction in a sample of elderly patients in 2 rehabilitation wards in Wellington, New Zealand. All patients in 2 wards over a 2-month period were approached and invited to complete a brief neuropsychological battery. Sixty-two patients volunteered, of whom 52 completed at least 3 of the 4 measures of executive functioning. The frequency of executive dysfunction in the resulting sample of 52 was determined. Impaired executive function was defined as impaired performance on at least 2 executive function tests. The authors administered the Hayling-Brixton tests, the verbal fluency test, the Trail-Making Test, the Mini-Mental State Examination (MMSE), and the Geriatric Depression Scale. Patients’ behavior was rated for executive problems on the Dysexecutive Questionnaire by themselves and by a nurse. The frequency of executive impairment was high at 13 out of 52 patients (25%). Only 1 of these 13 patients with executive difficulties was impaired according to their MMSE score. Screening for executive impairment among older rehabilitation inpatients is a necessary part of their medical management and rehabilitation. This should involve more than just administering the MMSE at admission. Several brief methods for screening for executive impairment are now available.

Keywords

executive cognitive impairment elderly inpatients rehabilitation

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