Executive Function and Personality Predict Instrumental Activities of Daily Living in Alzheimer Disease.
Executive Function and Personality Predict Instrumental Activities of Daily Living in Alzheimer Disease.
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DOI：
10.1016/j.jagp.2016.06.014
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发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Benedict RHB
中科院分区：
文献类型：
--
作者：
Roy S;Ficarro S;Duberstein P;Chapman BP;Dubovsky S;Paroski M;Szigeti K;Benedict RHB
以往的研究表明，执行功能（EF）和人格独立预测功能衰退。我们的目的是在考虑执行功能障碍后，确定人格特征是否能预测遗忘性轻度认知障碍（MCI）和阿尔茨海默病（AD）患者混合样本中日常生活工具活动（IADLs）的独立性。在一所大学医学中心的横断面分析中，研究了63名健康老年人（中位年龄：67.6岁，71%为女性）和119名不同程度AD（可能AD: 85；可能AD: 3；遗忘性MCI: 31）的患者（中位年龄：75.0岁，58%为女性）。采用标准化神经心理学测量、NEO五因素量表（NEO- ffi）和举报人报告的Lawton和Brody IADL量表。所有参与者都进行了神经心理学评估，包括自我和告密者报告NEO-FFI的管理。患者还接受了神经系统检查，他们的线人完成了Lawton和Brody IADL量表。当在患者样本中测试EF与人格对iadl的关系时，在考虑了年龄、教育程度和抑郁因素后，概念卡片分类、举报人开放性和举报人尽责性均显著预测iadl。此外，一项显著的相互作用表明，责任心低和执行功能障碍可以共同预测iadl的损害。人格与AD病理患者的iadl有独特的关联，这不能用EF来解释。这一发现证实了之前的猜测，即除了认知功能障碍之外，人格也是导致功能衰退的一个危险因素。早期识别易受伤害的个体可能允许干预以延长功能独立性。
Previous research shows that executive function (EF) and personality independently predict functional decline. Our objective was to determine whether personality traits predict independence with instrumental activities of daily living (IADLs), after accounting for executive dysfunction, in a mixed sample of patients with amnestic mild cognitive impairment (MCI) and Alzheimer disease (AD). In a cross-sectional analysis at a university medical center, 63 healthy older adults (median age: 67.6 years;71% women) and 119 patients (median age: 75.0 years; 58% women) with varying degrees of AD (probable AD: 85; possible AD: 3; amnestic MCI: 31) were studied. Standardized neuropsychological measures, NEO Five-Factor Inventory (NEO-FFI), and informant-report Lawton and Brody IADL scales were used. All participants underwent neuropsychological evaluation, including administration of self- and informant-report NEO-FFI. Patients additionally underwent neurologic examination, and their informants completed the Lawton and Brody IADL scale. When testing the association between EF and personality on IADLs in the patient sample, conceptual card sorting, informant-report Openness, and informant-report Conscientiousness all significantly predicted IADLs, after accounting for age, education, and depression. In addition, a significant interaction showed that low Conscientiousness and executive dysfunction, in combination, can predict impairment of IADLs. Personality has a unique association with IADLs in patients with AD pathology that is not explained by EF. The findings confirm prior speculation that personality, in addition to cognitive dysfunction, is a risk factor for functional decline. Early identification of vulnerable individuals may allow for intervention to prolong functional independence.
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