Journals of Gerontology Series B: Psychological Sciences and Social Sciences, Vol 54, Issue 5 S262-S270, Copyright © 1999 by The Gerontological Society of America

ARTICLES

Association between executive attention and physical functional performance in community-dwelling older women

MC Carlson, LP Fried, QL Xue, K Bandeen-Roche, SL Zeger and J Brandt
School of Hygiene & Public Health, Johns Hopkins University, Baltimore, Maryland, USA. mcarlson@jhsph.edu

OBJECTIVES: Executive functions supervise the contents of working memory, where information from long-term memory is integrated with information in the immediate present. This study examined whether executive attentional abilities were uniquely associated with the performance of complex, instrumental activities of daily living (IADLs) in cognitively intact and physically high-functioning older women. METHODS: Participants were 406 community-residing, older women aged 70- 80 years in the Women's Health and Aging Study (WHAS) II, screened to be physically high functioning and cognitively intact using the Mini- Mental State Exam. Hierarchical regression models, adjusted for demographic and disease variables, were used to evaluate the association of cognitive domains, including executive attention, memory, psychomotor speed, and spatial ability with summary measures of IADL (e.g., looking up and dialing a telephone number) and mobility- based ADL (e.g., walking 4 meters) function. RESULTS: Tests of executive attention were associated with performance on IADLs (6.6%) and, to a lesser degree, mobility-based ADLs (1%), adjusting for demographic and disease variables. In particular, the mental flexibility component of the Trail Making Test accounted for the majority of attentional variance in IADL performance. Older age, lower education, and African American race were also associated with poorer physical test performances. DISCUSSION: Executive difficulties in flexibly planning and initiating a course of action were selectively associated with slower performance of higher-order IADL tests, relative to other domains of cognition, in a high-functioning, community-based older cohort. These results suggest that executive functions may be important in mediating the onset and progression of physical functional declines.

This article has been cited by other articles:

				B. J. Hallam, N. D. Silverberg, A. K. LaMarre, I. R. A. Mackenzie, and H. H. Feldman Clinical Presentation of Prodromal Frontotemporal Dementia American Journal of Alzheimer's Disease and Other Dementias, January 1, 2008; 22(6): 456 - 467. [Abstract] [PDF]

				J. K. Johnson, L.-Y. Lui, and K. Yaffe Executive Function, More Than Global Cognition, Predicts Functional Decline and Mortality in Elderly Women J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2007; 62(10): 1134 - 1141. [Abstract] [Full Text] [PDF]

				M. Inzitari, M. Baldereschi, A. D. Carlo, M. D. Bari, N. Marchionni, E. Scafato, G. Farchi, D. Inzitari, and for the ILSA Working Group Impaired Attention Predicts Motor Performance Decline in Older Community-Dwellers With Normal Baseline Mobility: Results From the Italian Longitudinal Study on Aging (ILSA) J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2007; 62(8): 837 - 843. [Abstract] [Full Text] [PDF]

				H. H. Atkinson, C. Rosano, E. M. Simonsick, J. D. Williamson, C. Davis, W. T. Ambrosius, S. R. Rapp, M. Cesari, A. B. Newman, T. B. Harris, et al. Cognitive Function, Gait Speed Decline, and Comorbidities: The Health, Aging and Body Composition Study J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2007; 62(8): 844 - 850. [Abstract] [Full Text] [PDF]

				H. H. Dodge, Y. Du, J. A. Saxton, and M. Ganguli Cognitive Domains and Trajectories of Functional Independence in Nondemented Elderly Persons J. Gerontol. A Biol. Sci. Med. Sci., December 1, 2006; 61(12): 1330 - 1337. [Abstract] [Full Text] [PDF]

				A. K. Coppin, A. Shumway-Cook, J. S. Saczynski, K. V. Patel, A. Ble, L. Ferrucci, and J. M. Guralnik Association of executive function and performance of dual-task physical tests among older adults: analyses from the InChianti study. Age Ageing, November 1, 2006; 35(6): 619 - 624. [Abstract] [Full Text] [PDF]

				S. Studenski, M. C. Carlson, H. Fillit, W. T. Greenough, A. Kramer, and G. W. Rebok From Bedside to Bench: Does Mental and Physical Activity Promote Cognitive Vitality in Late Life? Sci. Aging Knowl. Environ., June 28, 2006; 2006(10): pe21 - pe21. [Abstract] [Full Text]

				L. L. Lavery, S. M. Starenchak, W. B. Flynn, M. A. Stoeff, R. Schaffner, and A. B. Newman The Clock Drawing Test Is an Independent Predictor of Incident Use of 24-Hour Care in a Retirement Community J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2005; 60(7): 928 - 932. [Abstract] [Full Text] [PDF]

				J. S Brach and J. M VanSwearingen Physical Impairment and Disability: Relationship to Performance of Activities of Daily Living in Community-Dwelling Older Men Physical Therapy, August 1, 2002; 82(8): 752 - 761. [Abstract] [Full Text] [PDF]

				G. E. Swan and D. Carmelli Evidence for Genetic Mediation of Executive Control: A Study of Aging Male Twins J. Gerontol. B. Psychol. Sci. Soc. Sci., March 1, 2002; 57(2): P133 - 143. [Abstract] [Full Text] [PDF]

				V. A. Freedman, H. Aykan, and L. G. Martin Aggregate Changes in Severe Cognitive Impairment Among Older Americans: 1993 and 1998 J. Gerontol. B. Psychol. Sci. Soc. Sci., March 1, 2001; 56(2): 100S - 111. [Abstract] [Full Text]