Specific measures of executive function predict cognitive decline in older adults

Lindsay R. Clark, Dawn M. Schiehser, Gali H. Weissberger, David P. Salmon, Dean C. Delis, Mark W. Bondi

Research output: Contribution to journalArticlepeer-review

125 Scopus citations


Decline in executive function has been noted in the prodromal stage of Alzheimer's disease (AD) and may presage more global cognitive declines. In this prospective longitudinal study, five measures of executive function were used to predict subsequent global cognitive decline in initially nondemented older adults. Of 71 participants, 15 demonstrated significant decline over a 1-year period on the Dementia Rating Scale (Mattis, 1988) and the remaining participants remained stable. In the year before decline, the decline group performed significantly worse than the no-decline group on two measures of executive function: the Color-Word Interference Test (CWIT; inhibition/switching condition) and Verbal Fluency (VF; switching condition). In contrast, decliners and non-decliners performed similarly on measures of spatial fluency (Design Fluency switching condition), spatial planning (Tower Test), and number-letter switching (Trail Making Test switching condition). Furthermore, the CWIT inhibition-switching measure significantly improved the prediction of decline and no-decline group classification beyond that of learning and memory measures. These findings suggest that some executive function measures requiring inhibition and switching provide predictive utility of subsequent global cognitive decline independent of episodic memory and may further facilitate early detection of dementia.

Original languageEnglish
Pages (from-to)118-127
Number of pages10
JournalJournal of the International Neuropsychological Society
Issue number1
StatePublished - Jan 2012
Externally publishedYes


FundersFunder number
National Institute on AgingK24AG026431


    • Executive functions
    • Global cognition
    • Mild cognitive impairment
    • Prediction
    • Prodromal Alzheimer's disease
    • Switching


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