Role of Executive Dysfunction and Dysexecutive Behavior in Late-Life Depression and Disability

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d13353934e143">Objective</h5> <p id="P1">Both executive dysfunction (ED) measured by performance-based tasks, and dysexecutive behavior (DB) measured by behavioral rating scales, contribute to late-life depression and co-morbid disability. There is a modest positive association of ED and DB, but less is known about their relative contributions to core aspects of neuropsychiatric conditions, and whether they provide unique or redundant information. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d13353934e148">Methods</h5> <p id="P2">Latent variable analyses were applied to ED, DB, depression, and disability data from 220 older patients with major depression and ED who had been enrolled in a psychosocial treatment study of depression. ED measures included the Trail Making Test, part B (TMB), Stroop Color Word Interference Test (CWIT), and Hopkins Verbal Learning Test-trail one (HVLT-1). The executive dysfunction scale from the Frontal Systems Behavior Scale (FrSBe), self and other-rated, served as the ratings-based measure of DB. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d13353934e153">Results</h5> <p id="P3">The measurement model, with all four latent variables related to one another demonstrated good fit (RMSEA = .06). In the structural models, DB was associated with both depression (β=.61) and disability (β=.42), while ED was associated with depression (β=.43) but not with disability (β= .16). Social problem-solving accounted for 49% of the influence of DB on late-life depression, while ED was not related to social problem-solving. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d13353934e158">Conclusion</h5> <p id="P4">ED and the lesser studied DB measures offer unique and complementary information. DB was robustly associated with late-life depression and disability. Patients with depression and executive dysfunction may be more likely to develop disability when they exhibit dysexecutive behavior and social problem-solving difficulties. </p> </div>