Prevalence of Impaired Executive Functions

NCT05311969 | Completed

• 1 other identifier: EXEPA
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 8

Brief Summary

The evaluation of executive functions, as well as the means of stimulating and preserving them, are at the heart of the challenges for maintaining a level of functional autonomy in the elderly, but also during the loss of this functional autonomy and when entering a situation of dependence and/or dementia. Research that has demonstrated the preponderant role of executive functions on functional abilities are examples of this. Components such as planning, organization, initiation, mental flexibility appear to be strongly correlated with the effective performance of complex activities of daily living. In addition, the capacities for autonomy were found to be significantly reduced, and significantly with the severity of the executive deficits. In addition, if these data have since contributed to determining a level of impairment of the executive processes specific to an early loss of autonomy, they are so in the context of early diagnosis of dementia and validation of a detection tool, early loss of autonomy. The scientific advances of the last five years contribute to a better understanding of the impact of executive disorders, but on the other hand, the diversity of the explanatory phenomena of these disorders considerably complicates their nosology within neuro-evolutionary pathologies. Ultimately, an analysis of executive function disorders must take into account cognitive and behavioral aspects, that is to say, beyond performance on tests identified as involving executive functions, behavioral disorders, emotional status and level of autonomy in activities of daily living. In the state of our knowledge, the consideration of executive functions represents a strategic point at the crossroads of the evaluation of the act of care and treatment. Establishing data on the prevalence of alterations in the executive functions of residents, exploring the possibilities of evaluation with a battery of tests little used in this context and linking "executive" profiles and clinical situations seems to us a relevant and interesting first step. However essential to provide a beginning of answer to these questions. This study being an exploratory study. The results of this study will constitute new prevalence data in the population of residents of nursing homes. The aim here is to establish data on the prevalence of alterations in the executive functions of residents, to explore the possibilities of evaluation with a battery of tests little used in this context and to relate the profiles "executives" and clinical situations. This in order to develop a methodology to draw up a general assessment, and to make comparisons of the different profiles, inter/intra pathologies and stages of evolution. Thus, a more in-depth knowledge of the specific profiles of Nursing Home residents will also lead to the reflection of pharmacological and non-pharmacological therapeutic strategies. Finally, it will ultimately be a question of presenting an inventory of the situation of Nursing Home to alert public policies. The main objective is to study the prevalence of impaired executive functions in nursing home residents. The secondary objectives are to explore the feasibility of carrying out executive function tests and to examine the coorelationbetween the levels of impairment of executive functions and the clinical and functional characteristics of residents.

Conditions

Executive Dysfunctions

Keywords

executive functions; nursing home; resident; dependence

Outcome Measures

Primary Outcomes (1)

• Prevalence of executive functions impairment

  12 months

Secondary Outcomes (3)

• Rate of passed tests

  12 months

• Correlation between executive functions impairment and percentage of dependence residents Correlation between executive functions impairment and percentage of residents with

  12 months

• Correlation between executive functions impairment and behavioral disorders

  12 months

Study Arms (1)

groups/cohort

EXPERIMENTAL

participants will perform the various neuropsychological tests provided for in the protocol

Other: cognitive evaluations and non cognitive evaluations

Interventions

cognitive evaluations and non cognitive evaluations OTHER

Cognitive evaluations with executive functions evaluations : * Mini Mental State Examination * Stroop Victoria Test * Hayling test * Frontal Assessment Battery test mental flexibility: * Trial Making Test (TMT) A and B * Connection test * Alphaflex test * Verbal and visuospatial working memory * Wechsler Adult Intelligence Scale (WAIS) span * Visuo-spatial span * Visuo-spatial span simplified version * Month Of the Year Backwards (MOTYB) Planning * Tinker Toy test * Clock Test Non-cognitive evaluations: The Katz Autonomy Scale Neuropsychiatric Inventory version Care team Geriatric Depression Scale 15-item version Apathy inventory

groups/cohort

Eligibility Criteria

• Age: 75 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• Permanent resident in Nursing Home or in temporary accommodation for more than 3 months
• speak and understand the French language
• Mini Mental State Examination (MMSE) between 7 and 24 dating from 8 maximum days
• Compulsorily affiliated with a social security scheme
• Agree to participate in the study in agreement with the trusted person (if applicable)
• co-signatures of the Consent Form between the investigator and the participant or the person of trust (if applicable)

You may not qualify if:

• Refusal to sign the consent form
• Resident in a specialized unit for behavioral disorders (Cognitive Behavioral Unit (CBU), Reinforced Accommodation Unit (RAU), Disoriented Elderly Unit (DEU), Centers of Natural Activities Drawn from Useful Occupations (NADUO) et cetera)
• Communication difficulties, sensory and/or motor deficits
• Medical contraindication in relation to a psychological state that could be altered due to participation in the study
• Resident at end of life (life expectancy \< 3 months)
• Resident under legal protection

Sponsors & Collaborators

• Fondation Korian pour le Bien Vieillir: lead
• Gerontopôle des Pays de la Loire: collaborator

Study Sites (8)

KORIAN La Côte Sauvage

Ars-en-Ré, 17590, France

Location

Korian Villa Louisa

Bordeaux, 33000, France

Location

Korian Villa Evora

Chartres, 28000, France

Location

Korian Le Catelli

L'Huisserie, 53970, France

Location

Korian Doubs Rivage

Montbéliard, 25200, France

Location

Korian Bois Robillard

Nantes, 44300, France

Location

Korian Le Baron

Orléans, 45000, France

Location

Korian Les Arcades

Paris, 75012, France

Location

Related Publications (18)

• Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. The unity and diversity of executive functions and their contributions to complex "Frontal Lobe" tasks: a latent variable analysis. Cogn Psychol. 2000 Aug;41(1):49-100. doi: 10.1006/cogp.1999.0734.

  PMID: 10945922 BACKGROUND

• Belleville S, Rouleau N, Van der Linden M. Use of the Hayling task to measure inhibition of prepotent responses in normal aging and Alzheimer's disease. Brain Cogn. 2006 Nov;62(2):113-9. doi: 10.1016/j.bandc.2006.04.006. Epub 2006 Jun 6.

  PMID: 16757076 BACKGROUND

• Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994 Dec;44(12):2308-14. doi: 10.1212/wnl.44.12.2308.

  PMID: 7991117 BACKGROUND

• Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000 Dec 12;55(11):1621-6. doi: 10.1212/wnl.55.11.1621.

  PMID: 11113214 BACKGROUND

• Fisk JE, Sharp CA. Age-related impairment in executive functioning: updating, inhibition, shifting, and access. J Clin Exp Neuropsychol. 2004 Oct;26(7):874-90. doi: 10.1080/13803390490510680.

  PMID: 15742539 BACKGROUND

• KATZ S, FORD AB, MOSKOWITZ RW, JACKSON BA, JAFFE MW. STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963 Sep 21;185:914-9. doi: 10.1001/jama.1963.03060120024016. No abstract available.

  PMID: 14044222 BACKGROUND

• Makino T, Umegaki H, Suzuki Y, Yanagawa M, Nonogaki Z, Nakashima H, Kuzuya M. Relationship between small cerebral white matter lesions and cognitive function in patients with Alzheimer's disease and amnestic mild cognitive impairment. Geriatr Gerontol Int. 2014 Oct;14(4):819-26. doi: 10.1111/ggi.12176. Epub 2013 Nov 12.

  PMID: 24215176 BACKGROUND

• Blanco Martin E, Ugarriza Serrano I, Elcoroaristizabal Martin X, Galdos Alcelay L, Molano Salazar A, Bereincua Gandarias R, Ingles Borda S, Uterga Valiente JM, Indakoetxea Juanbeltz MB, Moraza Lopez J, Barandiaran Amillano M, Fernandez-Martinez M. Dysexecutive syndrome in amnesic mild cognitive impairment: a multicenter study. BMC Neurol. 2016 Jun 4;16:88. doi: 10.1186/s12883-016-0607-2.

  PMID: 27260328 BACKGROUND

• Perry RJ, Hodges JR. Differentiating frontal and temporal variant frontotemporal dementia from Alzheimer's disease. Neurology. 2000 Jun 27;54(12):2277-84. doi: 10.1212/wnl.54.12.2277.

  PMID: 10881252 BACKGROUND

• Robert PH, Clairet S, Benoit M, Koutaich J, Bertogliati C, Tible O, Caci H, Borg M, Brocker P, Bedoucha P. The apathy inventory: assessment of apathy and awareness in Alzheimer's disease, Parkinson's disease and mild cognitive impairment. Int J Geriatr Psychiatry. 2002 Dec;17(12):1099-105. doi: 10.1002/gps.755.

  PMID: 12461757 BACKGROUND

• Roussel M, Lhommee E, Narme P, Czernecki V, Gall DL, Krystkowiak P, Diouf M, Godefroy O; GREFEX study group. Dysexecutive syndrome in Parkinson's disease: the GREFEX study. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2017 Sep;24(5):496-507. doi: 10.1080/13825585.2016.1226248. Epub 2016 Sep 1.

  PMID: 27585478 BACKGROUND

• Salthouse TA, Toth J, Daniels K, Parks C, Pak R, Wolbrette M, Hocking KJ. Effects of aging on efficiency of task switching in a variant of the trail making test. Neuropsychology. 2000 Jan;14(1):102-11.

  PMID: 10674802 BACKGROUND

• Stuss DT. Functions of the frontal lobes: relation to executive functions. J Int Neuropsychol Soc. 2011 Sep;17(5):759-65. doi: 10.1017/S1355617711000695. Epub 2011 May 24.

  PMID: 21729406 BACKGROUND

• Stuss DT, Alexander MP, Shallice T, Picton TW, Binns MA, Macdonald R, Borowiec A, Katz DI. Multiple frontal systems controlling response speed. Neuropsychologia. 2005;43(3):396-417. doi: 10.1016/j.neuropsychologia.2004.06.010.

  PMID: 15707616 BACKGROUND

• Tomaszewski Farias S, Cahn-Weiner DA, Harvey DJ, Reed BR, Mungas D, Kramer JH, Chui H. Longitudinal changes in memory and executive functioning are associated with longitudinal change in instrumental activities of daily living in older adults. Clin Neuropsychol. 2009 Apr;23(3):446-61. doi: 10.1080/13854040802360558. Epub 2008 Sep 23.

  PMID: 18821181 BACKGROUND

• Torralva T, Roca M, Gleichgerrcht E, Bekinschtein T, Manes F. A neuropsychological battery to detect specific executive and social cognitive impairments in early frontotemporal dementia. Brain. 2009 May;132(Pt 5):1299-309. doi: 10.1093/brain/awp041. Epub 2009 Mar 31.

  PMID: 19336463 BACKGROUND

• Torralva T, Roca M, Gleichgerrcht E, Lopez P, Manes F. INECO Frontal Screening (IFS): a brief, sensitive, and specific tool to assess executive functions in dementia. J Int Neuropsychol Soc. 2009 Sep;15(5):777-86. doi: 10.1017/S1355617709990415. Epub 2009 Jul 28.

  PMID: 19635178 BACKGROUND

• Tosto G, Zimmerman ME, Hamilton JL, Carmichael OT, Brickman AM; Alzheimer's Disease Neuroimaging Initiative. The effect of white matter hyperintensities on neurodegeneration in mild cognitive impairment. Alzheimers Dement. 2015 Dec;11(12):1510-1519. doi: 10.1016/j.jalz.2015.05.014. Epub 2015 Jun 13.

  PMID: 26079417 BACKGROUND

Study Officials

• Gilles BERRUT

  Gerontopôle des Pays de la Loire

  STUDY DIRECTOR

• Leila LAIFA-MARY

  Korian

  PRINCIPAL INVESTIGATOR

• Priscilla CLOT-FAYBESSE

  Korian

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 11, 2022
• First Posted: April 5, 2022
• Study Start: April 11, 2022
• Primary Completion: June 30, 2023
• Study Completion: July 30, 2023
• Last Updated: October 27, 2023

Record last verified: 2023-10

Locations

FR (8)