Executive control function: A rational basis for the diagnosis of vascular dementia.

  • Román G
  • Royall D
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Abstract

The authors propose a new definition of vascular dementia (VaD) based on executive dysfunction and formal assessment of executive control functions for the diagnosis of VaD. The instruments proposed are the rapid screening executive clock-drawing task (CLOX; Royall et al, 1998), and the more comprehensive Executive Interview Test (EXIT25; Royall et al, 1992). Extensive application of these tests in elderly subjects in retirement communities has shown that both are brief, simple to administer, and more sensitive case-finding tool for cognitively impaired individuals than the Mini-Mental State Examination (MMSE). The three tests (CLOX, EXIT25, MMSE) accurately separate nondemented subject from those with cortical or subcortical (frontal system) dementias. In addition, for controlled clinical trials of VaD, formal evaluation of motor and frontal sphincter functions—usually not considered part of the dementia syndrome-should also be included. Evaluation of gait and falls, timed-walk, manual dexterity, timed finger-tapping, and front bladder control should improve determination of functional status and disability, and more accurately measure the effects of potential therapies. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Author-supplied keywords

  • Cognitive Processes
  • Neuropsychological Assessment
  • Psychodiagnosis
  • Vascular Dementia
  • executive control function & formal assessment pro

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Authors

  • Gustavo C Román

  • Donald R Royall

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