The Dysexecutive Syndrome of Alzheimer's Disease: The GREFEX Study

Article type: Research Article

Authors: Godefroy, Olivier^{a; *} | Martinaud, Olivier^b | Verny, Marc^c | Mosca, Chrystèle^d | Lenoir, Hermine^e | Bretault, Eric^f | Roussel, Martine^a | GREFEX Study Group¹

Affiliations: [a] Department of Neurology, Laboratory of Functional Neurosciences, University Hospital of Amiens, France | [b] Department of Neurology, Rouen University Hospital, France | [c] Geriatric Center, CMRR, Pitié-Salpêtrière University Hospital (AP-HP and UPMC), Paris, France | [d] Department of Neurology, CMRR, University Hospital of Grenoble, France | [e] Department of Gerontology, Broca Hospital, AP HP, Paris Descartes University, Paris, France | [f] Department of Neurology, General Hospital of Cholet, France

Correspondence: [*] Correspondence to: Dr. Olivier Godefroy, Service de Neurologie CHU Nord, 80054 Amiens cedex, France. Tel./Fax: +33 322668240; E-mail: godefroy.olivier@chu-amiens.fr.

Note: [1] Investigators for the GREFEX (Groupe de Réflexion sur l’Evaluation des Fonctions Exécutives) Study Group: P.A. Joseph, C. Ardouin, D. Le Gall, T. Meulemans, B. Pillon, C. Bertola, C. Franconie, A. Bellman, P. Azouvi, C. Bindschadler, M. Vercelletto, F. Coyette, X. Seron, P. Robert, J. de Rotrou, M. Leclercq, H. Hénon, M. Krier, P. Labauge, B. Dubois. See the acknowledgments for more information.

Abstract: Background:Dysexecutive disorders are common in early-stage Alzheimer’s disease (AD) but have yet to be characterized in detail. Objective:The objectives of the present study based on validated diagnostic criteria were to determine the frequency and characterize the profile of behavioral and cognitive dysexecutive disorders in AD. Methods:102 patients with AD (mild: n = 92; moderate: n = 10; mean MMSE score: 23.2) were examined with the GREFEX battery. Neuropsychological data were interpreted within a validated framework based on the performance levels of 780 control participants from the GREFEX study. Results:Dysexecutive syndrome was observed in 87.5% (95%CI: 79–96) of the AD patients (p = 0.0001). The dysexecutive disorder profile was characterized by prominent impairments of planning, inhibition flexibility and generation in the cognitive domain (p = 0.0001 as compared to controls for all) and global hypoactivity in the behavioral domain (p = 0.0001 as compared to controls). Conclusions:Dysexecutive syndrome is observed in over 80% of AD patients and has a distinct profile.

Keywords: Alzheimer disease, attention, dementia, executive function, mild cognitive impairment

DOI: 10.3233/JAD-140585

Journal: Journal of Alzheimer's Disease, vol. 42, no. 4, pp. 1203-1208, 2014