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- Title
A-4 Executive Functioning Is an Important Predictor of Life Expectancy in Those with All-Cause Dementia.
- Authors
Schaffert, Jeff; Goette, Will; Fatima, Hudaisa; LoBue, Christian; Carlew, Anne; Rossetti, Heidi; Lacritz, Laura; Cullum, Munro
- Abstract
Objective: Neuropsychiatric, functional, motor, and demographic factors have been associated with life expectancy (LE) in those with dementia. Recent findings suggested cognition (assessed by the Mini-Mental State Exam [MMSE]) to be the strongest predictor of LE in Alzheimer's disease (ad ; Schaffert et al. 2022). We evaluated if more detailed neuropsychological scores predict LE in a larger sample of individuals with all-cause dementia. Method: Participants were 4090 deceased individuals (Mage = 74.5, Meducation = 14.8, Male = 44%, White = 90%, Non-Hispanic = 96%) with all-cause dementia (at visit 1, ad = 78%) from the National Alzheimer's Coordinating Center. Three index scores [executive function/speed/attention (EFAS), language, memory] were calculated from NACC's neuropsychological batteries. Variables (from visit 1) were entered into a forward regression model (p < 0.001 as point-of-entry) to predict days of LE, and included: age, gender, race (white/non-white), ethnicity (Hispanic/Non-Hispanic), diagnosis (ad /non- ad), abnormal neurological exam (yes/no), Functional Activities Questionnaire (FAQ, total score), Neuropsychiatric Inventory Questionnaire (NPI-Q, total score), MMSE, and EFAS, language, and memory composite Z-scores. Results: Performance on the EFAS composite explained the most variance in LE (R2 = 0.065), followed by age (R2 = 0.044), diagnosis (R2 = 0.023), FAQ (R2 = 0.016), gender (R2 = 0.012), abnormal neurological exam (R2 = 0.006), NPI-Q (R2 = 0.004), language abilities (R2 = 0.003), and Hispanic ethnicity (R2 = 0.003). Plus/minus one Z-score on the EFAS composite predicted 158 days of LE, and each year of age predicted 27 days of LE. Conclusions: EFAS performance and age explained >10% of LE variance. The MMSE failed to predict LE in this model that included more detailed neuropsychological data. EFAS impairment may be a more important predictor of LE compared to other neurocognitive domains and cognitive screeners.
- Subjects
EXECUTIVE function; LIFE expectancy; ALZHEIMER'S disease; DEMENTIA; RACE; ETHNIC differences
- Publication
Archives of Clinical Neuropsychology, 2022, Vol 37, Issue 6, p1239
- ISSN
0887-6177
- Publication type
Abstract
- DOI
10.1093/arclin/acac060.004