EXECUTIVE COGNITIVE-ABILITIES AND FUNCTIONAL STATUS AMONG COMMUNITY-DWELLING OLDER PERSONS IN THE SAN-LUIS VALLEY HEALTH AND AGING STUDY

OBJECTIVES: The purpose of this study was to evaluate the contribution of the executive cognitive functions to self-reported and observed pe rformance of activities of daily living and instrumental activities of daily living. DESIGN: These data were collected as part of a cross-se ctional survey of community-dwelling older persons, using statistical sampling, in a two-county area of southern Colorado. SETTING: Particip ants were interviewed and administered measures of general cognition, depression, executive functioning, and performance of self-care and in strumental activities, either in their homes or at the study clinic. P ARTICIPANTS: A total of 1158 community-dwelling persons between the ag es of 60 and 99 participated. Of these, 657 were female, 501 were male , 637 were Hispanic, and 521 were non-Hispanic whites. MEASUREMENTS: S ubjects were administered the Mini-Mental State Exam (MMSE), a measure of executive functioning (the Behavioral Dyscontrol Scale), the Cente r for Epidemiologic Studies Depression scale (CES-D), and the Structur ed Assessment of Independent Living Skills (SAILS, a measure of observ ed performance of daily tasks). They also were interviewed regarding t heir reported ADL and IADL status using measures from the Longitudinal Study on Aging. RESULTS: Both general mental status and executive fun ctioning demonstrated statistically significant univariate association s with all seven functional status measures (both self-report and obse rved performance). In a series of ordinary least squares regression mo dels, executive functioning was a predictor for self-reported ADLs and observed performance of complex IADL tasks such as managing money and medications. Mental status did not predict self-reported functioning but was a predictor of observed performance. Depression was a signific ant variable for self-report measures but not for observed performance . Executive functioning and general mental status demonstrated some de gree of independence from one another. CONCLUSION: Executive functioni ng is an important determinant of functional status for both self-repo rted and observed ADLs and IADLs and should be assessed routinely when evaluating the mental status and functional abilities of older people . These results replicate and extend previous research on executive fu nctioning among older persons by examining these factors in a large bi -ethnic community sample.