A comparison of the new executive functioning domains of the CAMCOG-R withexisting tests of executive function in elderly stroke survivors

Aim: to compare the two new executive function tests of the revised Cambrid ge Cognitive Examination (CAMCOG-R), a bedside measure of cognitive functio n, with existing neuropsychological assessments of executive function in el derly stroke survivors. Methods: we assessed 83 stroke survivors at 1 and 3 months post-strokc with the new CAMCOG-R, the Weigl colour form sorting test and Raven's coloured progressive matrices. We assessed functional recovery with the Barthel inde x and depression with the self-report 15-item geriatric depression scale. W e used descriptive statistics, Pearson correlation coefficients, paired t-t ests and principal axis factor analyses to interpret the data. Results: the new CAMCOG-R executive functioning tests showed moderate corre lation with the Weigl and Raven tests (P<0.01). Improved functional outcome as measured by the Barthel index was significantly associated with higher executive function test scores (P<0.05). Depression was significantly assoc iated with poorer performance on all tasks of executive function (P<0.05). A factor analysis of the scores on all of the neuropsychological tests reve aled a single strong factor that accounted for 66% of the variance. The CAM COG-R and the executive functioning subscales used in this population estab lished sensitivity to change over time. Conclusion: although the new executive tests of the CAMCOG-R compared reaso nably well with the Weigl and Raven neuropsychological tests, the extra tim e taken to administer the CAMCOG-R may not be justified. The new CAMCOG-R e xecutive function tests were vulnerable to the effects of depression. Final ly, the executive function tests might have provided more of a global measu re of cognitive function, raising doubts about their construct validity in our patient population.