Date on Master's Thesis/Doctoral Dissertation
Psychological and Brain Sciences
Clinical Psychology, PhD
Executive functions (Neuropsychology); Mild cognitive impairment--Diagnosis; Alzheimer's disease--Diagnosis
This study examined the utility of older adults’ awareness of their executive functioning abilities to predict future cognitive decline. The recently revised Cognitive Awareness Model (CAM) forms the conceptual background of this approach, and suggests that executive dysfunction disrupts awareness in a manner distinct from episodic memory dysfunction. The study design examined how awareness of executive functioning ability may predict both continuous decline on neuropsychological testing and qualitative change in diagnostic status. This form of prediction was tested using a longitudinal sample (n = 661) of older adults with either normal cognition, mild cognitive impairment (MCI), or Alzheimer’s disease (AD). Executive functioning awareness was operationalized as Everyday Cognition (ECog) questionnaire discrepancy scores, made up of the difference between informant and subject reports of daily task efficiency. Executive functioning discrepancy scores were shown to have moderate utility at predicting cognitive decline on several measures and modest utility at predicting diagnostic change. However, modest convergent validity and low discriminant validity were observed for executive functioning discrepancy scores in the context of memory discrepancy scores. Future research directions are reviewed, including the need to document the time course of early memory awareness deficits vs. early executive functioning awareness deficits.
Carmasin, Jeremy Stark, "Awareness of executive functioning as a diagnostic tool for mild cognitive impairment and Alzheimer's disease." (2015). Electronic Theses and Dissertations. Paper 2260.