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Feasibility of exploring executive functions in long-term care residents: Screening Executive Tests for the Elderly

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2024. Ressources en ligne : Abrégé : Impairment of cognitive functions is the primary reason for admission to long-term care units, with executive functions playing a pivotal role in dependency and behavioral issues. These functions pose significant challenges for nursing staff with regard to providing care. However, the assessment of executive functions in older individuals residing in nursing homes often relies on tests that are both time-consuming and difficult for this demographic. In many instances, executive functions are either not assessed or only examined in broad terms. Objective. The objective of this study was to analyze the feasibility of assessing the executive functions of nursing home residents, specifically aiming to distinguish subcomponents such as mental flexibility, working memory, planning, and inhibition. The residents included in the study underwent executive function assessments over three visits, and various tests were used for each subcomponent. Methods. Out of 530 residents, 46 gave their consent and 38 completed the three visits, with an average age of 90 ± 5 years (76.2% women) and a median Mini-Mental State Examination score of 20/30. Feasibility was evaluated based on the test being executed and the frequency of interruptions due to difficulty or fatigue on the part of the resident. Results. Only four tests proved suitable for older individuals in nursing homes. We propose grouping them into a battery named SETE (Screening Executive Tests for the Elderly). The four tests included the conflicting instructions subtest from the FAB test, the alpha test, the clock test, and the verbal span test. Conclusion. The use of these four tests would make it possible to build a map of executive function impairment by subcomponent. Enhanced knowledge of executive functions in long-term care residents will facilitate better adapted dependency management and the implementation of non-pharmacological interventions for behavioral disorders.
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Impairment of cognitive functions is the primary reason for admission to long-term care units, with executive functions playing a pivotal role in dependency and behavioral issues. These functions pose significant challenges for nursing staff with regard to providing care. However, the assessment of executive functions in older individuals residing in nursing homes often relies on tests that are both time-consuming and difficult for this demographic. In many instances, executive functions are either not assessed or only examined in broad terms. Objective. The objective of this study was to analyze the feasibility of assessing the executive functions of nursing home residents, specifically aiming to distinguish subcomponents such as mental flexibility, working memory, planning, and inhibition. The residents included in the study underwent executive function assessments over three visits, and various tests were used for each subcomponent. Methods. Out of 530 residents, 46 gave their consent and 38 completed the three visits, with an average age of 90 ± 5 years (76.2% women) and a median Mini-Mental State Examination score of 20/30. Feasibility was evaluated based on the test being executed and the frequency of interruptions due to difficulty or fatigue on the part of the resident. Results. Only four tests proved suitable for older individuals in nursing homes. We propose grouping them into a battery named SETE (Screening Executive Tests for the Elderly). The four tests included the conflicting instructions subtest from the FAB test, the alpha test, the clock test, and the verbal span test. Conclusion. The use of these four tests would make it possible to build a map of executive function impairment by subcomponent. Enhanced knowledge of executive functions in long-term care residents will facilitate better adapted dependency management and the implementation of non-pharmacological interventions for behavioral disorders.

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