A Systematic Review and Analysis of Each Domain of Executive Functions in Older Adults with Mild Cognitive Impairment
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Abstract
Introduction: Mild Cognitive Impairment (MCI) is regarded as an intermediate state between the normal cognitive decline associated with aging and more severe dementia. According to the diagnostic criteria for MCI established by the National Institute on Aging and the Alzheimer's Association, MCI is characterized by concerns regarding changes in cognition, impairment in one or more executive domains, and the preservation of independence in functional abilities. Aim: The aim of this systematic review was to establish the magnitude of impairment in each domain of executive function (working memory, attention, cognitive flexibility, inhibition, problem solving, and planning) in older adults with MCI. Methods: This review study used the guidelines of PRISMA (Preferred Reporting Items) for systematic review and meta-analysis of the included studies. Out of 2092 searched records, 10 clinical studies met the eligibility criteria and were included with data for systematic review and meta-analysis. According to Diamond’s (2013) model, executive function measures were coded separately according to the following its components: working memory, inhibitory control, cognitive flexibility, planning, attention, and processing speed. Results: Global effect size (ES) for executive functions was significantly found (g=−0.28; 95% confidence interval [CI] = [−0.51; −0.06]; Z=−2.53; p= 0.01). Subgroup analysis revealed that ES was significant and large for working memory and moderate for cognitive flexibility. The effect size for attention, inhibitory control, and planning was found to be non-significant. Conclusion: Working memory and cognitive flexibility were more impaired in older adults with MCI as compared to inhibition, attention, and planning ability.
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