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Screening Older Adults for Executive Dysfunction

Kennedy, Gary J. MD; Smyth, Carole A. MSN, ANP-GNP, APRN, BC

AJN The American Journal of Nursing: December 2008 - Volume 108 - Issue 12 - p 62–71
doi: 10.1097/01.NAJ.0000341886.15318.20
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Studies suggest that executive cognitive dysfunction can more reliably predict loss of autonomy than memory impairment can. Executive cognitive function allows for abstract thought, the planning and taking of actions toward a goal, and adaptation to the unexpected. And because executive function and memory operate in distinct regions of the brain, executive dysfunction can occur even when memory isn't impaired. The detection of executive dysfunction is essential to helping a patient remain as safe and independent as possible. Watch a free video demonstrating best practices for evaluating executive dysfunction in older adults at http://links.lww.com/A326.

The detection of executive dysfunction is essential to helping a patient remain as safe and independent as possible. The authors review several "best-practice" approaches.

Gary J. Kennedy is director of the Division of General Psychiatry, and Carole A. Smyth is an NP in the Medical House Call Program, at Montefiore Medical Center in Bronx, NY.

Contact author: Gary J. Kennedy, gkennedy@montefiore.org. The authors of this article have no significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.

How to Try This is a three-year project funded by a grant from the John A. Hartford Foundation to the Hartford Institute for Geriatric Nursing at New York University's College of Nursing in collaboration with AJN. This initiative promotes the Hartford Institute's geriatric assessment tools, Try This: Best Practices in Nursing Care to Older Adults:www.hartfordign.org/trythis. The series will include articles and corresponding videos, all of which will be available for free online at www.nursingcenter.com/AJNolderadults. Nancy A. Stotts, EdD, RN, FAAN (nancy.stotts@nursing.ucsf.edu), and Sherry A. Greenberg, MSN, APRN, BC, GNP (sherry@familygreenberg.com), are coeditors of the print series. The articles and videos are to be used for educational purposes only.

Routine use of Try This tools or approaches may require formal review and approval by your employer.

An essential refinement in cognitive assessment.

© 2008 Lippincott Williams & Wilkins, Inc.