The executive interview as a screening test for executive dysfunction in patients with mild dementia

OBJECTIVES: To validate the Executive Interview (EXIT25) as a screening instrument for executive cognitive dysfunction in patients with mild dementia. DESIGN: Validation using group comparison and correlation studies. SETTING: The Copenhagen University Hospital Memory Clinic, a multidisciplinary outpatient clinic based in a neurological setting. PARTICIPANTS: Thirty-three patients with mild dementia (MMSE score >= 20) and 30 healthy controls. MEASUREMENTS: The EXIT25, a 25-item screening instrument for executive dysfunction, was administered to all participants. Global cognitive function was measured using the MMSE. Patients were evaluated using traditional neuropsychological tests for executive dysfunction (Wisconsin Card Sorting Test, Trail Making Part B, Stroop Test, verbal fluency, design fluency, and verbal abstraction). Changes in behavior and functional impairment in activities of daily living were assessed using the Frontal Behavioral Inventory (FBI) and the Disability Assessment for Dementia Scale. RESULTS: EXIT25 scores were significantly higher in patients than in the healthy controls; MMSE scores could not account for the differences. Thirteen of the 25 items separated the two groups. EXIT25 was found to correlate significantly with the Stroop Test, the verbal fluency tests, and the FBI. CONCLUSION: The EXIT25 is able to capture executive cognitive deficits not primarily related to the general level of intellectual reduction in patients with mild dementia. In clinical practice, the EXIT25 might be a valuable supplement to the MMSE.