Background: Some executive functions may be selectively impaired in normal aging over and above the general cognitive decline. Methods: We examined the performance of healthy high functioning young (n = 77) and older (n = 57) individuals on three ‘executive’ tests: conditional exclusion, abstraction, and inhibition of prepotent responses. We compared their relationships to each other and to other cognitive functions including attention, psychomotor speed and working memory. Results: Conditional exclusion was significantly more impaired than abstraction or inhibition in the elderly compared to the younger group and unlike them, showed a nonlinear relationship with age. These findings were independent of other cognitive functions. Analysis of PCET performance characteristics showed that older individuals were particularly impaired in attaining the last of the three achievable categories, were slower, and had fewer error monitoring resources compared to the younger group. Conclusions: Conditional exclusion shows an age-related pattern of impairment distinct from inhibition and abstraction. We propose that in healthy well-functioning individuals, it taps processes integrating task set establishment and shifting in context of accumulating information. It may thus be useful as a specific marker of complex cognitive functions in studies of normal cognitive aging and in early detection of cognitive dysfunction.

Keywords:
Cognitive impairment, Early detection, Cognitive integration, Early dementia
1.
Cabeza R, Nyberg L, Park DC (eds): Cognitive Neuroscience of Aging: Linking Cognitive and Cerebral Aging. Oxford, Oxford University Press, 2004.
2.
Hedden T, Gabrieli JD: Insights into the ageing mind: a view from cognitive neuroscience. Nat Rev Neurosci 2004;5:87–96.
3.
Silver H, Goodman C, Bilker W: Age in high-functioning healthy men is associated with nonlinear decline in some ‘executive’ functions in late middle age. Dement Geriatr Cogn Disord 2009;27:292–300.
4.
Rabbitt P: Introduction methodologies and models in the study of executive functions; in Rabbitt P (ed): Methodology of Frontal and Executive Function. Hove, Psychology Press, 1997, pp 1–38.
5.
Miyake A, Friedman NP, Emerson MJ, et al: The unity and diversity of executive functions and their contributions to complex ‘frontal lobe’ tasks: a latent variable analysis. Cognit Psychol 2000;41:49–100.
6.
Kurtz MM, Wexler BE, Bell MD: The Penn Conditional Exclusion Test (PCET): relationship to the Wisconsin Card Sorting Test and work function in patients with schizophrenia. Schizophr Res 2004;68:95–102.
7.
Burgess PW: Theory and methodology in executive function research; in Rabbitt P (ed): Methodology of Frontal and Executive Function. Hove, Psychology Press, 1997, pp 39–60.
8.
Koren D, Seidman LJ, Harrison RH, et al: Factor structure of the Wisconsin Card Sorting Test: dimensions of deficit in schizophrenia. Neuropsychology 1998;12:289–302.
9.
Gur RC, Ragland JD, Moberg PJ, Turner TH, Bilker WB, Kohler C, Siegel SJ, Gur RE: Computerized neurocognitive scanning: I. Methodology and validation in healthy people. Neuropsychopharmacology 2001;25:766–776.
10.
Glahn DC, Cannon TD, Gur RE, Ragland JD, Gur RC: Working memory constrains abstraction in schizophrenia. Biol Psychiatry 2000;47:34–42.
11.
Kurtz MM, Ragland JD, Moberg PJ, Gur RC: The Penn Conditional Exclusion Test: a new measure of executive-function with alternate forms of repeat administration. Arch Clin Neuropsychol 2004;19:191–201.
12.
Silver H, Goodman C: Impairment in error monitoring predicts poor executive function in schizophrenia patients. Schizophr Res 2007;94:156–163.
13.
Silver H, Goodman C, Bilker W, Gur RC, Isakov V, Knoll G, Feldman P: Impaired error monitoring contributes to face recognition deficit in schizophrenia patients. Schizophr Res 2006;85:151–161.
14.
Gur RC, Raland JD, Moberg PJ, et al: Computerized neurocognitive scanning: II. The profile of schizophrenia. Neuropsychopharmacology 2001;25:777–788.
15.
Silver H, Goodman C, Bilker WB Knoll G, Gur RC, Povar G: Suboptimal processing strategy and working memory impairments predict abstraction deficit in schizophrenia. J Clin Exp Neuropsychol 2007;29:823–830.
16.
Silver H, Feldman P, Bilker W, et al: Working memory deficit as a core neuropsychological dysfunction in schizophrenia. Am J Psychiatry 2003;160:1809–1816.
17.
Silver H, Goodman C, Knoll G, et al: Schizophrenia patients with a history of severe violence differ from nonviolent schizophrenia patients in perception of emotions but not cognitive function. J Clin Psychiatry 2005;66:300–308.
18.
Feder PI: The log likelihood ratio in segmented regression. Ann Stat 1975;3:84–97.
19.
Csörgõ M, Horváth L: Limit Theorems in Change-Point Analysis. New York, Wiley & Sons, 1997.
20.
Tucker-Drob EM, Salthouse TA: Adult age trends in the relations among cognitive abilities. Psychol Aging 2008;23:453–460.
21.
Raz N, Lindenberger U, Rodrigue KM, Kennedy KM, Head D, Williamson A, Dahle C, Gerstorf D, Acker JD: Regional brain changes in aging healthy adults: general trends, individual differences and modifiers. Cereb Cortex 2005;15:1676–1689.
22.
Stern Y: Cognitive reserve. Neuropsychologia 2009;47:2015–2028.
23.
Mutter SA, Pliske RM: Aging and illusory correlation in judgments of co-occurrence. Psychol Aging 1994;9:1:53–63.
24.
Tversky A, Kahneman D: Availability: a heuristic for judging frequency and probability. Cognit Psychol 1973;5:207–232.
25.
Sarter M, Turchi J: Age and dementia associated impairments in divided attention: psychological constructs, animal models, and underlying neuronal mechanisms. Dement Geriatr Cogn Disord 2002;13:46–58.
26.
Sharp DJ, Scott SK, Mehta MA, Wise RJ: The neural correlates of declining performance with age: evidence for age related changes in executive control. Cereb Cortex 2006;16:1739–1749.
27.
De Sanctis P, Gomez-Ramirez M, Sehatpour P, Wylie GR, Foxe JJ: Preserved executive function in high performing elderly is driven by large-scale recruitment of prefrontal cortical mechanisms. Hum Brain Mapp 2009;30:4198–4214.
28.
Gold JM, Hahn B, Strauss GP, Waltz JA: Turning it upside down: areas of preserved cognitive function in schizophrenia. Neuropsychol Rev 2009;19:294–311.
29.
Sakai K: Task set and prefrontal cortex. Annu Rev Neurosci 2008;31:219–245.
30.
Ridderinkhof KR, Ullsperger M, Crone EA, Nieuwenhuis S: The role of the medial frontal cortex in cognitive control. Science 2004;306:443–447.
31.
Tsujimoto S, Genovesio A, Wise SP: Evaluating self-generated decisions in frontal pole cortex of monkeys. Nat Neurosci 2010;13:120–126.
32.
Elderkin-Thompson V, Ballmaier M, Hellemann G, Pham D, Kumar A: Executive function and MRI prefrontal volumes among healthy older adults. Neuropsychology 2008;22:626–637.
33.
Luebke J, Barbasa H, Peters A: Effects of normal aging on prefrontal area 46 in the rhesus monkey. Brain Res Rev 2010;6:212–232.
34.
Robbins TW, Arnsten AFT: The neuropsychopharmacology of fronto-executive function: monoaminergic modulation. Annu Rev Neurosci 2009;32:267–287.
35.
Badre D, Hoffman J, Cooney JW, D’Esposito M: Hierarchical cognitive control deficits following damage to the human frontal lobe. Nat Neurosci 2009;12:515–522.
36.
Moghaddam B, Homayoun H: Divergent plasticity of prefrontal cortex networks. Neuropsychopharmacology 2008;33:42–55.
37.
Dickstein DL, Kabaso D, Rocher A, Luebke JI, Wearne SL, Hof PR: Changes in the structural complexity of the aged brain. Aging Cell 2007;6:275–284.
38.
Bretsky P, Guralnik JM, Launer L, Albert M, Seeman TE: The role of APOE-4 in longitudinal cognitive decline. MacArthur Studies of Successful Aging. Neurology 2003;60:1077–1081.
39.
Nagel IE, Chicherio C, Li SC, von Oertzen T, Sander T, Villringer A, Heekeren HR, Bäckman L, Lindenberger U: Human aging magnifies genetic effects on executive functioning and working memory. Front Hum Neurosci 2008;2:1.
40.
Lee BK, Glass TA, Wand GS, McAtee MJ, Bandeen-Roche K, Bolla KI, Schwartz BS: Apolipoprotein e genotype, cortisol, and cognitive function in community-dwelling older adults. Am J Psychiatry 2008;165:1456–1464.
41.
Olson BL, Holshouser BA, Britt W 3rd, Mueller C, Baqai W, Patra S, Petersen F, Kirsch WM: Longitudinal metabolic and cognitive changes in mild cognitive impairment patients. Alzheimer Dis Assoc Disord 2008;22:269–277.
42.
Robbins TW, Arnstein AFT: The neuropsychopharmacology of fronto-executive function: monoaminergic modulation. Annu Rev Neurosci 2009;32:267–287.
43.
Verhaeghen P, Cerella J: Aging, executive control, and attention: a review of meta-analyses. Neurosci Biovbehav Rev 2002;26:849–857.
44.
Lee T, Henry JD, et al: Genetic influences on cognitive functions in the elderly: a selective review of twin studies. Brain Res Rev 2010;64:1–13.
45.
Petersen RC, Roberts RO, et al: Prevalence of mild cognitive impairment is higher in men. The Mayo Clinic Study of Aging. Neurology 2010;75:889–897.
46.
Kraemer HC, Yesavage JA, Taylor JL, et al: How can we learn about developmental processes from cross-sectional studies, or can we? Am J Psychiatry 2000;157:163–171.
47.
Carlson MC, Xue Q, Zhou J, Fried LP: Executive decline and dysfunction precedes declines in memory: the Women’s Health and Aging Study II. J Gerontol A Biol Sci Med Sci 2009;64:110–117.
48.
Grady CL, Haxby JV, Horwitz B, et al: Longitudinal study of the early neuropsychological and cerebral metabolic changes in dementia of the Alzheimer type. J Clin Exp Neuropsychol 1988;10:576–596.
49.
Baddeley AD, Bressi S, Della Sala S, Logie R, Spinnler H: The decline of working memory in Alzheimer’s disease: a longitudinal study. Brain 1991;114:2521–2542.
50.
Albert M, Blacker D, Moss MB, Tanzi R, McArdle JJ: Longitudinal change in cognitive performance among individuals with mild cognitive impairment. Neuropsychology 2007;21:158–169.
51.
Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E: Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303–308.
52.
Follett KJ, Hess TM: Aging, cognitive complexity, and the fundamental attribution error. J Gerontol B Psychol Sci Soc Sci 2002;57:P312–P323.
53.
Heuninckx S, Wenderoth N, Debaere F, Peeters R, Swinnen SP: Neural basis of aging: the penetration of cognition into action control. J Neurosci 2005;25:6787–6796.
© 2010 S. Karger AG, Basel
2010
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.