The relationship between baseline executive functioning and treatment response for individuals with mild cognitive impairment receiving cognitive rehabilitation

Amanda L Gooding, Fordham University


Cognitive rehabilitation (CR) for Mild Cognitive Impairment (MCI) and early Alzheimer's disease (AD) is becoming more readily available to the geriatric population in an attempt to curb the insidious decline in cognitive and functional performance. However, there is a dearth of research regarding the factors that are associated with a better response to CR, specifically the role of baseline neuropsychological status, in this population. Based on neurodevelopmental trajectories of neuropsychological decline and current research on the neurobiological changes associated with the frontal lobe systems, the impact of executive functioning on treatment response is a particularly salient topic to be evaluated in the context of CR. As such, the primary aims of this investigation were to determine whether: 1) participants' baseline executive functioning is associated with changes in learning and memory performance after completion of CR treatment; and 2) whether baseline executive functioning moderates treatment response and has a differential impact, depending on whether participants receive different types of CR. Methods: Seventy-four participants with MCI were recruited. All participants underwent neuromedical and psychiatric screening before recruitment, as well as comprehensive neuropsychological evaluations at baseline and at four-month follow-up. Participants were randomly assigned to one of three treatment groups, which included generic CR, Cognitive Vitality Training (CVT; i.e., generic CR plus motivational instructional techniques), or an active control condition (i.e., commercially available crossword puzzles, Sudoku, etc.). Results: Baseline executive functioning was not significantly related to changes in verbal and nonverbal learning and memory performance after completion of treatment across the entire MCI sample. Additionally, executive functioning did not moderate the relationship between treatment condition and changes in performance on measures of verbal and nonverbal learning and memory. Conclusions: The current findings were divergent from prior research that suggests that executive functioning is a predictor of treatment response following completion of rehabilitation programs for other neurologic populations, including stroke or traumatic brain injury (TBI). However, this study was significantly limited by restricted variance in the range of the executive functioning scores, since the majority of participants performed well above average on both of the two primary measures of executive functioning.

Subject Area

Clinical psychology|Experimental psychology|Cognitive psychology

Recommended Citation

Gooding, Amanda L, "The relationship between baseline executive functioning and treatment response for individuals with mild cognitive impairment receiving cognitive rehabilitation" (2014). ETD Collection for Fordham University. AAI3643069.