The assessment of executive function abilities in healthy and neurodegenerative aging-A selective literature review

Numerous studies have examined executive function (EF) abilities in cognitively healthy older adults and those living with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Currently, there are no standard accepted protocols for testing specific EFs; thus, researchers have used their preferred tool, which leads to variability in assessments of decline in a particular ability across studies. Therefore, there is a need for guidance as to the most sensitive tests for assessing EF decline. A search of the most current literature published between 2000 and 2022 on EF studies assessing cognitively healthy older adults and individuals living with MCI and AD was conducted using PubMed/Medline, PsycINFO, Embase, Web of Science, and Google Scholar. Emphasis was placed on the EF's dual-tasking, inhibition, shifting or switching, and working memory updating. Many tasks and their outcomes were reviewed. Of particular importance was the difference in outcomes for tasks applied to the same group of participants. These various EF assessment tools demonstrate differences in effectively identifying decline in EF ability due to the aging process and neurodegenerative conditions, such as MCI and AD. This review identifies various factors to consider in using particular EF tasks in particular populations, including task demand and stimuli factors, and also when comparing differing results across studies.

Persisting inhibition biases efficient rule inference under uncertainty

Introduction

Task set inhibition supports optimal switching among tasks by actively suppressing the interference from recently executed competing task sets. It is typically studied in cued task-switching paradigms where there is no uncertainty about the task set or rule to prepare for on each trial. While inhibition has been shown to influence the speed and the accuracy of task execution, affecting task set retrieval, preparation, or implementation in conditions of task set switching, it remains uninvestigated whether it also affects rule selection under uncertainty.

Methods

We implemented an ad-hoc four-rule card sorting task and categorized the rules selected by participants after a rule shift according to the recency of their last usage. We included a measure of working memory capacity (WMC) to control for its involvement in the rule selection process.

Results

Participants exhibited a reduced preference for recently abandoned rules than less recently abandoned ones. Furthermore, we found that such a preference was not associated with WMC.

Discussion

The results suggest that decision-making processes underlying rule inference and selection may be influenced by task-set inhibition, configuring as a conflict adjustment mechanism to the sequential history of rules application.

Split-half reliability estimates of an online card sorting task in a community sample of young and elderly adults

Executive function is vital for normal social, cognitive, and motor functions. Executive function decline due to aging increases the risk of disability and falls in older adults, which has become an urgent public health issue. Fast and convenient neuropsychological tools are thus needed to identify high-risk groups as early as possible to conduct a timely intervention. Card sorting tasks, such as Wisconsin Card Sorting Task (WCST) and its variants, are popular tools for measuring executive function. This study investigated the reliability of an open-source, self-administered, online, short-version card sorting task with a sample of young (n = 107, 65 females, age: M = 30.1 years, SD = 5.5 years) and elderly Chinese (n = 113, 53 females, age: M = 64.0 years, SD = 6.7 years). We developed an automated scoring and visualization procedure following the recent recommendations on scoring perseverative responses to make the results comparable to the standardized WCST. Reliability estimates of commonly used measures were calculated using the split-half method. All task indices' reliabilities were reasonably good in both old and young groups except for "failure-to-maintain-set." Elderly Chinese adults showed compromised task performance on all measures compared with the young Chinese adults at the group level. The R script of automated scoring and estimation of reliability is publicly available.

Multivariate associations between dopamine receptor availability and risky investment decision-making across adulthood

Enhancing dopamine increases financial risk taking across adulthood but it is unclear whether baseline individual differences in dopamine function are related to risky financial decisions. Here, thirty-five healthy adults completed an incentive-compatible risky investment decision task and a PET scan at rest using [11C]FLB457 to assess dopamine D2-like receptor availability. Participants made choices between a safe asset (bond) and a risky asset (stock) with either an expected value less than the bond ("bad stock") or expected value greater than the bond ("good stock"). Five measures of behavior (choice inflexibility, risk seeking, suboptimal investment) and beliefs (absolute error, optimism) were computed and D2-like binding potential was extracted from four brain regions of interest (midbrain, amygdala, anterior cingulate, insula). We used canonical correlation analysis to evaluate multivariate associations between decision-making and dopamine function controlling for age. Decomposition of the first dimension (r = 0.76) revealed that the strongest associations were between measures of choice inflexibility, incorrect choice, optimism, amygdala binding potential, and age. Follow-up univariate analyses revealed that amygdala binding potential and age were both independently associated with choice inflexibility. The findings suggest that individual differences in dopamine function may be associated with financial risk taking in healthy adults.

An Item Response Theory Analysis of the Wisconsin Card Sorting Test in Normal Aging, Alzheimer's Disease and Parkinson's Disease: Neurophysiological Approach

The Wisconsin Card Sorting Test (WCST) is widely used to assess executive function, specifically mental flexibility. Item Response Theory (IRT) has several advantages over classical test theory, including the invariance of the measure. This study aimed to apply IRT to study the psychometric properties of WCST in control subjects and patients with idiopathic Parkinson's disease (PD) and Alzheimer's disease (AD). The sample consisted of 86 controls, 77 Parkinson's disease subjects, and 155 AD subjects. The Rasch model was applied to binary data from the conversion to percentiles adjusted for age and schooling. The R program was used to calibrate the difficulty parameter. The characteristic curves of the items and the estimation of the difficulty parameter for each diagnostic group were obtained. WCST makes it possible to separate between different skill levels among the three diagnostic entities and its application may be useful for other neuropsychological tests. In conclusion, WCST has good clinical sensitivity and excellent discriminant validity in the groups under study, making it possible to separate them between different levels of ability or latent trait. Its application may be useful for other neuropsychological tests.

Psychopathology and Neurocognition in the Era of the p-Factor: The Current Landscape and the Road Forward

Neurocognitive abilities have frequently been claimed to be involved in the aetiology of psychopathology. Neurocognitive deficits have been reported across many disorders, and theoretical perspectives associate these deficits to the onset and maintenance of the symptomology. Recently, the heterogeneity of symptoms, and comorbidity of disorders, have motivated the development of structural models of psychopathology. Structural models indicate that factors such as internalising, externalising, thought disorder and the p-factor account for a wide variety of symptomology. It is unclear how neurocognitive abilities are best examined within these structures to advance our understanding of psychopathology. In this paper, we use Caspi et al.’s seminal writings as a framework to describe how neurocognitive abilities have been previously associated with categorical disorders and recently associated, and claimed to drive, the factors of psychopathology. We discuss the implications of the p-factor as a substantive construct or statistical artefact, and how this impacts the exploration of neurocognitive abilities and psychopathology. Further, we provide the case for alternative structural approaches, describe an innovative hypothesis of neurocognitive functioning, the multidimensional hypothesis, and explain how this may further our understanding of the heterogeneity of neurocognitive performance and psychopathology at the individual level. Finally, we provide a road forward for the future examination of neurocognitive abilities in psychopathology.

Age Differences in the Subcomponents of Executive Functioning

OBJECTIVES

Across the life span, deficits in executive functioning (EF) are associated with poor behavioral control and failure to achieve goals. Though EF is often discussed as one broad construct, a prominent model of EF suggests that it is composed of three subdomains: inhibition, set shifting, and updating. These subdomains are seen in both younger (YA) and older adults (OA), with performance deficits across subdomains in OA. Therefore, our goal was to investigate whether subdomains of EF might be differentially affected by age, and how these differences may relate to broader global age differences in EF.

METHODS

To assess these age differences, we conducted a meta-analysis at multiple levels, including task level, subdomain level, and of global EF. Based on previous work, we hypothesized that there would be overall differences in EF in OA.

RESULTS

Using 1,268 effect sizes from 401 articles, we found overall differences in EF with age. Results suggested that differences in performance are not uniform, such that variability in age effects emerged at the task level, and updating was not as affected by age as other subdomains.

DISCUSSION

These findings advance our understanding of age differences in EF, and stand to inform early detection of EF decline.

A neurally plausible schema-theoretic approach to modelling cognitive dysfunction and neurophysiological markers in Parkinson's disease

The cognitive mechanisms underlying sequential action selection in routine or everyday activities may be understood in terms of competition within a hierarchically organised network of action schemas. We present a neurobiologically plausible elaboration of an existing schema-based cognitive model of action selection in which the basal ganglia implements an activation-based selection process that mediates between assumed cortical representations of rule-based schemas. More specifically, the model employs a network of basal ganglia units with computations performed by individual BG nuclei, embedded in a corticothalamic loop that disinhibits schemas according to the received feedback. We provide bridging assumptions for linking the operation of the model with ERP components that describe the error-related negativity (ERN) and the parietal switch positivity (PSP), and evaluate the model against behavioural and neural markers of performance of the Wisconsin Card Sorting Test by healthy control participants and Parkinson's Disease patients.

Performance and brain activity during the Wisconsin Card Sorting Test in adolescents with obsessive-compulsive disorder and adolescents with weight-restored anorexia nervosa

Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) both show a peak age of onset during adolescence and share a number of phenotypic features, such as rigid rule-bound behavior and perseverative thinking. There is evidence of difficulties with set shifting or task switching in adults with each disorder, but evidence in adolescents is limited. Furthermore, no studies have previously directly compared AN and OCD on this cognitive process or examined comparative neural correlates. This study provides exploratory analyses to address this gap by measuring brain activity with functional magnetic resonance imaging (fMRI) during a computerized version of the Wisconsin Card Sorting Test (WCST) in female adolescents with weight-restored AN (WR-AN) (n = 14), OCD (n = 11), and healthy controls (n = 24). Results revealed greater perseverative errors in the OCD group than healthy controls and WR-AN, but no difference between WR-AN and healthy controls. Greater activity in the right front pole, inferior frontal gyrus, and middle frontal gyrus during the task (compared to a control matching task) was associated with more perseverative errors in the OCD group, but not healthy controls. The correlation between perseverative errors and brain response to the task in the WR-AN group was not different from either comparison group. These findings propose a hypothesis that behavioral similarities between OCD and AN, as well as difficulties with set shifting in adults with AN, are driven by obsessive-compulsive features present in AN rather than a shared underlying neurocognitive signature. This notion should be tested in larger samples in future studies.

Age, education and gender effects on Wisconsin card sorting test: standardization, reliability and validity in healthy Argentinian adults

The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological assessment of executive functioning. The aim of this study was to provide norm values and analyze the psychometric properties of WCST in healthy Argentinian adults aged from 18 to 89 years old (N = 235). Descriptive statistics are reported as means, standard deviations and percentiles, with the effects of age, education and gender being investigated by ANOVA, and with the effect sizes being calculated. The psychometrics were studied using the WCST structure, reliability, convergent validity, and discriminant validity, and WCST norms adjusted for age and educational level are proposed. This instrument is a reliable and valid tool for the assessment of executive functions. However, as the age- and educational-related effects were demonstrated, these characteristics need to be considered before interpreting WCST scores. Regarding gender, no differences were found. Our results expand the geographical and sociocultural applicability of WCST.

Aging, Working Memory, and Discrimination Learning

Older adults easily learn probabilistic relationships between cues and outcomes when the predictive event is the occurrence of a cue, but have greater difficulty when the predictive event is the nonoccurrence of a cue (Mutter & Pliske, 1996; Mutter & Plumlee, 2004; Mutter & Williams, 2004). This study explored whether this age-related deficit occurs in a simpler learning context and whether it might be related to working memory (WM) decline. We gave younger and older adults simultaneous discrimination tasks that allowed us to compare their ability to learn deterministic relationships when either the occurrence (feature positive; FP) or the nonoccurrence (feature negative; FN) of a distinctive feature predicted reinforcement. We also included a group of younger adults who performed the discrimination tasks under a concurrent WM load. Both age and WM load had a detrimental effect on initial FP and FN discrimination; however, these effects persisted only in FN discrimination after additional learning experience. Learning predictive relationships requires inductive reasoning processes that apparently do not operate as efficiently in individuals with reduced WM capacity. The impact of WM decline may ultimately be greater for negative cue–outcome relationships because learning these relationships requires more difficult inductive reasoning processes, which place greater demands on WM.

Age-differences in cognitive flexibility when overcoming a preexisting bias through feedback

INTRODUCTION

Older adults are often worse than younger adults at adapting to changing situational demands, and this difference is commonly attributed to an age-related decline in acquiring and updating information. Previous research on aging and cognitive flexibility has used measures that require adapting to novel associations learned during a laboratory task (e.g., choice X led to positive outcomes but now leads to negative outcomes). However, in everyday life people must frequently overcome associations based on preexisting beliefs and biases (e.g., you like to eat cake, but your doctor said to limit your sugar intake). The goal of the present study was to examine possible age-differences in overcoming a preexisting bias and determine whether age-related changes in the acquisition and updating of information influence this form of flexibility.

METHOD

Older (n = 20) and younger (n = 20) adults completed a novel task in which repeated choices were made between a sure option (gain or loss) and one of two risky options that were initially ambiguous. Optimal performance required overcoming a framing bias toward being risk seeking to avoid a sure loss and risk averse when offered a sure gain. Probe questions assessed knowledge of choice outcomes, while skin conductance assessed physiological reactions to choices and choice outcomes.

RESULTS

Both older and younger adults demonstrated flexibility by reducing the impact of bias over trials, but younger adults had better performance overall. Age-differences were associated with distinct aspects of processing. Young adults had more precise knowledge of choice outcomes and developed skin conductance responses in anticipation of bad choices that were not apparent in older adults.

CONCLUSIONS

Older adults showed significant improvement over trials in their ability to decrease bias-driven choices, but younger showed greater flexibility. Age-differences in task performance were based on differences in learning and corresponding representations of task-relevant information.

The Relationship of Cognitive Performance and the Theta-Alpha Power Ratio Is Age-Dependent: An EEG Study of Short Term Memory and Reasoning during Task and Resting-State in Healthy Young and Old Adults

Objective: The Theta-Alpha ratio (TAR) is known to differ based upon age and cognitive ability, with pathological electroencephalography (EEG) patterns routinely found within neurodegenerative disorders of older adults. We hypothesized that cognitive ability would predict EEG metrics differently within healthy young and old adults, and that healthy old adults not showing age-expected EEG activity may be more likely to demonstrate cognitive deficits relative to old adults showing these expected changes.

Methods: In 216 EEG blocks collected in 16 young and 20 old adults during rest (eyes open, eyes closed) and cognitive tasks (short-term memory [STM]; matrix reasoning [RM; Raven's matrices]), models assessed the contributing roles of cognitive ability, age, and task in predicting the TAR. A general linear mixed-effects regression model was used to model this relationship, including interaction effects to test whether increased cognitive ability predicted TAR differently for young and old adults at rest and during cognitive tasks.

Results: The relationship between cognitive ability and the TAR across all blocks showed age-dependency, and cognitive performance at the CZ midline location predicted the TAR measure when accounting for the effect of age (p < 0.05, chi-square test of nested models). Age significantly interacted with STM performance in predicting the TAR (p < 0.05); increases in STM were associated with increased TAR in young adults, but not in old adults. RM showed similar interaction effects with aging and TAR (p < 0.10).

Conclusion: EEG correlates of cognitive ability are age-dependent. Adults who did not show age-related EEG changes were more likely to exhibit cognitive deficits than those who showed age-related changes. This suggests that healthy aging should produce moderate changes in Alpha and TAR measures, and the absence of such changes signals impaired cognitive functioning.

Cognitive flexibility in neurological disorders: Cognitive components and event-related potentials

Performance deficits on the Wisconsin Card Sorting Test (WCST) in patients with prefrontal cortex (PFC) lesions are traditionally interpreted as evidence for a role of the PFC in cognitive flexibility. However, WCST deficits do not occur exclusively after PFC lesions, but also in various neurological and psychiatric disorders. We propose a multi-component approach that can accommodate this pattern of omnipresent WCST deficits: the WCST is not a pure test of cognitive flexibility, but relies on the effective functioning of multiple dissociable cognitive components. Our review of recent efforts to decompose WCST performance deficits supports this view by revealing that WCST deficits in different neurological disorders can be attributed to alterations in different components. Frontoparietal changes underlying impaired set shifting seem to give rise to WCST deficits in patients with amyotrophic lateral sclerosis, whereas the WCST deficits associated with primary dystonia and Parkinson's disease are rather related to frontostriatal changes underlying deficient rule inference. Clinical implications of these findings and of a multi-component view of WCST performance are discussed.

Cognitive persistence: Development and validation of a novel measure from the Wisconsin Card Sorting Test

The Wisconsin Card Sorting Test (WCST) has long been used as a neuropsychological assessment of executive function abilities, in particular, cognitive flexibility or "set-shifting". Recent advances in scoring the task have helped to isolate specific WCST performance metrics that index set-shifting abilities and have improved our understanding of how prefrontal and parietal cortex contribute to set-shifting. We present evidence that the ability to overcome task difficulty to achieve a goal, or "cognitive persistence", is another important prefrontal function that is characterized by the WCST and that can be differentiated from efficient set-shifting. This novel measure of cognitive persistence was developed using the WCST-64 in an adult lifespan sample of 230 participants. The measure was validated using individual variation in cingulo-opercular cortex function in a sub-sample of older adults who had completed a challenging speech recognition in noise fMRI task. Specifically, older adults with higher cognitive persistence were more likely to demonstrate word recognition benefit from cingulo-opercular activity. The WCST-derived cognitive persistence measure can be used to disentangle neural processes involved in set-shifting from those involved in persistence.

Visual Acuity does not Moderate Effect Sizes of Higher-Level Cognitive Tasks

BACKGROUND/STUDY CONTEXT

Declining visual capacities in older adults have been posited as a driving force behind adult age differences in higher-order cognitive functions (e.g., the "common cause" hypothesis of Lindenberger & Baltes, 1994, Psychology and Aging, 9, 339-355). McGowan, Patterson, and Jordan (2013, Experimental Aging Research, 39, 70-79) also found that a surprisingly large number of published cognitive aging studies failed to include adequate measures of visual acuity. However, a recent meta-analysis of three studies (La Fleur and Salthouse, 2014, Psychonomic Bulletin & Review, 21, 1202-1208) failed to find evidence that visual acuity moderated or mediated age differences in higher-level cognitive processes. In order to provide a more extensive test of whether visual acuity moderates age differences in higher-level cognitive processes, we conducted a more extensive meta-analysis of topic.

METHODS

Using results from 456 studies, we calculated effect sizes for the main effect of age across four cognitive domains (attention, executive function, memory, and perception/language) separately for five levels of visual acuity criteria (no criteria, undisclosed criteria, self-reported acuity, 20/80-20/31, and 20/30 or better).

RESULTS

As expected, age had a significant effect on each cognitive domain. However, these age effects did not further differ as a function of visual acuity criteria.

CONCLUSION

The current meta-analytic, cross-sectional results suggest that visual acuity is not significantly related to age group differences in higher-level cognitive performance-thereby replicating La Fleur and Salthouse (2014). Further efforts are needed to determine whether other measures of visual functioning (e.g., contrast sensitivity, luminance) affect age differences in cognitive functioning.

Compensatory processing during rule-based category learning in older adults

Healthy older adults typically perform worse than younger adults at rule-based category learning, but better than patients with Alzheimer's or Parkinson's disease. To further investigate aging's effect on rule-based category learning, we monitored event-related potentials (ERPs) while younger and neuropsychologically typical older adults performed a visual category-learning task with a rule-based category structure and trial-by-trial feedback. Using these procedures, we previously identified ERPs sensitive to categorization strategy and accuracy in young participants. In addition, previous studies have demonstrated the importance of neural processing in the prefrontal cortex and the medial temporal lobe for this task. In this study, older adults showed lower accuracy and longer response times than younger adults, but there were two distinct subgroups of older adults. One subgroup showed near-chance performance throughout the procedure, never categorizing accurately. The other subgroup reached asymptotic accuracy that was equivalent to that in younger adults, although they categorized more slowly. These two subgroups were further distinguished via ERPs. Consistent with the compensation theory of cognitive aging, older adults who successfully learned showed larger frontal ERPs when compared with younger adults. Recruitment of prefrontal resources may have improved performance while slowing response times. Additionally, correlations of feedback-locked P300 amplitudes with category-learning accuracy differentiated successful younger and older adults. Overall, the results suggest that the ability to adapt one's behavior in response to feedback during learning varies across older individuals, and that the failure of some to adapt their behavior may reflect inadequate engagement of prefrontal cortex.

Brazilian preliminary norms and investigation of age and education effects on the Modified Wisconsin Card Sorting Test, Stroop Color and Word test and Digit Span test in adults

Executive functions are involved in a series of human neurological and psychiatric disorders. For this reason, appropriate assessment tools with age and education adjusted norms for symptom diagnosis are necessary.

Specifying Associations Between Conscientiousness and Executive Functioning: Mental Set Shifting, Not Prepotent Response Inhibition or Working Memory Updating

Conscientiousness is characterized by self-control, organization, and goal orientation and is positively related to a number of health and professional outcomes. Thus, it is commonly suggested that conscientiousness should be related to superior executive functioning (EF) abilities, especially prepotent response inhibition. However, little empirical support for this notion has emerged, perhaps due to oversimplified and underspecified modeling of EF. The current study sought to fill this gap by testing relations between conscientiousness and three facets of EF using a nested factors latent variable approach. Participants (N = 420; Mage  = 22.5; 50% male; 91% Caucasian) completed a measure of conscientiousness and nine EF tasks designed to tap three related yet distinguishable facets of EF: working memory updating, mental set shifting, and prepotent response inhibition. Structural equation models showed that conscientiousness is positively associated with the EF facet of mental set shifting but not response inhibition or working memory updating. Despite the common notion that conscientiousness is associated with cognitive abilities related to rigid control over impulses (i.e., inhibition), the current results suggest the cognitive ability most associated with conscientiousness is characterized by flexibility and the ability to adapt to changing environmental contingencies and task demands.

Selectivity in associative learning: a cognitive stage framework for blocking and cue competition phenomena

BLOCKING IS THE MOST IMPORTANT PHENOMENON IN THE HISTORY OF ASSOCIATIVE LEARNING THEORY: for over 40 years, blocking has inspired a whole generation of learning models. Blocking is part of a family of effects that are typically termed "cue competition" effects. Common amongst all cue competition effects is that a cue-outcome relation is poorly learned or poorly expressed because the cue is trained in the presence of an alternative predictor or cause of the outcome. We provide an overview of the cognitive processes involved in cue competition effects in humans and propose a stage framework that brings these processes together. The framework contends that the behavioral display of cue competition is cognitively construed following three stages that include (1) an encoding stage, (2) a retention stage, and (3) a performance stage. We argue that the stage framework supports a comprehensive understanding of cue competition effects.

Prefrontal cortex and executive functions in healthy adults: a meta-analysis of structural neuroimaging studies

Lesion studies link the prefrontal cortex (PFC) to executive functions. However, the evidence from in vivo investigations in healthy people is mixed, and there are no quantitative estimates of the association strength. To examine the relationship between PFC volume and cortical thickness with executive cognition in healthy adults, we conducted a meta-analysis of studies that assessed executive functions and PFC volume (31 samples,) and PFC thickness (10 samples) in vivo, N=3272 participants. We found that larger PFC volume and greater PFC thickness were associated with better executive performance. Stronger associations between executive functions and PFC volume were linked to greater variance in the sample age but was unrelated to the mean age of a sample. Strength of association between cognitive and neuroanatomical indices depended on the executive task used in the study. PFC volume correlated stronger with Wisconsin Card Sorting Test than with digit backwards span, Trail Making Test and verbal fluency. Significant effect size was observed in lateral and medial but not orbital PFC. The results support the "bigger is better" hypothesis of brain-behavior relation in healthy adults and suggest different neural correlates across the neuropsychological tests used to assess executive functions.

Impact of aging brain circuits on cognition

Brain networks that engage the hippocampus and prefrontal cortex are central for enabling effective interactions with our environment. Some of the cognitive processes that these structures mediate, such as encoding and retrieving episodic experience, wayfinding, working memory and attention are known to be altered across the lifespan. As illustrated by examples given below, there is remarkable consistency across species in the pattern of age-related neural and cognitive change observed in healthy humans and other animals. These include changes in cognitive operations that are known to be dependent on the hippocampus, as well as those requiring intact prefrontal cortical circuits. Certain cognitive constructs that reflect the function of these areas lend themselves to investigation across species, allowing brain mechanisms at different levels of analysis to be studied in greater depth.

Executive function on the Psychology Experiment Building Language tests

The measurement of executive function has a long history in clinical and experimental neuropsychology. The goal of the present report was to determine the profile of behavior across the lifespan on four computerized measures of executive function contained in the recently developed Psychology Experiment Building Language (PEBL) test battery http://pebl.sourceforge.net/ and evaluate whether this pattern is comparable to data previously obtained with the non-PEBL versions of these tests. Participants (N = 1,223; ages, 5-89 years) completed the PEBL Trail Making Test (pTMT), the Wisconsin Card Sort Test (pWCST; Berg, Journal of General Psychology, 39, 15-22, 1948; Grant & Berg, Journal of Experimental Psychology, 38, 404-411, 1948), the Tower of London (pToL), or a time estimation task (Time-Wall). Age-related effects were found over all four tests, especially as age increased from young childhood through adulthood. For several tests and measures (including pToL and pTMT), age-related slowing was found as age increased in adulthood. Together, these findings indicate that the PEBL tests provide valid and versatile new research tools for measuring executive functions.

The odd-even effect in Sudoku puzzles: effects of working memory, aging, and experience

The odd-even effect in numerical processing has been explained as the easier processing of even numbers compared with odd numbers. We investigated this effect in Sudoku puzzles, a reasoning problem that uses numbers but does not require arithmetic operations. Specifically, we asked whether the odd-even effect occurred with Sudoku puzzles and whether individual differences in working memory (WM), aging, and experience with Sudoku modulated this effect. We manipulated the presence of odd and even numbers in Sudoku puzzles, measured WM with the Wisconsin Card Sorting Test and backward digit span task, tested older and younger adults, and collected Sudoku experience frequency. Performance on Sudoku was more accurate for even puzzles than odd ones. Younger, experienced, and higher-WM participants were more accurate on Sudoku, but these individual difference variables did not interact with the odd-even effect. Odd numbers may impose more cognitive load than even numbers, but future research is needed to examine how age, experience, or WM may influence the odd-even effect.

Ameliorative effect of traditional Japanese medicine yokukansan on age-related impairments of working memory and reversal learning in rats

Aging is thought to impair prefrontal cortical (PFC) structure-sensitive cognitive functions and flexibility, such as working memory and reversal learning. A traditional Japanese medicine, yokukansan (YKS), is frequently used to treat age-related neurodegenerative disorders such as Alzheimer's disease in Japan, but its pharmacological properties have not been elucidated. The present study was designed to examine whether YKS improves age-related cognitive deficits using aged rats. YKS was administered to 21-month-old rats for 3 months. The ability to learn initially a reward rule for a T-maze discrimination task (initial learning) was examined in young control (4-month-old), aged control (24-month-old) and YKS-treated aged (24-month-old) rats. Subsequently, working memory and reversal learning were examined in delayed alternation and reversal discrimination T-maze tasks, respectively. Locomotor activity was also measured in new environments. Although performance accuracy in the initial learning procedure did not differ among any experimental groups, accuracy in the delayed alternation task was significantly decreased in aged rats compared to young rats. Aged rats also showed significant decreases in accuracy in the reversal discrimination task. YKS treatment significantly ameliorated the age-related decreases in accuracy in the delayed alternation and reversal discrimination tasks. The ameliorative effects of YKS on impaired delayed alternation performance were reduced by intracranial infusions of a dopamine D1 receptor antagonist, SCH 23390, into the prelimbic cortical region of the PFC, and the YKS effects on impaired reversal learning were done by the infusions into the orbitofrontal cortex (OFC). Locomotor activity did not change in any experimental group. Thus, YKS ameliorated age-related impairments of working memory and reversal learning, which might be mediated by a dopaminergic mechanism in the PFC structure. These investigations provide information important for the treatment of brain dysfunctions in the elderly people.

Impairment of Concept Formation Ability in Children with ADHD: Comparisons between Lower Grades and Higher Grades

OBJECTIVE

We investigated executive functions (EFs), as evaluated by the Wisconsin Card Sorting Test (WCST), and other EF between lower grades (LG) and higher grades (HG) in elementary-school-age attention deficit hyperactivity disorder (ADHD) children.

METHODS

We classified a sample of 112 ADHD children into 4 groups (composed of 28 each) based on age (LG vs. HG) and WCST performance [lower vs. higher performance on WCST, defined by the number of completed categories (CC)] Participants in each group were matched according to age, gender, ADHD subtype, and intelligence. We used the Wechsler intelligence Scale for Children 3rd edition to test intelligence and the Computerized Neurocognitive Function Test-IV, which included the WCST, to test EF.

RESULTS

Comparisons of EFs scores in LG ADHD children showed statistically significant differences in performing digit spans backward, some verbal learning scores, including all memory scores, and Stroop test scores. However, comparisons of EF scores in HG ADHD children did not show any statistically significant differences. Correlation analyses of the CC and EF variables and stepwise multiple regression analysis in LG ADHD children showed a combination of the backward form of the Digit span test and Visual span test in lower-performance ADHD participants significantly predicted the number of CC (R(2)=0.273, p<0.001).

CONCLUSION

This study suggests that the design of any battery of neuropsychological tests for measuring EF in ADHD children should first consider age before interpreting developmental variations and neuropsychological test results. Researchers should consider the dynamics of relationships within EF, as measured by neuropsychological tests.

Orbitofrontal dopaminergic dysfunction causes age-related impairment of reversal learning in rats

Reversal learning is a domain that involves cognitive flexibility and is defined as the ability to rapidly alter established patterns of behavior when confronted with changing circumstances. This function depends critically on the orbitofrontal cortex (OFC) in the prefrontal cortical (PFC) structure, which is among the most sensitive to the influences of aging, and impaired reversal learning is a common functional disturbance of aged brain. The present study was designed to clarify the precisely neurochemical basis of this impaired learning in rats. For this purpose, we first examined reversal learning in young (3-month-old) and aged (24-month-old) rats using a T-maze discrimination task. The ability of aged rats to learn initially a reward rule for a T-maze discrimination task was almost equal to that of young rats, suggesting that simple discrimination ability was normal in aged rats. However, the ability to learn a reversed rule in a subsequent task was markedly impaired in aged rats. In addition, aged rats had reduced dopaminergic transmission concomitant with attenuated tyrosine hydroxylase (TH) activity in the OFC. Moreover, age-related impairment of reversal learning was improved by an intra-OFC infusion of 30 ng, but not 10 ng, of the D1 receptor agonist SKF 81297. Increasing dose of SKF 81297 to 100 ng also improved the impairment, but this effect was weaker than that of 30 ng, indicating that the SKF 81297 response was an inverted "U" pattern. The maximum SKF 81297 response (30 ng) was abolished by the D1 receptor antagonist SCH 23390. Thus, age-related impairment of reversal learning was due to a D1 receptor-mediated hypodopaminergic mechanism in the OFC. This finding provides direct evidence showing the involvement of OFC dopaminergic dysfunction in the development of cognitive inflexibility during the normal aging process.

Aging and decision making under uncertainty: behavioral and neural evidence for the preservation of decision making in the absence of learning in old age

Decision making under uncertainty is an essential component of everyday life. Recent psychological studies suggest that older adults, despite age-related neurological decline, can make advantageous decisions when information about the contingencies of the outcomes is available. In this study, a two-choice prediction paradigm has been used, in conjunction with functional magnetic resonance imaging (fMRI), to investigate the effects of normal aging on neural substrates underlying uncertain decision making in the absence of learning that have not been addressed in previous neuroimaging studies. Neuroimaging results showed that both the healthy older and young adults recruited a network of brain regions comprising the right dorsolateral prefrontal cortex, bilateral inferior parietal lobule, medial frontal cortex, and right lateral orbitofrontal cortex during the prediction task. As was hypothesized, the performance of older adults in the prediction task was not impaired compared to young adults. Although no significant age-related increases in brain activity have been found, we observed an age-related decrease in activity in the right inferior parietal lobule. We speculate that the observed age-related decrease in parietal activity could be explained by age-related differences in decision making behavior revealed by questionnaire results and maximizing scores. Together, this study demonstrates behavioral and neural evidence for the preservation of decision making in older adults when information about the contingencies of the outcome is available.

Executive Functions after Age 5: Changes and Correlates

Research and theorizing on executive function (EF) in childhood has been disproportionately focused on preschool age children. This review paper outlines the importance of examining EF throughout childhood, and even across the lifespan. First, examining EF in older children can address the question of whether EF is a unitary construct. The relations among the EF components, particularly as they are recruited for complex tasks, appear to change over the course of development. Second, much of the development of EF, especially working memory, shifting, and planning, occurs after age 5. Third, important applications of EF research concern the role of school-age children's EF in various aspects of school performance, as well as social functioning and emotional control. Future research needs to examine a more complete developmental span, from early childhood through late adulthood, in order to address developmental issues adequately.

Effects of age, genes, and pulse pressure on executive functions in healthy adults

Executive functions (EF) evidence significant age-related declines, but the mechanisms underpinning those changes are unclear. In this study, we focus on two potential sources of variation: a physiological indicator of vascular health, and genetic variants related to vascular functions. In a sample of healthy adults (n=158, ages 18-81), we examine the effects of age, pulse pressure, and two polymorphisms (comt val158met and ace insertion/deletion) on working memory and cognitive flexibility. Results indicate that in addition to often-replicated age differences, the alleles of two polymorphisms that promote vasoconstriction (comt val and ace D) and reduced availability of dopamine in neocortical synapses (comt val), negatively impact virtually all aspects of EF tasks that involve working memory. In some cases, suppression of cognitive performance is limited to men or necessitates a combination of both risk-associated alleles. After accounting for genetic and age-related variation, pulse pressure had no additional effect on EF. These findings suggest that in healthy adults, the effects of genetic risk factors significantly modulate the course of cognitive aging.

Age differences in perseveration: cognitive and neuroanatomical mediators of performance on the Wisconsin Card Sorting Test

Aging effects on the Wisconsin Card Sorting Test (WCST) are fairly well established but the mechanisms of the decline are not clearly understood. In this study, we examined the cognitive and neural mechanisms mediating age-related increases in perseveration on the WCST. MRI-based volumetry and measures of selected executive functions in conjunction with the WCST were obtained in a sample of 117 healthy young and older adults. Path analysis indicated that age-related increase in perseveration is completely accounted for by declines in processing speed and temporal processing, deficits in working memory mediated by decreased prefrontal cortical volume, and the indirect influence of prefrontally-mediated declines in inhibition via working memory. We conclude that age-related increase in perseveration is indeed differentially dependent on the integrity of prefrontal cortex and on declines in selected cognitive processes dependent on this region.

The role of switching, inhibition and working memory in older adults' performance in the Wisconsin Card Sorting Test

The Wisconsin Card Sorting Test (WCST) is considered a typical executive test. However, several interesting questions are still open as to the specific executive processes underlying this task. In the present study, we explored how local and global switching, inhibition and working memory, assessed through the Number-Letter, the Stop Signal and the Reading Span tasks, relate to older adults' performance in the WCST. Results showed that older adults' performance variability in the number of perseverative errors was predicted by the local switch component of the Number-Letter task. Results also showed age-related differences in inhibition, working memory and global switching, while local switching resulted largely spared in aging. This study provides evidence that switching abilities may contribute to performance of older adults in the WCST. It also provides initial evidence suggesting that switching processes, associated with local switch costs, are involved in performance on the WCST, at least in older adults.

Inefficiency in self-organized attentional switching in the normal aging population is associated with decreased activity in the ventrolateral prefrontal cortex

Studies of the aging brain have demonstrated that areas of the frontal cortex, along with their associated top-down executive control processes, are particularly prone to the neurodegenerative effects of age. Here, we investigate the effects of aging on brain and behavior using a novel task, which allows us to examine separate components of an individual's chosen strategy during routine problem solving. Our findings reveal that, contrary to previous suggestions of a specific decrease in cognitive flexibility, older participants show no increased level of perseveration to either the recently rewarded object or the recently relevant object category. In line with this lack of perseveration, lateral and medial regions of the orbito-frontal cortex, which are associated with inhibitory control and reward processing, appear to be functionally intact. Instead, a general loss of efficient problem-solving strategy is apparent with a concomitant decrease in neural activity in the ventrolateral prefrontal cortex and the posterior parietal cortex. The dorsolateral prefrontal cortex is also affected during problem solving, but age-related decline within this region appears to occur at a later stage.

The role of white matter hyperintensities and medial temporal lobe atrophy in age-related executive dysfunctioning

Various studies support an association between white matter hyperintensities (WMH) and deficits in executive function in nondemented ageing. Studies examining executive functions and WMH have generally adopted executive function as a phrase including various functions such as flexibility, inhibition, and working memory. However, these functions include distinctive cognitive processes and not all may be affected as a result of WMH. Furthermore, atrophy of the medial temporal lobe (MTA) is frequently observed in ageing. Nevertheless, in previous studies of nondemented ageing MTA was not considered when examining a relationship between white matter and executive function. The goal of the present study was to examine how WMH and MTA relate to a variety of executive functions, including flexibility, fluency, inhibition, planning, set shifting, and working memory. Strong correlations were observed between WMH and MTA and most of the executive functions. However, only MTA was related to flexibility and set shifting performance. Regression analysis furthermore showed that MTA was the strongest predictor of working memory, after which no further significant association with WMH was noted. Alternatively, both MTA and periventricular hyperintensities independently predicted inhibition performance. These findings emphasize the importance of MTA when examining age-related decline in executive functioning.

Exploring Age-Related Decline on the Wisconsin Card Sorting Test

It is well established that performance on the Wisconsin Card Sorting Test (WCST) tends to decline with advanced age, but the reason for this decline has not been established. The objective of the present study was to clarify this question using a qualitative approach to the task. The WCST was administered to 19 older adults and 25 younger participants. In addition to standard testing procedures, all participants were asked to verbalize their response strategy when placing each card. Results of this procedure implicate poor set shifting and set maintenance, consistent with reduced efficiency of feedback utilization, as the primary cause for age-related decline on the WCST.

The role of age and prior beliefs in contingency judgment

This experiment investigated how prior beliefs affect young and older adults' ability to detect differences in objective contingency. Participants received new evidence that the objective contingency between two events was positive, negative, or zero when they believed that there was a positive or negative relationship between events, when they believed that the events were unrelated, and when they had no knowledge of the relationship between the events. They were then asked to estimate the objective contingency and recall the contingency evidence. Beliefs that events were or could be related improved young adults' contingency discrimination. Moreover, these beliefs did not produce biases in young adults' memory for the contingency evidence, but rather affected how they weighted this evidence at judgment. In contrast, these same beliefs did not improve older adults' contingency discrimination, but did produce biases in their memory for the evidence that were similar to those seen in their judgment. These findings are discussed in terms of age-related changes in working memory executive processes that impair older adults' ability to fully evaluate both belief-confirming and disconfirming contingency evidence and update their beliefs with this information.

Age-dependent changes of auditory evoked potentials--effect of task difficulty

The goal of this study was to evaluate the patterns of age-dependent changes of P3 components of auditory event-related potentials exploring the effects of task difficulty. The participants (age span: 19-68 years, n=55, divided into five age groups) took part in an easy and in a difficult two-tone oddball frequency discrimination task with speed or accuracy instructions, and in a novelty oddball task. The latency of the P3 components increased with aging. While in the easy task a linear P3b latency increase could be seen, in the difficult tasks (difficult frequency discrimination or distracting novel stimuli) an accelerated latency increase was observed for the P3b and P3a. In the two-tone oddball paradigm age had no effect on P3b amplitude, but in the novelty oddball task the amplitude of P3 potentials decreased with age. These results indicate that distracting stimuli increase task demands, and in difficult tasks decay can be observed more easily due to the accumulation of various processing mechanisms characterizing aging.

Age differences in concept formation

In order to identify the source of age-related deficits in concept formation, older and younger adults completed a new Concept Matching Test, tests of selective attention, and the Sorting Test, a standardized test of concept formation (Delis, Kaplan, & Kramer, 2001). Older adults showed intact concept identification, the ability to generate abstract concepts from stimulus features, but age differences were observed when irrelevant features were present. In addition, selective attention, but not concept identification ability, predicted age-related declines on the Sorting Test. Thus, reduced concept formation in older adults may stem from declines in abilities other than the capacity for abstraction.

Encoding changes in orbitofrontal cortex in reversal-impaired aged rats

Previous work in rats and primates has shown that normal aging can be associated with a decline in cognitive flexibility mediated by prefrontal circuits. For example, aged rats are impaired in rapid reversal learning, which in young rats depends critically on the orbitofrontal cortex. To assess whether aging-related reversal impairments reflect orbitofrontal dysfunction, we identified aged rats with reversal learning deficits and then recorded single units as these rats, along with unimpaired aged cohorts and young control rats, learned and reversed a series of odor discrimination problems. We found that the flexibility of neural correlates in orbitofrontal cortex was markedly diminished in aged rats characterized as reversal-impaired in initial training. In particular, although many cue-selective neurons in young and aged-unimpaired rats reversed odor preference when the odor-outcome associations were reversed, cue-selective neurons in reversal-impaired aged rats did not. In addition, outcome-expectant neurons in aged-impaired rats failed to become active during cue sampling after learning. These altered features of neural encoding could provide a basis for cognitive inflexibility associated with normal aging.

Reward-based decision-making and aging

Healthy aging is associated with a number of neuroanatomical and neurobiological alterations that result in various cognitive changes. Both, the dopaminergic as well as the serotonergic system are subject to change during aging. Receptor loss and severe structural changes in PFC and striatum have been reported. Aging is associated with a progressive decline in several cognitive functions, such as episodic memory, working memory, and processing speed. Furthermore, it is associated with deficits in tasks requiring adaptation to external feedback of right or wrong, or task-switching. Here, we develop the hypothesis that this loss of behavioral flexibility is caused by structural and functional alterations of the reward system leading to impairments in reward processing, learning stimulus reinforcement associations, and reward-based decision-making. We review (a) data on neural correlates and substrates of reward processing in young healthy animals and humans, (b) evidence for age related functional and structural alterations of the reward system, and (c) behavioral and neuroimaging data of age effects on reward-based decision-making processes. Implications for neuroeconomics and neurodegenerative diseases are discussed.

Age differences in stroop interference in working memory

Working memory capacity can be conceptualized as the ability to use controlled attention in short term memory (Engle, Tuholski, Laughlin, & Conway, 1999). We tested this idea in young and older adults by combining the task demands of two neuropsychological tests, word span, and Stroop color-naming. Young and older adults were asked to name the colors of a series of congruent and incongruent color-words (between 2 and 6 words/trial). After all the color-words were presented participants attempted to recall the colors in their serial order. This task required inhibition of the prepotent word reading response (i.e., color naming), with a concurrent memory load (caused by the need to maintain already named colors in short-term memory). Older adults showed greater interference effects, and these interference effects increased as a function of memory load. Regression analyses showed that measures of working memory capacity and executive function accounted for unique variance in incongruent color-word errors for older adults. Defining working memory capacity as the ability to use controlled attention in short-term memory may be a fruitful way to think about this concept in studies of executive function.

Mental flexibility: age effects on switching

Mental flexibility is required to track and systematically alternate between 2 response sets. In this study, 719 individuals, 20 to 89 years old, engaged in 3 different tasks that required verbal and nonverbal cognitive switching. Of importance, each task allowed for independent measurement of component skills that are embedded in the higher level tasks. When gender, education, Full Scale IQ, and component skills were partialed out by multiple regression analyses, significant age effects were revealed for each task. This study provides evidence that executive functions--and verbal and nonverbal cognitive switching in particular--are affected by age independently from age-related changes in component skills. The results are discussed in terms of theories of executive control and neurologic correlates across the adult life span.

Age-related differences in performance on the Wisconsin card sorting test: a meta-analytic review

Two meta-analyses investigating age-related differences in performance on a popular measure of executive function, the Wisconsin Card Sorting Test (WCST), are reported. The 1st meta-analysis examined age-related changes in performance for the number of categories achieved, and the 2nd meta-analysis examined performance for the number of perseverative errors committed. Results indicated that robust age differences were present on both measures. Further analysis of moderator variables revealed reliable effects of education and test version on both measures, whereas test modality led to marginally significant differences in effect sizes obtained only for the number of categories achieved. Findings are discussed along with current accounts of age differences in performance of the WCST.

Effect of aging on stimulus-reward association learning

The flexible learning of stimulus-reward associations when required by situational context is essential for everyday behavior. Older adults experience a progressive decline in several cognitive functions and show deficiencies in neuropsychological tasks requiring flexible adaptation to external feedback, which could be related to impairments in reward association learning. To study the effect of aging on stimulus-reward association learning 20 young and 20 older adults performed a probabilistic object reversal task (pORT) along with a battery of tests assessing executive functions and general intellectual abilities. The pORT requires learning and reversing associations between actions and their outcomes. Older participants collected fewer points, needed more trials to reach the learning criterion, and completed less blocks successfully compared to young adults. This difference remained statistically significant after correcting for the age effect of other tests assessing executive functions. This suggests that there is an age-related difference in reward association learning as measured using the pORT, which is not closely related to other executive functions with respect to the age effect. In human aging, structural alterations of reward detecting structures and functional changes of the dopaminergic as well as the serotonergic system might contribute to the deficit in reward association learning observed in this study.

Spontaneous alpha peak frequency predicts working memory performance across the age span

Working memory capacity has been consistently shown to decline with increasing age. Mechanisms underlying this decline are poorly understood. One index that has been found to predict performance on memory tests is alpha peak frequency, the peak of spectral alpha power of the EEG. Activity in the alpha band has been also associated with higher cognitive functions including attention and anticipation and has been shown to slow with age. Few studies, however, have examined whether there might be a relationship between WM decline and alpha peak frequency. The present study specifically investigated this relationship. Digit span was used as the index of WM function. The study made use of 550 normal subjects aged between 11 and 70 years in the Brain Resource International Database. The data were acquired from six laboratories located in the USA (2), Europe (2) and Australia (2). Forward and reverse digit span were found to be lower in older relative to younger age groups. Spontaneous alpha peak frequency slowed with age and more so at anterior than posterior sites. Frontal alpha peak frequency was found to be a significant predictor of reverse digit span, with each 1 Hz increase in frequency associated with a 0.21 increase in reverse digit span score and this was independent of age, indicating a positive relationship between alpha peak frequency and working memory performance.