[Faisabilité de l'exploration des fonctions exécutives des résidents d'établissement d'hébergement pour personnes âgées].

Abstract

Impairment of cognitive functions is the primary reason for admission to long-term care units, with executive functions playing a pivotal role in dependency and behavioral issues. These functions pose significant challenges to nursing staff in providing care. However, the assessment of executive functions in elderly individuals residing in nursing homes often relies on tests that are both time-consuming and difficult for this demographic. In many instances, executive functions are either not assessed or only examined in broad terms.

Objective: The objective of this study was to analyze the feasibility of assessing executive functions in elderly nursing home residents, specifically aiming to distinguish sub-components such as mental flexibility, working memory, planning, and inhibition. The residents included in the study underwent executive function assessments over three visits, using various tests for each sub-component.

Methods: Out of 530 residents, 46 gave their consent and 38 completed the three visits, with an average age of 90±5 years (76.2% women) and a median MMSE score of 20/30. Feasibility was evaluated based on the test being executed and the frequency of interruptions due to difficulty or fatigue on the part of the resident.

Results: Only four tests proved suitable for elderly individuals in nursing homes, and we propose grouping them into a battery named SETE (Screening Executive Tests for Elderly): the conflicting instructions from the FAB, the alpha test, the clock test, and the verbal span test.

Conclusion: The use of these four tests would enable the construction of a map delineating executive function impairment by sub-component. Enhanced knowledge of executive functions in long-term care residents will facilitate better adapted dependency management and the implementation of non-pharmacological interventions for behavioral disorders.