Skip to main content
SpringerLink
Log in

Executive Function and Survival in the Context of Chronic Illness

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Individual differences in executive function (EF) have been shown to predict risk factors for chronic illness. It is not currently known whether EFs also predict survival time following a diagnosis of a chronic illness.

Purpose

The objective of this investigation was to examine the association between individual differences in EF and survival time among individuals suffering from one or more chronic illness.

Methods

A sample of 162 community-dwelling older adults who suffered from a chronic illness at baseline underwent thorough medical and neurological examinations to ensure freedom from actual or probable dementia. Participants completed cognitive testing and were subsequently followed for 10 years; survival was assessed as survival time over the follow-up interval.

Results

Findings indicated that individual differences in EF predicted survival time, and this association held when adjustments were made for demographic variables (age, sex), education, and body mass index.

Conclusion

Individual differences in EF may be important determinants of survival in the context of chronic illness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. Analysis of the WAIS-R subtest frequency distributions revealed significant skewness for the Block Design variable selectively. Following removal of three outliers and a log10 transformation, normality was achieved. The inclusion of the transformed Block Design variable in the primary analysis did not change the pattern or statistical significance of the findings; Digit Symbol remained the only significant predictor of survival time. Accordingly, the original untransformed analyses are presented in Table 2.

References

  1. Williams PG, Thayer JF. Executive functioning and health: Introduction to the special series. Ann Behav Med. 2009; 37(2): 101–105.

    Article  PubMed  Google Scholar 

  2. Hall PA, Fong GT. Temporal self-regulation theory: A model for individual health behavior. Health Psychology Review. 2007; 1(1): 3–52.

    Article  Google Scholar 

  3. Miyake A, Friedman NP, Emerson MJ, Witzki AH, Howerter A, Wager TD. The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: A latent variable analysis. Cogn Psychol. 2000; 41(1): 49–100.

    Article  CAS  PubMed  Google Scholar 

  4. Friedman NP, Miyake A, Young SE, Defries JC, Corley RP, Hewitt JK. Individual differences in executive functions are almost entirely genetic in origin. J Exp Psychol Gen. 2008; 137(2): 201–225.

    Article  PubMed  Google Scholar 

  5. Colcombe SJ, Kramer AF, Erickson KI, et al. Cardiovascular fitness, cortical plasticity, and aging. Proc Natl Acad Sci U S A. 2004; 101(9): 3316–3321.

    Article  CAS  PubMed  Google Scholar 

  6. Smiley-Oyen AL, Lowry KA, Francois SJ, Kohut ML, Ekkekakis P. Exercise, fitness, and neurocognitive function in older adults: The “selective improvement” and “cardiovascular fitness” hypotheses. Ann Behav Med. 2008; 36(3): 280–291.

    Article  PubMed  Google Scholar 

  7. Hinkin CH, Castellon SA, Durvasula RS, et al. Medication adherence among HIV+ adults: Effects of cognitive dysfunction and regimen complexity. Neurology. 2002; 59(12): 1944–1950.

    CAS  PubMed  Google Scholar 

  8. Hinkin CH, Hardy DJ, Mason KI, et al. Medication adherence in HIV-infected adults: Effect of patient age, cognitive status, and substance abuse. AIDS. 2004; 18(Suppl 1): S19–S25.

    PubMed  Google Scholar 

  9. Insel K, Morrow D, Brewer B, Figueredo A. Executive function, working memory, and medication adherence among older adults. J Gerontol B Psychol Sci Soc Sci. 2006; 61(2): P102–P107.

    PubMed  Google Scholar 

  10. Stilley CS, Sereika S, Muldoon MF, Ryan CM, Dunbar-Jacob J. Psychological and cognitive function: Predictors of adherence with cholesterol lowering treatment. Ann Behav Med. 2004; 27(2): 117–124.

    Article  PubMed  Google Scholar 

  11. Hall PA, Elias LJ, Crossley M. Neurocognitive influences on health behavior in a community sample. Health Psychol. 2006; 25(6): 778–782.

    Article  PubMed  Google Scholar 

  12. Blume AW, Marlatt GA. The role of executive cognitive functions in changing substance use: What we know and what we need to know. Ann Behav Med. 2009; 37(2): 117–125.

    Article  PubMed  Google Scholar 

  13. Williams PG, Suchy Y, Rau HK. Individual differences in executive functioning: Implications for stress regulation. Ann Behav Med. 2009; 37(2): 126–140.

    Article  PubMed  Google Scholar 

  14. Solberg Nes L, Roach AR, Segerstrom SC. Executive functions, self-regulation, and chronic pain: A review. Ann Behav Med. 2009; 37(2): 173–183.

    Article  PubMed  Google Scholar 

  15. Hall PA, Elias LJ, Fong GT, Harrison AH, Borowsky R, Sarty GE. A social neuroscience perspective on physical activity. J Sport Exerc Psychol. 2008; 30(4): 432–449.

    PubMed  Google Scholar 

  16. Hall PA, Fong GT, Epp LJ, Elias LJ. Executive function moderates the intention-behavior link for physical activity and dietary behavior. Psychol Health. 2008; 23: 309–326.

    Article  Google Scholar 

  17. Hofmann W, Gschwendner T, Friese M, Wiers RW, Schmitt M. Working memory capacity and self-regulatory behavior: Toward an individual differences perspective on behavior determination by automatic versus controlled processes. J Pers Soc Psychol. 2008; 95(4): 962–977.

    Article  PubMed  Google Scholar 

  18. Wong CL, Mullan BA. Predicting breakfast consumption: An application of the theory of planned behaviour and the investigation of past behaviour and executive function. Br J Health Psychol. 2009; 14(Pt 3): 489–504.

    Article  PubMed  Google Scholar 

  19. Hall PA, Dubin JA, Crossley M, Holmqvist ME, D’Arcy C. Does executive function explain the IQ-mortality association? Evidence from the Canadian study on health and aging. Psychosom Med. 2009; 71(2): 196–204.

    Article  PubMed  Google Scholar 

  20. Duff K, Mold JW, Gidron Y. Cognitive functioning predicts survival in the elderly. J Clin Exp Neuropsychol. 2009; 31(1): 90–95.

    Article  PubMed  Google Scholar 

  21. Batty GD, Deary IJ, Gottfredson LS. Premorbid (early life) IQ and later mortality risk: Systematic review. Ann Epidemiol. 2007; 17(4): 278–288.

    Article  PubMed  Google Scholar 

  22. Gale CR, Deary IJ, Schoon I, Batty GD. IQ in childhood and vegetarianism in adulthood: 1970 British cohort study. BMJ. 2007; 334(7587): 245.

    Article  PubMed  Google Scholar 

  23. Jefferis BJMH, Manor O, Power C. Cognitive development in childhood and drinking behaviour over two decades in adulthood. J Epidemiol Community Health. 2008; 62(6): 506–512.

    Article  CAS  PubMed  Google Scholar 

  24. Batty GD, Deary IJ, Macintyre S. Childhood IQ in relation to risk factors for premature mortality in middle-aged persons: The Aberdeen Children of the 1950s study. J Epidemiol Community Health. 2007; 61(3): 241–247.

    Article  PubMed  Google Scholar 

  25. Batty GD, Deary IJ, Schoon I, Gale CR. Mental ability across childhood in relation to risk factors for premature mortality in adult life: The 1970 British Cohort Study. J Epidemiol Community Health. 2007; 61(11): 997–1003.

    Article  PubMed  Google Scholar 

  26. Chandola T, Deary IJ, Blane D, Batty GD. Childhood IQ in relation to obesity and weight gain in adult life: The National Child Development (1958) Study. Int J Obes. 2006; 30(9): 1422–1432.

    Article  CAS  Google Scholar 

  27. Deary IJ, Whalley LJ, Batty GD, Starr JM. Physical fitness and lifetime cognitive change. Neurology. 2006; 67(7): 1195–1200.

    Article  PubMed  Google Scholar 

  28. Hart CL, Taylor MD, Davey Smith G, et al. Childhood IQ, social class, deprivation, and their relationships with mortality and morbidity risk in later life: Prospective observational study linking the Scottish Mental Survey 1932 and the Midspan studies. Psychosom Med. 2003; 65(5): 877–883.

    Article  PubMed  Google Scholar 

  29. Batty GD, Shipley MJ, Mortensen LH, et al. IQ in late adolescence/early adulthood, risk factors in middle age and later all-cause mortality in men: The Vietnam Experience Study. J Epidemiol Community Health. 2008; 62(6): 522–531.

    Article  CAS  PubMed  Google Scholar 

  30. Batty GD, Mortensen EL, Nybo Andersen A, Osler M. Childhood intelligence in relation to adult coronary heart disease and stroke risk: Evidence from a Danish birth cohort study. Paediatr Perinat Epidemiol. 2005; 19(6): 452–459.

    Article  PubMed  Google Scholar 

  31. Canadian Study on Health and Aging Working Group. Canadian Study on Health and Aging: Study methods and prevalence of dementia. Can Med Assoc j. 1994; 150: 899–913.

    Google Scholar 

  32. McDowell I, Aylesworth R, Stewart M, Hill G, Lindsay J. Study sampling in the Canadian Study of Health and Aging. Int Psychogeriatr. 2001; 13(Supp 1): 19–28.

    Article  PubMed  Google Scholar 

  33. Wechsler DM. Wechsler Adult Intelligence Scale-Revised (WAIS-R). Psychological Corporation. 1981.

  34. Langenecker SA, Briceno EM, Hamid NM, Nielson KA. An evaluation of distinct volumetric and functional MRI contributions toward understanding age and task performance: A study in the basal ganglia. Brain Res. 2007; 1135(1): 58–68.

    Article  CAS  PubMed  Google Scholar 

  35. Lessov-Schlaggar CN, Swan GE, Reed T, Wolf PA, Carmelli D. Longitudinal genetic analysis of executive function in elderly men. Neurobiol Aging. 2007; 28(11): 1759–1768.

    Article  PubMed  Google Scholar 

  36. Lockwood KA, Alexopoulos GS, Van Gorp WG. Executive dysfunction in geriatric depression. Am J Psychiatry. 2002; 159(7): 1119–1126.

    Article  PubMed  Google Scholar 

  37. McPherson S, Fairbanks L, Tiken S, Cummings JL, Back-Madruga C. Apathy and executive function in Alzheimer's disease. J Int Neuropsychol Soc. 2002; 8(3): 373–381.

    Article  PubMed  Google Scholar 

  38. Murphy KR, Barkley RA, Bush T. Executive functioning and olfactory identification in young adults with attention deficit-hyperactivity disorder. Neuropsychology. 2001; 15(2): 211–220.

    Article  CAS  PubMed  Google Scholar 

  39. van de Pol LA, Korf ES, van der Flier WM, et al. Magnetic resonance imaging predictors of cognition in mild cognitive impairment. Arch Neurol. 2007; 64(7): 1023–1028.

    Article  PubMed  Google Scholar 

  40. Verghese J, Wang C, Lipton RB, Holtzer R, Xue X. Quantitative gait dysfunction and risk of cognitive decline and dementia. J Neurol Neurosurg Psychiatry. 2007; 78(9): 929–935.

    Article  PubMed  Google Scholar 

  41. Nakahachi T, Ishii R, Iwase M, et al. Frontal activity during the digit symbol substitution test determined by multichannel near-infrared spectroscopy. Neuropsychobiology. 2008; 57(4): 151–158.

    Article  PubMed  Google Scholar 

  42. Cabeza R, Nyberg L. Imaging cognition II: An empirical review of 275 PET and fMRI studies. J Cogn Neurosci. 2000; 12(1): 1–47.

    Article  CAS  PubMed  Google Scholar 

  43. Thayer JF, Lane RD. Claude Bernard and the heart-brain connection: Further elaboration of a model of neurovisceral integration. Neurosci Biobehav Rev. 2009; 33(2): 81–88.

    Article  PubMed  Google Scholar 

  44. Batty GD, Deary IJ. Early life intelligence and adult health. BMJ. 2004; 329(7466): 585–586.

    Article  PubMed  Google Scholar 

  45. Batty GD, Wennerstad KM, Smith GD, et al. IQ in early adulthood and later cancer risk: Cohort study of one million Swedish men. Ann Oncol. 2007; 18(1): 21–28.

    Article  CAS  PubMed  Google Scholar 

  46. Taylor MD, Hart CL, Davey Smith G, et al. Childhood mental ability and smoking cessation in adulthood: Prospective observational study linking the Scottish Mental Survey 1932 and the Midspan studies. J Epidemiol Community Health. 2003; 57(6): 464–465.

    Article  CAS  PubMed  Google Scholar 

  47. Batty GD, Shipley MJ, Dundas R, et al. Does IQ explain socio-economic differentials in total and cardiovascular disease mortality? Comparison with the explanatory power of traditional cardiovascular disease risk factors in the Vietnam Experience Study. Eur Heart J. 2009; 30(15): 1903–1909.

    Article  PubMed  Google Scholar 

  48. Rabbitt P, Lunn M, Wong D. Understanding terminal decline in cognition and risk of death: Methodological and theoretical implications of practice and dropout effects. Eur Psychol. 2006; 11(3): 164–171.

    Article  Google Scholar 

  49. Baddeley A. The central executive: A concept and some misconceptions. J Int Neuropsychol Soc. 1998; 4(5): 523–526.

    Article  CAS  PubMed  Google Scholar 

  50. Stuss DT, Benson DF. Neuropsychological studies of the frontal lobes. Psychol Bull. 1984; 95(1): 3–28.

    Article  CAS  PubMed  Google Scholar 

  51. Barkley RA. Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychol Bull. 1997; 121(1): 65–94.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Supported by an operating grant and New Investigator Award from the Canadian Institutes of Health Research to the first author. The community portion of the CSHA was supported by base funding from Health Canada.

Author information

Authors and Affiliations

  1. Departments of Kinesiology & Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada, N2L 3G1

    Peter A. Hall Ph.D.

  2. Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    Margaret Crossley Ph.D.

  3. Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

    Carl D’Arcy Ph.D.

Authors
  1. Peter A. Hall Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Margaret Crossley Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carl D’Arcy Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter A. Hall Ph.D..

About this article

Cite this article

Hall, P.A., Crossley, M. & D’Arcy, C. Executive Function and Survival in the Context of Chronic Illness. ann. behav. med. 39, 119–127 (2010). https://doi.org/10.1007/s12160-010-9162-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-010-9162-z

Keywords

Search

Navigation