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Impaired executive functions

Because these skills integrate information at higher level across cognitive domains, damage to the executive system typically involves a cluster of deficiencies, not just one ability. The loss of that "administrative" control affects the ability to organize and regulate multiple types of information and, therefore, behaviors.

Damage to the executive system, often leads to:

  • Socially inappropriate behavior
  • Inability to apply consequences from past actions
  • Difficulty with abstract concepts (the inability to make the leap from the symbolic to the real world)
  • Difficulty in planning and initiation (getting started)
  • Difficulty with verbal fluency
  • Inability to multitask
  • Difficulty processing, storing, and/or retrieving information
  • Frequent “policing” by others to monitor the appropriateness of their actions
  • Loss of fine motor skills like grabbing something with your thumb and forefinger more than gross motor skills like running and jumping
  • Moody or “roller coaster” emotions
  • Lack of concern toward people and animals
  • Loss of interest in activities
  • Unawareness or denial that their behavior is a problem
  • Antisocial behavior associated with disinhibition
  • Trouble planning for the future

In addition to frontotemporal dementia, executive function deficits are associated with a number of psychiatric and developmental disorders, including obsessive-compulsive disorder, Tourette's syndrome, depression, schizophrenia, attention-deficit/hyperactivity disorder, autism and addiction.

Executive functions are difficult to assess directly since they coordinate other cognitive skills. Damage to memory, language, visuospatial skills and other cognitive functions can impact how a person performs on tests of executive function. Executive skills are also grounded in real world experience, which makes laboratory tests more difficult to create. The instruments used to assess executive behavior require mental agility, foresight, planning and freedom from distraction. Widely used tests include the Word Fluency Task, Stroop Test, Wisconsin Card Sorting Test, Trailmaking Test and Porteus Mazes.