Executive dysfunctions mediate between altered sensory processing and daily activity performance in older adults

Abstract

Background: Sensory processing is essential for the interaction with the environment and for adequate daily function. Sensory processing may deteriorate with aging and restrict daily activity performance. Aging may also affect Executive functions (EFs) which are critical for daily activity performance. Yet, most studies refer separately to the impacts of sensory processing or EFs and use clinical evaluations that do not necessarily reflect functional restrictions in real life. This study aims to describe the prevalence of altered sensory processing in the elderly as expressed in daily life scenarios and explore whether EFs mediate between altered sensory processing and daily activity performance in older adults.

Methods: This cross-sectional study included 167 healthy independently functioning people aged 65 and above who were living in the community, had sufficient cognitive status and no symptoms of depression (based on the GDS and the MMSE). All participants completed a socio-demographic-health questionnaire, the Adolescent/Adult Sensory Profile, the Behavior Rating Inventory of Executive Function-Adult Version and the Daily Living Questionnaire.

Results: Altered sensory processing, and mainly by the reduced ability to register and modulate sensory input from daily environment, were prevalent in older adults. Their impacts on daily activity performance were mediated by executive dysfunctions.

Conclusions: Executive dysfunctions may worsen the negative effects of altered sensory processing on daily activity performance in older adults. The interaction between EFs and sensory processing should receive growing attention in intervention and prevention programs for older adults, with the emphasis on their expressions and implications on peoples' function in real life context.

Keywords: Activities of daily living; Executive functions; Older adults; Sensory processing.

Fig. 1

Mean Differences between Participants with Extreme and Normal Sensory Processing (BRIEF-A). Note. BRI = Behavioral Regulation Index; MI = Metacognition Index; GEC = Global Executive Composite

Fig. 2

Mean Differences between Participants with Extreme and Normal Sensory Processing in each DLQ section. Note. *p ≤ .050; **p ≤ .010; ***p ≤ .00

Fig. 3

Structural Equation Modeling: Relationship between Age, Sensory Processing, Executive Functions, and Daily Activity Performance. Note. N = 167, χ²(15) = 21.68, p = .12, CFI = .98, NFI = .96, RMSEA = .05. ⁺p < .100; ^*p ≤ .050; ^**p ≤ .010; ^***p ≤ .001