Reliability and validity of the executive interview (exit) and quick exit among community dwelling older adults

DOI

10.1016/j.jagp.2013.08.009

Document Type

Journal Article

Publication Date

12-1-2014

Publication Title

American Journal of Geriatric Psychiatry

Volume

22

Issue

12

First Page

1444

Last Page

1451

ISSN

10647481

Keywords

aged, cognition, Executive functions

Abstract

Objectives To investigate the psychometric properties of the Executive Interview (EXIT) and Quick EXIT in community dwelling older adults. Design Secondary analysis of data obtained as part of a longitudinal study of cognitive function in late-life depression. Setting A university hospital. Participants Community-dwelling adults (N = 422), aged 59 years and older, with current or recent history of non-psychotic unipolar major depression, and never-depressed comparison subjects. Measurements The EXIT and other measures of executive control functions (ECF), non-executive cognitive domains, and global cognitive function. We calculated Quick EXIT scores from the EXIT. Results The EXIT demonstrated high inter-rater reliability (Intraclass correlation coefficient = 0.978, F(7, 21) = 174.85, p <0.001), and both the EXIT and Quick EXIT demonstrated moderate internal consistency (α = 0.66 and α = 0.68, respectively). Both tests also demonstrated acceptable convergent validity against several standard tests of ECF (rs-0.399 to 0.322, except for the Trail Making Test B, where rs was 0.057 to 0.063) as well as against measures of multifactorial cognitive function (rs-0.432 to 0.491). Both tests, however, demonstrated inconsistent discriminant validity against a variety of standard non-ECF tests (rs-0.013 to 0.376). Conclusions Both the EXIT and the Quick EXIT have adequate reliability and appear to require ECF in this population. However, both the EXIT and the Quick EXIT also reflect non-ECF domains. The EXIT and Quick EXIT should be considered to be measures of global cognitive function rather than pure ECF measures. Given similar reliability and validity, the Quick EXIT is recommended clinically as it is briefer and less burdensome than the full EXIT.

Open Access

Green Accepted

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