What Role Do Executive Functions Play in the Etiology of Behavioral and Psychological Symptoms of Dementia? an Integrative Review

The aim of our study was to review the literature on the relationship between executive dysfunction (EDF) and the behavioral and psychological symptoms of dementia (BPSD). We searched for papers that addressed one or both of two questions: a) is there a causal relationship between EDF and BPSD?; b) What are the main hypotheses or theoretical models that explain this relationship? A systematic search was made identify all possibly relevant papers on the Scopus Elsevier and PubMed databases, using an algorithm with the keywords most often used to search for references on EDF and BPSD. We found 112 works in Scopus-Elsevier and 59 in PubMed; 20 were repeated, resulting in 151 distinct publications. We excluded 143 of these because they did not consider EDF as an independent variable and BPSD as a dependent variable. Five more works came out of a reverse search on the bibliography from the 8 remaining papers, resulting in 13 works for our review. Two groups were formed according to their investigative design to establish the relationship between EDF and BPSD. The studies generally found an association between EDF and BPSD, but few of them have investigated the nature of this relationship, with little clarification of the mechanism through which the former contributes to the emergence of the latter.