Assessment of executive functions in early-onset cognitive impairment and dementia
Thesis event information
Date and time of the thesis defence
Topic of the dissertation
Assessment of executive functions in early-onset cognitive impairment and dementia
Doctoral candidate
Master of Psychology Veera Tikkanen
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Clinical Medicine, Neurology
Subject of study
Medicine
Opponent
Docent Mervi Jehkonen, University of Tampere
Custos
Docent Johanna Krüger, University of Oulu
Assessment of executive functions in early-onset cognitive impairment and dementia
New methods for timely detection of early onset dementia
Cognitive difficulties, such as problems with memory or attention, are common among working-age adults: about one in five experience some cognitive problems. However, the underlying causes can vary widely, ranging from stress and sleep disturbances to progressive, neurodegenerative diseases. In Finland, an estimated 2,700 people under the age of 65 are living with dementia, and approximately 600 new cases are diagnosed each year. The symptoms of early-onset dementia may be atypical and often manifest particularly as difficulties in executive functions, such as planning, initiating, or maintaining goal-directed and multi-step activities. It is always important to determine the cause of reported cognitive difficulties. Traditional screening tests, which mainly focus on memory functions, may not detect these problems early enough, especially in working-age individuals. Therefore, assessment of executive functions should already be included in the early stages of cognitive evaluation.
This dissertation developed and evaluated new approaches for screening early onset dementia. The results show that combining a novel digital cognitive test battery assessing executive functions (the Flexible Attention Test, FAT) with blood-based biomarkers of neural injury (sNfL, sGFAP) provides a promising way to identify patients who require further diagnostic assessment. The combination of neuropsychological performance and serum biomarkers distinguished patients with dementia or mild cognitive impairment from other memory clinic patients more accurately than either method alone. The FAT proved as effective for screening as traditional neuropsychological tests, while offering advantages in efficiency and ease of administration. The research also evaluated two brief paper-and-pencil screening tests for executive dysfunction (the Ineco Frontal Screening and the Frontal Assessment Battery). The results showed that patients with early onset dementia or mild cognitive impairment performed worse on these tests than those whose symptoms were due to other causes, such as depression or sleep problems.
Overall, the dissertation provides practical tools for early screening and detection of early onset dementia. Incorporating new neuropsychological methods and their combination with serum biomarkers already at the screening stage may facilitate earlier access to care and support timely diagnosis.
Cognitive difficulties, such as problems with memory or attention, are common among working-age adults: about one in five experience some cognitive problems. However, the underlying causes can vary widely, ranging from stress and sleep disturbances to progressive, neurodegenerative diseases. In Finland, an estimated 2,700 people under the age of 65 are living with dementia, and approximately 600 new cases are diagnosed each year. The symptoms of early-onset dementia may be atypical and often manifest particularly as difficulties in executive functions, such as planning, initiating, or maintaining goal-directed and multi-step activities. It is always important to determine the cause of reported cognitive difficulties. Traditional screening tests, which mainly focus on memory functions, may not detect these problems early enough, especially in working-age individuals. Therefore, assessment of executive functions should already be included in the early stages of cognitive evaluation.
This dissertation developed and evaluated new approaches for screening early onset dementia. The results show that combining a novel digital cognitive test battery assessing executive functions (the Flexible Attention Test, FAT) with blood-based biomarkers of neural injury (sNfL, sGFAP) provides a promising way to identify patients who require further diagnostic assessment. The combination of neuropsychological performance and serum biomarkers distinguished patients with dementia or mild cognitive impairment from other memory clinic patients more accurately than either method alone. The FAT proved as effective for screening as traditional neuropsychological tests, while offering advantages in efficiency and ease of administration. The research also evaluated two brief paper-and-pencil screening tests for executive dysfunction (the Ineco Frontal Screening and the Frontal Assessment Battery). The results showed that patients with early onset dementia or mild cognitive impairment performed worse on these tests than those whose symptoms were due to other causes, such as depression or sleep problems.
Overall, the dissertation provides practical tools for early screening and detection of early onset dementia. Incorporating new neuropsychological methods and their combination with serum biomarkers already at the screening stage may facilitate earlier access to care and support timely diagnosis.
Created 24.10.2025 | Updated 13.11.2025