Stroop Switching Card Test: Brief screening of executive functioning across the lifespan

• ¹ University of Caen Normandy, France
• ² United Arab Emirates University, United Arab Emirates

Background. The relationship between executive functioning (EF; high-level processes involved in monitoring and controlling goal-directed behaviour) and age has shown contradictory findings. Some studies have reported an age-related change in certain EF across the life span whereas others did not. This may result from the lack of neuropsychological tests of EF that are applicable across all life stages. This study sought to address this issue by developing a new neuropsychological test (Stroop Switching Card Test; SSCT) designed to assess 3 components of EF, namely inhibition, switching and updating. Objective. This study aimed at examining the utility of SSCT in the assessment of EF from childhood to old age, in order to identify the most sensitive measures of early EF decline. Method. A sample of 129 participants ranging in age from 9 to 75 years completed: i) standardized neuropsychological tests (SNT) evaluating flexibility (Trail Making Test), inhibition (Stroop test), and updating (Forward and Backward Digit Span), and SSCT. Principal component analysis and multiple regression analysis were used to demonstrate the utility of SSCT (i.e., response time, the total number of errors, inverse efficiency score; IES) for age-related EF decline. Results and discussion. A U-shaped relationship was found between age and EF as assessed by both SNT and SSCT, with larger costs in response time (i.e., time of competition in each test) for children (Mean± SD: 10 ±1 years), middle-aged (50±5 years) and older adults (66±4). Most interestingly principal component analysis revealed that the IES was selectively increased in older adults demonstrating that this measure is more sensitive to age-related change in EF as compared with measures from SNT. Moreover, multiple linear regression showed that measures from SNT could predict response time in SSCT, suggesting that the latter could be used as a global measure of EF efficiency across the lifespan. Conclusion. The findings demonstrated that the SSCT, and more specifically the IES is more sensitive to ageing than SNT.