B – 141 Evaluating Disinhibition in Older Adults: Implications of Caregiver-Reported vs. Performance-Based Assessments for Clinical Decision-Making

Abstract Objective This study examines the relationship between cognitive disinhibition, as measured by the Delis-Kaplan Executive Function System (DKEFS) Color-Word Interference Test (CWI), and caregiver-reported disinhibition via the Neuropsychiatric Inventory Questionnaire (NPI-Q) in a geriatric population. The goal is to assess whether subjective caregiver observations align with objective neuropsychological performance. Findings have implications for clinical assessment, diagnostic accuracy, and care planning for older adults with cognitive impairment. Method Participants were older adults (aged ≥65) who underwent outpatient neuropsychological assessment and were accompanied by a caregiver (N = 529; 236 female). Caregivers completed a validated disinhibition tool, including the summed value of disinhibition severity, caregiver-reported distress, and patient distress on the NPI-Q. T-tests were conducted comparing DKEFS CWI performance between those who endorsed any disinhibition versus none. A regression analysis was also conducted to determine whether caregiver-reported disinhibition scores on the NPI-Q were significantly associated with CWI performance. Results The average age of participants was 66 years, with an average of 15 years of formal education. No significant difference was found in CWI scores between individuals with and without caregiver-reported disinhibition (t = 0.1548, p > 0.05). Additionally, caregiver-assessed disinhibition severity was not significantly associated with CWI scores (β = -0.08, p > 0.05). However, qualitative review of regression score distribution showed better model fit past a certain severity threshold. Conclusion No significant relationship was found between caregiver-reported behavioral disinhibition and cognitive disinhibition. Future research should explore moderating factors such as age, education, and gender.