Executive Functions: a relevant feature of cognitive decline. Clinical impact of experimental evidence

Both physiological and pathological decline in aging is characterized by a loss of cognitive functioning from mild to severe. This decline involves many cognitive domains, and it is characterized by memory difficulties, poor mental flexibility, lower ability to inhibit responses and appropriately respond to environmental stim- uli. According to its severity, cognitive decline can affect daily life activities. However, in the classification of Mild Cognitive Decline (MCD), low attentional focus in the clinical field was directed toward executive functioning, a cognitive domain highly relevant for goal-directed behaviors and positive daily functioning. Analyzing the main features of executive functioning in MCD and the main differences from healthy to pathological aging can help define the impaired trend of functioning, which affects decline. Clinicians should consider including executive functioning in the diagnostic classification of MCD. This new classification would be useful for developing novelty treatments focused on enhancing this domain to reduce the impact on the daily life of elderly people. Experimental evidence on executive functioning in MCI may clarify these aspects.