Assessing inhibitory control in early-stage Alzheimer's and Parkinson's disease using the Hayling Sentence Completion Test

The ability to inhibit irrelevant information is essential for coping with the demands of everyday life. Inhibitory deficits are present in all stages of dementia and commonly observed in people with Parkinson's disease (PwPD). Inhibition is frequently tested with the Stroop test, but this may lack ecological validity. This study investigates inhibitory control in people with Alzheimer's disease dementia (PwD) and PwPD using the Hayling Sentence Completion Test (HSCT), which aspires to be a more ecologically valid task. A total of 117 people completed the HSCT, a test where participants have to complete a sentence with an unrelated word. The sample comprised 30 PwD, 33 PwPD, and 54 healthy older controls. We compared response times and the number and type of errors across the three groups. Completion time in Part B (Inhibition) did not distinguish between PwD, PwPD, and controls when controlling for the initiation speed, but a higher proportion of Category A errors (producing a word that fits the sentence when instructed otherwise) was a unique characteristic of inferior performance in PwD and PwPD. While not part of the standard test scoring protocol, controlling for the initiation speed and distinguishing between speed and accuracy in test performance appear to be essential for accurate evaluation of the inhibitory control in HSCT in older people. The findings suggest that the HSCT may be sensitive to verbal suppression deficits and may provide insight into inhibitory control in PwD and PwPD.