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Costa MV, Diniz MF, Nascimento KK, Pereira KS, Dias NS, Malloy-Diniz LF, Diniz BS. Accuracy of three depression screening scales to diagnose major depressive episodes in older adults without neurocognitive disorders. BRAZILIAN JOURNAL OF PSYCHIATRY 2016; 38:154-6. [PMID: 27304758 PMCID: PMC7111373 DOI: 10.1590/1516-4446-2015-1818] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 12/25/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine the sensitivity and specificity of three depression screening scales to diagnose major depressive episodes in the elderly. METHODS Participants (n=129, 88% female) answered a semi-structured psychiatric interview (Mini International Neuropsychiatric Interview) to determine the diagnosis of major depressive disorder. After this, depressive symptoms in depressed and non-depressed subjects were assessed by independent administration of the 15-item Geriatric Depression Scale (GDS-15), Patient Health Questionnaire-9 (PHQ-9), and 17-item Hamilton Rating Scale for Depression (HDRS-17). RESULTS Patients with major depression and controls did not differ in age and gender distribution. The sensitivity and specificity of all scales to identify a major depressive episode in older adults were ≥ 90%. There were no significant differences between the areas under the curve for PHQ-9 vs. HDRS-17 (z = 1.2, p = 0.2), PHQ-9 vs. GDS-15 (z = 0.26, p = 0.8), or HDRS-17 vs. GDS-15 (z = 1.2, p = 0.2). CONCLUSION This study provides evidence supporting the use of PHQ-9 and GDS-15, both of which are simple to administer and easy to interpret, to diagnose major depressive episodes in older adults without neurocognitive disorders.
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Gomes-Tiago AP, Costa DDS, Alvim-Soares AM, Malloy-Diniz LF, de Miranda DM. Sleep duration and intensity of ADHD symptoms. BRAZILIAN JOURNAL OF PSYCHIATRY 2016; 38:348-349. [PMID: 27828562 PMCID: PMC7111357 DOI: 10.1590/1516-4446-2015-1847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/21/2016] [Indexed: 12/03/2022]
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de Almondes KM, Costa MV, Malloy-Diniz LF, Diniz BS. The Relationship between Sleep Complaints, Depression, and Executive Functions on Older Adults. Front Psychol 2016; 7:1547. [PMID: 27774078 PMCID: PMC5054021 DOI: 10.3389/fpsyg.2016.01547] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 09/22/2016] [Indexed: 11/17/2022] Open
Abstract
Aim: In this manuscript, we report data on the association between executive functions screened by Frontal Assessment Battery, Five Digit Test and Digit Span with self-reported depressive symptoms and sleep complaints in non-demented older adults. Methods: A total sample of 95 non-demented older adults performed Geriatric Depression Scale short version, Frontal Assessment Battery, Five Digit Test, Digit Span, and clinical interview. We split participants in groups stratified by age according to: young-old (60–69 years of age), old-old (70–79 years), and oldest-old (>80 years) and compared these three groups on the sociodemographic characteristics and executive functions performance. We carried out Poisson regression with robust error variance to verify sleep complaints and depression effects on executive functions performance. Gender, age, years of formal education, use of antidepressants and of benzodiazepines were considered as confounding variables, taking into account executive functions as dependent and sleep complaints and depression as independent variables. Results: Controlling the effect of age, gender, years of formal education, use of benzodiazepines and of antidepressants there was a significant influence of depression in motor programming, inhibitory control, and working memory. Individuals without depression show motor programming scores 68.4% higher, inhibitory control scores 3 times greater and working memory scores also 3 times greater than individuals without depression. There was a significant influence of sleep complaints in phonemic fluency, motor programming, inhibitory control, and working memory. Individuals without sleep complaints show phonemic fluency scores 2 times greater than, motor programming scores 85.9% higher, inhibitory control scores 3 times greater and working memory scores also 3 times greater than individuals without sleep complaints. Conclusions: Sleep complaints are associated with phonemic fluency, motor programming, inhibitory control, and working memory impairment. Depression symptoms presence are associated with motor programming and working memory performances. Depression and sleep complaints interaction would determine worse phonemic fluency, inhibitory control and working memory cognitive performance than these two conditions alone.
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Medeiros W, Torro-Alves N, Malloy-Diniz LF, Minervino CM. Executive Functions in Children Who Experience Bullying Situations. Front Psychol 2016; 7:1197. [PMID: 27616998 PMCID: PMC5000580 DOI: 10.3389/fpsyg.2016.01197] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/28/2016] [Indexed: 11/13/2022] Open
Abstract
Bullying is characterized by intentional, repetitive, and persistent aggressive behavior that causes damage to the victim. Many studies investigate the social and emotional aspects related to bullying, but few assess the cognitive aspects it involves. Studies with aggressive individuals indicate impairment in executive functioning and decision-making. The objective of this study was to assess hot and cold executive functions in children who experience bullying. A total of 60 children between 10 and 11 years of age were included in the study. They were divided into four groups: aggressors (bullies), victims, bully-victims, and control. Tests for decision-making, inhibitory control, working memory, and cognitive flexibility were used. The bully group made more unfavorable choices on the Iowa Gambling Task, which may indicate difficulties in the decision-making process. The victim group took longer to complete the Trail Making Test (Part B) than aggressors, suggesting lower cognitive flexibility in victims. The hypothesis that aggressors would have lower performance in other executive functions such as inhibitory control, working memory, and cognitive flexibility has not been confirmed. This study indicates that bullies have an impairment of hot executive functions whereas victims have a comparatively lower performance in cold executive functions. In addition to social and cultural variables, neurocognitive and emotional factors seem to influence the behavior of children in bullying situations.
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Mourao RJ, Mansur G, Malloy-Diniz LF, Castro Costa E, Diniz BS. Depressive symptoms increase the risk of progression to dementia in subjects with mild cognitive impairment: systematic review and meta-analysis. Int J Geriatr Psychiatry 2016; 31:905-11. [PMID: 26680599 DOI: 10.1002/gps.4406] [Citation(s) in RCA: 164] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/15/2015] [Accepted: 11/17/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE There is a long-standing debate in the literature whether depressive symptoms increase the risk of dementia in older with mild cognitive impairment (MCI). We aim to conduct a meta-analysis of studies that evaluated the risk of dementia in subjects with MCI and depressive symptoms compared with subjects with MCI and no depressive symptoms. METHODS We calculated the relative risk of progression to dementia in subjects with MCI and depressive symptoms compared with subjects with MCI and no depressive symptoms using a generic inverse variance method with random effect models. RESULTS Eighteen studies were included in the meta-analysis, with a sample size of 10,861 MCI subjects. The pooled relative risk of progressing to dementia was 1.28 CI95% [1.09-1.52] (p = 0.003) in the group of MCI subjects with depressive symptoms compared with the MCI subjects with no depressive symptoms. DISCUSSION Our results provide additional evidence that depressive symptoms determine an additive risk effect to the progression to dementia in subjects with MCI. The comorbidity between depression and cognitive impairment can be an intervention target for prevention of dementia in MCI subjects. Copyright © 2015 John Wiley & Sons, Ltd.
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Costa DDS, de Paula JJ, Alvim-Soares AM, Pereira PA, Malloy-Diniz LF, Rodrigues LOC, Romano-Silva MA, de Miranda DM. COMT Val(158)Met Polymorphism Is Associated with Verbal Working Memory in Neurofibromatosis Type 1. Front Hum Neurosci 2016; 10:334. [PMID: 27458360 PMCID: PMC4932101 DOI: 10.3389/fnhum.2016.00334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 06/16/2016] [Indexed: 12/26/2022] Open
Abstract
Neurofibromatosis type I (NF1) is a neurogenetic disease marked by multiple cognitive and learning problems. Genetic variants may account for phenotypic variance in NF1. Here, we investigated the association between the catechol-O-methyltransferase (COMT) Val(158)Met polymorphism and working memory and arithmetic performance in 50 NF1 individuals. A significant association of the COMT polymorphism was observed only with verbal working memory, as measured by the backward digit-span task with an advantageous performance for Met/Met carriers. To study how genetic modifiers influence NF1 cognitive performance might be of importance to decrease the unpredictability of the cognitive profile among NF1 patients.
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de Paula JJ, Albuquerque MR, Lage GM, Bicalho MA, Romano-Silva MA, Malloy-Diniz LF. Impairment of fine motor dexterity in mild cognitive impairment and Alzheimer's disease dementia: association with activities of daily living. ACTA ACUST UNITED AC 2016; 38:235-8. [PMID: 27508398 PMCID: PMC7194270 DOI: 10.1590/1516-4446-2015-1874] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/23/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Cognitive impairment is a hallmark of mild cognitive impairment (MCI) and Alzheimer's disease dementia (AD). Although the cognitive profile of these patients and its association with activities of daily living (ADLs) is well documented, few studies have assessed deficits in fine motor dexterity and their association with ADL performance. The objective of this research paper is to evaluate fine motor dexterity performance among MCI and AD patients and to investigate its association with different aspects of ADLs. METHODS We assessed normal aging controls, patients with multiple- and single-domain amnestic MCI (aMCI), and patients with mild AD. Fine motor dexterity was measured with the Nine-Hole Peg Test and cognitive functioning by the Mattis Dementia Rating Scale. We analyzed the data using general linear models. RESULTS Patients with AD or multiple-domain aMCI had slower motor responses when compared to controls. AD patients were slower than those with single-domain aMCI. We found associations between cognition and instrumental ADLs, and between fine motor dexterity and self-care ADLs. CONCLUSION We observed progressive slowing of fine motor dexterity along the normal aging-MCI-AD spectrum, which was associated with autonomy in self-care ADLs.
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Paula JJD, Costa DDS, Oliveira F, Alves JO, Passos LR, Malloy-Diniz LF. Impulsivity and compulsive buying are associated in a non-clinical sample: an evidence for the compulsivity-impulsivity continuum? ACTA ACUST UNITED AC 2016; 37:242-4. [PMID: 26376055 DOI: 10.1590/1516-4446-2014-1644] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Compulsive buying is controversial in clinical psychiatry. Although it is defined as an obsessive-compulsive disorder, other personality aspects besides compulsivity are related to compulsive buying. Recent studies suggest that compulsivity and impulsivity might represent a continuum, with several psychiatric disorders lying between these two extremes. In this sense, and following the perspective of dimensional psychiatry, symptoms of impulsivity and compulsivity should correlate even in a non-clinical sample. The present study aims to investigate whether these two traits are associated in a healthy adult sample. METHODS We evaluated 100 adults, with no self-reported psychiatric disorders, using the Barratt Impulsiveness Scale-11 and two scales of compulsive buying. RESULTS Using multiple linear regressions, we found that impulsivity accounted for about 15% of variance in the compulsive-buying measure. CONCLUSIONS Our results suggest that an association between impulsivity and compulsive buying occurs even in non-clinical samples, evidence that compulsivity and impulsivity might form a continuum and that compulsive buying might be an intermediate condition between these two personality traits.
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de Paula JJ, Bicalho MA, Ávila RT, Cintra MTG, Diniz BS, Romano-Silva MA, Malloy-Diniz LF. A Reanalysis of Cognitive-Functional Performance in Older Adults: Investigating the Interaction Between Normal Aging, Mild Cognitive Impairment, Mild Alzheimer's Disease Dementia, and Depression. Front Psychol 2016; 6:2061. [PMID: 26858666 PMCID: PMC4727063 DOI: 10.3389/fpsyg.2015.02061] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 12/31/2015] [Indexed: 12/12/2022] Open
Abstract
Depressive symptoms are associated with cognitive-functional impairment in normal aging older adults (NA). However, less is known about this effect on people with mild Cognitive Impairment (MCI) and mild Alzheimer's disease dementia (AD). We investigated this relationship along with the NA-MCI-AD continuum by reanalyzing a previously published dataset. Participants (N = 274) underwent comprehensive neuropsychological assessment including measures of Executive Function, Language/Semantic Memory, Episodic Memory, Visuospatial Abilities, Activities of Daily Living (ADL), and the Geriatric Depression Scale. MANOVA, logistic regression and chi-square tests were performed to assess the association between depression and cognitive-functional performance in each group. In the NA group, depressed participants had a lower performance compared to non-depressed participants in all cognitive and functional domains. However, the same pattern was not observed in the MCI group or in AD. The results suggest a progressive loss of association between depression and worse cognitive-functional performance along the NA-MCI-AD continuum.
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Malloy-Diniz LF, Paula JJD, Vasconcelos AG, Almondes KMD, Pessoa R, Faria L, Coutinho G, Costa DS, Duran V, Coutinho TV, Corrêa H, Fuentes D, Abreu N, Mattos P. Normative data of the Barratt Impulsiveness Scale 11 (BIS-11) for Brazilian adults. BRAZILIAN JOURNAL OF PSYCHIATRY 2015; 37:245-8. [DOI: 10.1590/1516-4446-2014-1599] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Albuquerque MR, Franchini E, Lage GM, Da Costa VT, Costa IT, Malloy-Diniz LF. THE RELATIVE AGE EFFECT IN COMBAT SPORTS: AN ANALYSIS OF OLYMPIC JUDO ATHLETES, 1964-2012. Percept Mot Skills 2015; 121:300-8. [PMID: 26302193 DOI: 10.2466/10.pms.121c15x2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study assessed the relative age effect (RAE) in judo athletes who participated in the Olympic Games from 1964 to 2012. The names and birthdates of the Olympic judo athletes were collected from open-access websites. Data from male (n=1,762) and female (n=665) competitors were analyzed separately. Chi-squared tests were performed to investigate REA in medalists, and by weight categories and sexes. When the analyses used semesters to divide the period when the athletes were born, a RAE was found in male heavyweight athletes and male medallists. Thus, in a selected group of judo athletes who had participated at the highest competitive level, RAEs were present in both athletes who won Olympic medals and heavyweight athletes in the male group.
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de Paula JJ, Diniz BS, Bicalho MA, Albuquerque MR, Nicolato R, de Moraes EN, Romano-Silva MA, Malloy-Diniz LF. Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds. Front Aging Neurosci 2015; 7:139. [PMID: 26257644 PMCID: PMC4507055 DOI: 10.3389/fnagi.2015.00139] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 07/06/2015] [Indexed: 12/28/2022] Open
Abstract
Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer's disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity.
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Bertola L, Mota NB, Copelli M, Satler/S. Diniz B, Ribeiro S, Malloy-Diniz LF. P4‐111: Semantic network and executive aspects impact semantic verbal fluency task in healthy elderly, mild cognitive impairment, and Alzheimer's disease patients. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fiaux do Nascimento KK, Pereira KS, Satler/S. Diniz B, Malloy-Diniz LF, Butters M. P3‐092: Plasma and cerebrospinal fluid amyloid‐b levels in late‐life depression: A systematic review and meta‐analysis. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fuentes D, Rzezak P, Pereira FR, Malloy-Diniz LF, Santos LC, Duran FLS, Barreiros MA, Castro CC, Busatto GF, Tavares H, Gorenstein C. Mapping brain volumetric abnormalities in never-treated pathological gamblers. Psychiatry Res 2015; 232:208-13. [PMID: 25952288 DOI: 10.1016/j.pscychresns.2015.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 03/17/2015] [Accepted: 04/02/2015] [Indexed: 01/17/2023]
Abstract
Several magnetic resonance imaging (MRI) studies to date have investigated brain abnormalities in association with the diagnosis of pathological gambling (PG), but very few of these have specifically searched for brain volume differences between PG patients and healthy volunteers (HV). To investigate brain volume differences between PG patients and HV, 30 male never-treated PG patients (DSM-IV-TR criteria) and 30 closely matched HV without history of psychiatric disorders in the past 2 years underwent structural magnetic resonance imaging with a 1.5-T instrument. Using Freesurfer software, we performed an exploratory whole-brain voxelwise volume comparison between the PG group and the HV group, with false-discovery rate correction for multiple comparisons (p < 0.05). Using a more flexible statistical threshold (p < 0.01, uncorrected for multiple comparisons), we also measured absolute and regional volumes of several brain structures separately. The voxelwise analysis showed no clusters of significant regional differences between the PG and HV groups. The additional analyses of absolute and regional brain volumes showed increased absolute global gray matter volumes in PG patients relative to the HV group, as well as relatively decreased volumes specifically in the left putamen, right thalamus and right hippocampus (corrected for total gray matter). Our findings indicate that structural brain abnormalities may contribute to the functional changes associated with the symptoms of PG, and they highlight the relevance of the brain reward system to the pathophysiology of this disorder.
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Assis LDO, de Paula JJ, Assis MG, de Moraes EN, Malloy-Diniz LF. Psychometric properties of the Brazilian version of Pfeffer's Functional Activities Questionnaire. Front Aging Neurosci 2014; 6:255. [PMID: 25309432 PMCID: PMC4174881 DOI: 10.3389/fnagi.2014.00255] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 09/08/2014] [Indexed: 11/25/2022] Open
Abstract
Pfeffer's Functional Activities Questionnaire (FAQ) is one of the most commonly employed tools in studies on pathological cognitive aging. Despite the different versions of the questionnaire translated for use in clinical practice, few studies have analyzed the psychometric properties of the Brazilian version of the FAQ (P-FAQ). Thus, the aim of the present study was to analyze the P-FAQ with regard to internal consistency, factorial structure and associations with demographic factors (age, sex, and schooling), depressive symptoms, cognitive measures and other measures of functionality. One hundred sixty-one older adults were divided into four groups (91 with dementia, 46 with mild cognitive impairment, 11 with psychiatric disorders and 13 healthy controls). All participants were evaluated by cognitive, behavioral and functional tests and scales. Their caregivers answered the P-FAQ. The questionnaire showed high internal consistency (α = 0.91). Factor analysis revealed a two-factor structure, which, accounted for 66% of the total variance. The P-FAQ was not correlated with demographic factors, was weakly correlated with depressive symptoms (ϱ = 0.271, p < 0.01, R2 = 7%) and strongly correlated with cognitive measures (Matttis Dementia Rating Scale total score: ϱ = −0.574, p < 0.01, R2 = 33%) as well as complex instrumental activities of daily living (ϱ = −0.845, p < 0.01, R2 = 71%). Cognitive performance and depression status were independent predictors of P-FAQ scores in regression models. The present findings indicate that the P-FAQ has satisfactory reliability, internal consistency, construct validity and ecological validity. Therefore, this questionnaire can be used in clinical practice and research involving the Brazilian population of older adults.
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Bertola L, Mota NB, Copelli M, Rivero T, Diniz BS, Romano-Silva MA, Ribeiro S, Malloy-Diniz LF. Graph analysis of verbal fluency test discriminate between patients with Alzheimer's disease, mild cognitive impairment and normal elderly controls. Front Aging Neurosci 2014; 6:185. [PMID: 25120480 PMCID: PMC4114204 DOI: 10.3389/fnagi.2014.00185] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 07/09/2014] [Indexed: 12/26/2022] Open
Abstract
Verbal fluency is the ability to produce a satisfying sequence of spoken words during a given time interval. The core of verbal fluency lies in the capacity to manage the executive aspects of language. The standard scores of the semantic verbal fluency test are broadly used in the neuropsychological assessment of the elderly, and different analytical methods are likely to extract even more information from the data generated in this test. Graph theory, a mathematical approach to analyze relations between items, represents a promising tool to understand a variety of neuropsychological states. This study reports a graph analysis of data generated by the semantic verbal fluency test by cognitively healthy elderly (NC), patients with Mild Cognitive Impairment-subtypes amnestic (aMCI) and amnestic multiple domain (a+mdMCI)-and patients with Alzheimer's disease (AD). Sequences of words were represented as a speech graph in which every word corresponded to a node and temporal links between words were represented by directed edges. To characterize the structure of the data we calculated 13 speech graph attributes (SGA). The individuals were compared when divided in three (NC-MCI-AD) and four (NC-aMCI-a+mdMCI-AD) groups. When the three groups were compared, significant differences were found in the standard measure of correct words produced, and three SGA: diameter, average shortest path, and network density. SGA sorted the elderly groups with good specificity and sensitivity. When the four groups were compared, the groups differed significantly in network density, except between the two MCI subtypes and NC and aMCI. The diameter of the network and the average shortest path were significantly different between the NC and AD, and between aMCI and AD. SGA sorted the elderly in their groups with good specificity and sensitivity, performing better than the standard score of the task. These findings provide support for a new methodological frame to assess the strength of semantic memory through the verbal fluency task, with potential to amplify the predictive power of this test. Graph analysis is likely to become clinically relevant in neurology and psychiatry, and may be particularly useful for the differential diagnosis of the elderly.
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Costa DDS, Paula JJD, Alvim-Soares Júnior AM, Diniz BS, Romano-Silva MA, Malloy-Diniz LF, Miranda DMD. ADHD inattentive symptoms mediate the relationship between intelligence and academic performance in children aged 6-14. ACTA ACUST UNITED AC 2014; 36:313-21. [PMID: 25028778 DOI: 10.1590/1516-4446-2013-1201] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 01/28/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Fluid intelligence and the behavioral problems of attention-deficit/hyperactivity disorder (ADHD) are related to academic performance, but how this association occurs is unclear. This study aimed to assess mediation and moderation models that test possible pathways of influence between these factors. METHODS Sixty-two children with ADHD and 33 age-matched, typically developing students were evaluated with Raven's Colored Progressive Matrices and the spelling and arithmetic subtests of the Brazilian School Achievement Test. Dimensional ADHD symptomatology was reported by parents. RESULTS Our findings suggest that fluid intelligence has a significant impact on academic tests through inattention. The inattentive dimension was the principal behavioral source of influence, also accounting for the association of hyperactive-impulsive manifestations with school achievement. This cognitive-to-behavioral influence path seems to be independent of diagnosis related group, and gender, but lower socioeconomic status might increase its strength. CONCLUSION Fluid intelligence is a relevant factor in the influence of ADHD behavioral symptoms on academic performance, but its impact is indirect. Therefore, early identification of both fluid intelligence and inattentive symptoms is of the utmost importance to prevent impaired academic performance and future difficulties in functioning.
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Bertola L, Cunha Lima ML, Romano-Silva MA, de Moraes EN, Diniz BS, Malloy-Diniz LF. Impaired generation of new subcategories and switching in a semantic verbal fluency test in older adults with mild cognitive impairment. Front Aging Neurosci 2014; 6:141. [PMID: 25071550 PMCID: PMC4076742 DOI: 10.3389/fnagi.2014.00141] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 06/12/2014] [Indexed: 11/21/2022] Open
Abstract
The semantic verbal fluency task is broadly used in the neuropsychological assessment of elderly subjects. Even some studies have identified differences in verbal fluency clustering and switching measures between subjects with normal aging and a clinical condition such as mild cognitive impairment (MCI) and Alzheimer's disease, the results are not always consistent. This study aimed to compare clustering and switching measures of an animal's semantic verbal fluency task among normal controls (NC, n = 25), amnestic mild cognitive impairment (aMCI; n = 25), amnestic multiple domain Mild Cognitive Impairment (a+mdMCI; n = 25) and Alzheimer's disease (AD; n = 25) Brazilian subjects. The analyses were executed considering three (unifying the MCI subtypes) and four groups. As the data were not normally distributed, we carried out non-parametric tests (Kruskal-Wallis and Mann-Whitney tests) to evaluate the differences in performance in the measures of the verbal fluency test among the groups. The comparison demonstrated that the groups differed in the total of correct words produced, number of clusters and switching but the measure of new subcategories was the only with significant difference among the NC and all the clinical groups. The measure of new subcategories is the number of original subcategories inside the higher category of animals that the subject produced, such as farm, domestic, African animals. Our results indicate that semantic memory impairment is a visible and recent deficit that occurs even in non-demented subjects with very MCI and the implications of these findings are discussed.
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Lage GM, Miranda DM, Romano-Silva MA, Campos SB, Albuquerque MR, Corrêa H, Malloy-Diniz LF. Association between the catechol-O-methyltransferase (COMT) Val158Met polymorphism and manual aiming control in healthy subjects. PLoS One 2014; 9:e99698. [PMID: 24956262 PMCID: PMC4067272 DOI: 10.1371/journal.pone.0099698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/17/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Prefrontal dopamine is catabolized by the catechol-O-methyltransferase (COMT) enzyme. Current evidence suggests that the val/met single nucleotide polymorphism in the COMT gene can predict the efficiency of executive cognition in humans. Individuals carrying the val allele perform more poorly because less synaptic dopamine is available. METHODOLOGY/PRINCIPAL FINDINGS We investigated the influence of the COMT polymorphism on motor performance in a task that requires different executive functions. We administered a manual aiming motor task that was performed under four different conditions of execution by 111 healthy participants. Participants were grouped according to genotype (met/met, met/val, val/val), and the motor performance among groups was compared. Overall, the results indicate that met/met carriers presented lower levels of peak velocity during the movement trajectory than the val carriers, but met/met carriers displayed higher accuracy than the val carriers. CONCLUSIONS/SIGNIFICANCE This study found a significant association between the COMT polymorphism and manual aiming control. Few studies have investigated the genetics of motor control, and these findings indicate that individual differences in motor control require further investigation using genetic studies.
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Paula JJD, Bertola L, Ávila RTD, Assis LDO, Albuquerque M, Bicalho MA, Moraes END, Nicolato R, Malloy-Diniz LF. Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people. ACTA ACUST UNITED AC 2014; 36:143-52. [PMID: 24554276 DOI: 10.1590/1516-4446-2012-1003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 05/23/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs) based on the Katz and Lawton indices for Alzheimer's disease (AD) and mild cognitive impairment (MCI). METHODS In this study, 85 patients with MCI and 93 with AD, stratified by age (≤ 74 years, > 74 years), completed the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis), reliability (internal consistency), and criterion-related validity (receiver operating characteristic analysis and logistic regression) were assessed. RESULTS Three factors of ADL (self-care, domestic activities, and complex activities) were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL). The components showed good internal consistency (> 0.800) and moderate (younger participants) or high (older participants) accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. CONCLUSION The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD.
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Sallum I, Mata F, Miranda DM, Malloy-Diniz LF. Staying and shifting patterns across IGT trials distinguish children with externalizing disorders from controls. Front Psychol 2013; 4:899. [PMID: 24348449 PMCID: PMC3845255 DOI: 10.3389/fpsyg.2013.00899] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 11/14/2013] [Indexed: 11/13/2022] Open
Abstract
The Iowa Gambling Task (IGT) is the most widely instrument used in the assessment of affective decision-making in several populations with frontal impairment. The standard performance measure on the IGT is obtained by calculating the difference between the advantageous and the disadvantageous choices. This standard score does not allows the assessment of the use of different strategies to deal with contingencies of gain and losses across the task. This study aims to compare the standard score method used in IGT with a method that analyses the patterns of staying and shifting among different decks across the 100 choices, considering contingencies of choices with and without losses. We compared the IGT performance of 24 children with externalizing disorders (Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder) and 24 healthy age-matched children. The analyses of the standard score across all blocks failed to show differences among children with externalizing disorders and control children. However, healthy children showed a pattern of shifting more from disadvantageous decks to advantageous decks and choosing more consecutive cards from the advantageous decks across all blocks, independently of the contingency of losses. On the other hand, children with externalizing disorders presented a pattern of shifting more from advantageous decks to disadvantageous ones in comparison to healthy children and repeatedly chose cards from the B deck across all blocks. This findings show that even though differences among groups might not be found when using the standard analyses, a different type of analysis might be able to show distinct strategies on the execution of the test.
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Lage GM, Malloy-Diniz LF, Neves FS, Gallo LG, Valentini AS, Corrêa H. A kinematic analysis of manual aiming control on euthymic bipolar disorder. Psychiatry Res 2013; 208:140-4. [PMID: 23102536 DOI: 10.1016/j.psychres.2012.09.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Revised: 08/08/2012] [Accepted: 09/25/2012] [Indexed: 10/27/2022]
Abstract
Motor deficits in tasks that require force steadiness or scaling of movement velocity have been found in bipolar disorder (BD). A potential explanation for these results is the abnormal functioning of the frontostriatal circuitry. We designed this study to investigate the possible impairments in a manual aiming task. Participants comprised 15 euthymic BD patients and 15 healthy controls, who performed 100 trials of a goal-directed manual movement with a non-inking pen on a digitizing tablet. Four different conditions of execution were required. The control condition appeared on the computer screen in 70% of the trials, and the other three conditions, (a) distractor, (b) inhibition of response and (c) higher index of difficulty, each appeared in 10% of the trials. Compared to the controls, the BD patients were less fluent in their movements, relied more heavily on visual feedback to control their manual movements and presented a lower spatial accuracy. We found that motor deficits in euthymic BD were observed in the kinematic analysis of manual aiming. Our findings are consistent with the hypothesis of abnormal functioning of the frontostriatal circuitry in euthymic BD.
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Mata F, Sallum I, Miranda DM, Bechara A, Malloy-Diniz LF. Do general intellectual functioning and socioeconomic status account for performance on the Children's Gambling Task? Front Neurosci 2013; 7:68. [PMID: 23760222 PMCID: PMC3669750 DOI: 10.3389/fnins.2013.00068] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 04/15/2013] [Indexed: 12/04/2022] Open
Abstract
Studies that use the Iowa Gambling Task (IGT) and its age-appropriate versions as indices of affective decision-making during childhood and adolescence have demonstrated significant individual differences in scores. Our study investigated the association between general intellectual functioning and socioeconomic status (SES) and its effect on the development of affective decision-making in preschoolers by using a computerized version of the Children's Gambling Task (CGT). We administered the CGT and the Columbia Mental Maturity Scale (CMMS) to 137 Brazilian children between the ages of 3 and 5 years old to assess their general intellectual functioning. We also used the Brazilian Criterion of Economic Classification (CCEB) to assess their SES. Age differences between 3- and 4-years-old, but not between 4- and 5-years-old, confirmed the results obtained by Kerr and Zelazo (2004), indicating the rapid development of affective decision-making during the preschool period. Both 4- and 5-years-old performed significantly above chance on blocks 3, 4, and 5 of the CGT, whereas 3-years-old mean scores did not differ from chance. We found that general intellectual functioning was not related to affective decision-making. On the other hand, our findings showed that children with high SES performed better on the last block of the CGT in comparison to children with low SES, which indicates that children from the former group seem more likely to use the information about the gain/loss aspects of the decks to efficiently choose cards from the advantageous deck throughout the task.
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Lage GM, Malloy-Diniz LF, Fialho JVAP, Gomes CMA, Albuquerque MR, Corrêa H. Correlation between impulsivity dimensions and the control in a motor timing task. ACTA ACUST UNITED AC 2011. [DOI: 10.20338/bjmb.v6i3.182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Little is known about the role of the attentional, motor and non-planning impulsivities in motor timing tasks. The aim of this study was to correlate the motor performance in a motor timing task with the performance in neuropsychological tests of twenty two volunteers. Before the execution of the motor task, participant wore a headphone and heard five times each temporal reference (2,500 and 3,500 msec) that consisted of two “bips”. After, the motor timing task was performed in five trials of each temporal reference. The task consisted in transporting tennis balls in a pre-defined sequence in each criterion time. It was evaluated: reaction time, movement time, constant error and absolute error. The neuropsychological tests IGT and CPT-II were applied to the evaluation of impulsivities. The findings indicated that attentional impulsivity was more related to the motor performance than the motor and non- planning impulsivities.
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