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Bossoni AS, Peres MFP, Leite CDC, Fortini I, Conforto AB. Headache at the chronic stage of cerebral venous thrombosis. Cephalalgia 2022; 42:1476-1486. [PMID: 35899769 DOI: 10.1177/03331024221113825] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Headache is the most frequent symptom of cerebral venous thrombosis (CVT) but there is limited information about the frequency and phenotype of headache, weeks to months after cerebral venous thrombosis (post-cerebral venous thrombosis headache, post cerebral venous thrombosis headache). OBJECTIVE To assess the frequency, characteristics and predictors of PCH. METHODS In this cross-sectional study, the frequency and characteristics of PCH were assessed in cerebral venous thrombosis survivors. Patients were interviewed between six months and five years after the cerebral venous thrombosis diagnosis. Clinical and imaging characteristics at the time of cerebral venous thrombosis diagnosis, as well as history of headache prior to cerebral venous thrombosis were compared in subjects with (GroupPCH) and without PCH (Groupcontrol). RESULTS Subjects (n = 100; 82% women) were assessed, on average, at 1.1 ± 1.6 years of follow-up. PCH was present in 59% of the patients, phenotypes of tension-type-like headache were present in 31/59 (52.6%) and of migraine-like headache in 16/59 (27.1%). History of primary headache prior to cerebral venous thrombosis was significantly more common (OR: 6.4; 95% CI: 1.7-36.3) in GroupPCH (33.9%) than in Groupcontrol (7.3%). CONCLUSION Post cerebral venous thrombosis headache was present in more than half of the patients. History of prior headache may be a risk factor for post cerebral venous thrombosis headache. Prospective studies are required to confirm these findings and determine mechanisms, as well as interventions for prevention and treatment of post cerebral venous thrombosis headache.
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Affiliation(s)
- Alexandre Souza Bossoni
- Neurology Clinical Division, Hospital das Clínicas/São Paulo University, São Paulo - SP, Brazil
| | | | - Claudia da Costa Leite
- Institute of Radiology, Hospital das Clínicas/São Paulo University, São Paulo - SP, Brazil
| | - Ida Fortini
- Neurology Clinical Division, Hospital das Clínicas/São Paulo University, São Paulo - SP, Brazil
| | - Adriana Bastos Conforto
- Neurology Clinical Division, Hospital das Clínicas/São Paulo University, São Paulo - SP, Brazil.,Hospital Israelita Albert Einstein, São Paulo - SP, Brazil
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2
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A Systematic Review of Neuropsychological Tests for the Assessment of Dementia in Non-Western, Low-Educated or Illiterate Populations. J Int Neuropsychol Soc 2020; 26:331-351. [PMID: 31511111 DOI: 10.1017/s1355617719000894] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Neuropsychological tests are important instruments to determine a cognitive profile, giving insight into the etiology of dementia; however, these tests cannot readily be used in culturally diverse, low-educated populations, due to their dependence upon (Western) culture, education, and literacy. In this review we aim to give an overview of studies investigating domain-specific cognitive tests used to assess dementia in non-Western, low-educated populations. The second aim was to examine the quality of these studies and of the adaptations for culturally, linguistically, and educationally diverse populations. METHOD A systematic review was performed using six databases, without restrictions on the year or language of publication. RESULTS Forty-four studies were included, stemming mainly from Brazil, Hong Kong, Korea, and considering Hispanics/Latinos residing in the USA. Most studies focused on Alzheimer's disease (n = 17) or unspecified dementia (n = 16). Memory (n = 18) was studied most often, using 14 different tests. The traditional Western tests in the domains of attention (n = 8) and construction (n = 15), were unsuitable for low-educated patients. There was little variety in instruments measuring executive functioning (two tests, n = 13), and language (n = 12, of which 10 were naming tests). Many studies did not report a thorough adaptation procedure (n = 39) or blinding procedures (n = 29). CONCLUSIONS Various formats of memory tests seem suitable for low-educated, non-Western populations. Promising tasks in other cognitive domains are the Stick Design Test, Five Digit Test, and verbal fluency test. Further research is needed regarding cross-cultural instruments measuring executive functioning and language in low-educated people.
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Magklara E, Stephan BCM, Robinson L. Current approaches to dementia screening and case finding in low- and middle-income countries: Research update and recommendations. Int J Geriatr Psychiatry 2019; 34:3-7. [PMID: 30247787 DOI: 10.1002/gps.4969] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 08/06/2018] [Indexed: 12/21/2022]
Abstract
Approximately 47 million people have dementia worldwide, with this figure, it is expected to almost triple by 2050. Most people with dementia (approximately two-thirds) live in low- and middle-income countries (LMICs). This presents a significant challenge for such countries that often have limited financial resources and less well-developed health and social care systems. In the absence of a cure, reducing the future costs of dementia care and burden of disease may be best achieved by a greater emphasis on (1) more timely diagnosis with earlier intervention to maintain functional independence and (2) undertaking "screening" in groups at high risk of developing dementia, case finding, and using brief cognitive assessment instruments. In clinical settings, a wide range of instruments for dementia screening and diagnosis are currently available; however, few cognitive assessment tools have been developed specifically for clinical use within LMIC settings. Screening for dementia and cognitive impairment in LMICs largely relies on tools adapted from high-income countries (HICs); these often lack validation in these settings leading to education, literacy, and cultural biases. Research is urgently needed to develop cognitive assessment tools and dementia diagnostic approaches that are appropriate and feasible for clinical use in LMIC settings.
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Affiliation(s)
- Eleni Magklara
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Blossom C M Stephan
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.,Newcastle Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Robinson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.,Newcastle Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK
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4
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Jomar RT, Lourenço RA, Lopes CDS. [Dimensional structure of the Brazilian version of the Functional Activities Questionnaire (FAQ-BR)]. CAD SAUDE PUBLICA 2018; 34:e00209917. [PMID: 30427420 DOI: 10.1590/0102-311x00209917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 05/18/2018] [Indexed: 11/21/2022] Open
Abstract
This study aimed to assess the dimensional structure and internal consistency of the Brazilian version of the Functional Activities Questionnaire (FAQ-BR) for measurement of functional capacity in the elderly, based on the informant's report. This was a cross-sectional study with 525 non-institutionalized elderly informants, in which confirmatory factor analyses (CFA) and exploratory/confirmatory factor analyses (E/CFA) modeled according to CFA principles were used to identify the most parsimonious model and that with the best fit. The internal consistency of the FAQ-BR was assessed by composite reliability, and correlations between its dimensions were examined to investigate discriminant factor validity. CFA did not corroborate the unidimensional structure as originally proposed. Next, E/CFA fit a bidimensional structure that was reassessed by CFA, displaying a model without cross loads as the most parsimonious and with adequate fit indices. The internal consistency of FAQ-BR was considered satisfactory, and the correlation between its dimensions was acceptable. These findings are important, since they demonstrate the scale's capacity to capture the elderly's functional capacity construct in a different sociocultural context from that in which it was originally developed. The FAQ-BR can thus be considered an appropriate bidimensional instrument for measuring the elderly's functional capacity based on the informant's report, and its use in studies with similar populations is recommended.
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de Melo DM, Barbosa AJG. [Use of the Mini-Mental State Examination in research on the elderly in Brazil: a systematic review]. CIENCIA & SAUDE COLETIVA 2017; 20:3865-76. [PMID: 26691810 DOI: 10.1590/1413-812320152012.06032015] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 07/16/2015] [Indexed: 11/22/2022] Open
Abstract
The Mini-Mental State Examination (MMSE) is the most widely used cognitive screening test around the world. In Brazil, different MMSE versions and many cut-off points have been used. A systematic review of papers indexed in Scielo was conducted in order to analyze use of the MMSE in Brazilian empirical studies with elderly people. To search for these texts, the complete name of the instrument and its abbreviation were used. A growth trend in the scientific production during the 1998 to 2013 period was observed. Eleven versions of the MMSE were identified and the Bertolucci et al. version was the most cited. Over half of the studies used schooling as the criteria to establish cut-off points. The studies were predominantly conducted using samples recruited from large cities in the Southeastern region and in the community. Despite the growing trend of research with the elderly using the MMSE, the psychometric properties of this scale of measurement have been the subject of little investigation. Despite the widespread use of the MMSE in Brazil, there is a lack of standardization and evidence of validity for this this scale of measurement.
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6
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Conti J. Cognitive assessment: A challenge for occupational therapists in Brazil. Dement Neuropsychol 2017; 11:121-128. [PMID: 29213503 PMCID: PMC5710680 DOI: 10.1590/1980-57642016dn11-020004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Accepted: 05/24/2017] [Indexed: 12/02/2022] Open
Abstract
Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life. OBJECTIVE The aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice. METHODS The instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed. RESULTS The search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment). CONCLUSION There are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice.
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Affiliation(s)
- Juliana Conti
- Occupational Therapy Division of the Hospital das
Clínicas/Sao Paulo University, São Paulo, SP, Brazil
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Paiva GCDC, Fialho MB, Costa DDS, Paula JJD. Ecological validity of the five digit test and the oral trails test. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 74:29-34. [PMID: 26602200 DOI: 10.1590/0004-282x20150184] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/17/2015] [Indexed: 11/22/2022]
Abstract
Tests evaluating the attentional-executive system are widely used in clinical practice. However, proximity of an objective cognitive test with real-world situations (ecological validity) is not frequently investigated. The present study evaluate the association between measures of the Five Digit Test (FDT) and the Oral Trails Test (OTT) with self-reported cognitive failures in everyday life as measured by the Cognitive Failures Questionnaire (CFQ). Brazilian adults from 18-to-65 years old voluntarily performed the FDT and OTT tests and reported the frequency of cognitive failures in their everyday life through the CFQ. After controlling for the age effect, the measures of controlled attentional processes were associated with cognitive failures, yet the cognitive flexibility of both FDT and OTT accounted for by the majority of variance in most aspects of the CFQ factors. The FDT and the OTT measures were predictive of real-world problems such as cognitive failures in everyday activities/situations.
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Affiliation(s)
- Gabrielle Chequer de Castro Paiva
- Laboratório de Experimentação em Psicologia e Neuropsicologia, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mariana Braga Fialho
- Laboratório de Experimentação em Psicologia e Neuropsicologia, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Danielle de Souza Costa
- Laboratório de Experimentação em Psicologia e Neuropsicologia, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Jonas Jardim de Paula
- Laboratório de Experimentação em Psicologia e Neuropsicologia, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
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8
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de Paula JJ, Paiva GCDC, Costa DDS. Use of a modified version of the switching verbal fluency test for the assessment of cognitive flexibility. Dement Neuropsychol 2015; 9:258-264. [PMID: 29213970 PMCID: PMC5619367 DOI: 10.1590/1980-57642015dn93000008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objective Verbal fluency tests are widely used for the assessment of executive
functions. However, traditional versions of the test depend on several
cognitive factors beyond these components. The aim of this study was to
evaluate the associations of a modified version of the verbal fluency with
specific measures of executive functions. Methods Sixty adults were evaluated using traditional versions of verbal fluency
(animals/fruits) and a modified condition where subjects must switch between
animals and fruits. Processing speed, semantic abilities, psychiatric
symptoms and executive functions were also assessed. Results Partial correlations between the verbal fluency tests and measures of
executive functions, controlled for demographic, cognitive and psychiatric
symptoms, suggest that cognitive flexibility has 9% shared variance with the
verbal fluency test – category animals, 2 % with category fruits, 8% with
total words in switching condition, and 20% with total correct word-pairs
produced in switching condition. The other aspects of executive functions
during the task had shared variance of between 1% and 7% with the verbal
fluency tasks. Conclusion The results suggest that correct word-pairs produced in switching verbal
fluency may be a more specific measure for evaluating cognitive flexibility
compared to other versions of verbal fluency.
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Affiliation(s)
- Jonas Jardim de Paula
- Departamento de Psicologia, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte MG, Brasil.,Laboratório de Experimentação em Psicologia e Neuropsicologia (Labep_neuro), Belo Horizonte MG, Brasil.,Instituto Nacional de Ciência e Tecnologia em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte MG, Brasil
| | | | - Danielle de Souza Costa
- Laboratório de Experimentação em Psicologia e Neuropsicologia (Labep_neuro), Belo Horizonte MG, Brasil.,Instituto Nacional de Ciência e Tecnologia em Medicina Molecular, Universidade Federal de Minas Gerais, Belo Horizonte MG, Brasil
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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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Affiliation(s)
- Luciana de Oliveira Assis
- Post Graduation Program in Neuroscience, Federal University of Minas Gerais Belo Horizonte, Brazil ; Faculty of Humanities, Social Sciences and Health, FUMEC University Belo Horizonte, Brazil
| | - Jonas J de Paula
- Department of Psychology, Faculty of Medical Sciences of Minas Gerais Belo Horizonte, MG, Brazil ; Faculty of Medicine, National Institute of Science and Technology - Molecular Medicine, Federal University of Minas Gerais Belo Horizonte, Brazil
| | - Marcella G Assis
- Department of Occupational Therapy, Faculty of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais Belo Horizonte, Brazil
| | - Edgar N de Moraes
- Department of Clinics, Faculty of Medicine, Federal University of Minas Gerais Belo Horizonte, Brazil
| | - Leandro F Malloy-Diniz
- Faculty of Medicine, National Institute of Science and Technology - Molecular Medicine, Federal University of Minas Gerais Belo Horizonte, Brazil ; Laboratory of Neuropsychological Investigations (LIN), Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais Belo Horizonte, Brazil
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10
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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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Affiliation(s)
- Jonas J de Paula
- Laboratory of Research in Clinical Neuroscience (LINC), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Laiss Bertola
- Laboratory of Research in Clinical Neuroscience (LINC), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Rafaela T de Ávila
- Laboratory of Research in Clinical Neuroscience (LINC), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luciana de O Assis
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maicon Albuquerque
- Laboratory of Research in Clinical Neuroscience (LINC), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Maria A Bicalho
- Department of Medical Practice, School of Medicine, UFMG, Belo Horizonte, MG, Brazil
| | - Edgar N de Moraes
- Department of Medical Practice, School of Medicine, UFMG, Belo Horizonte, MG, Brazil
| | - Rodrigo Nicolato
- National Science and Technology Institute for Molecular Medicine, School of Medicine, UFMG, Belo Horizonte, MG, Brazil
| | - Leandro F Malloy-Diniz
- Laboratory of Research in Clinical Neuroscience (LINC), Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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The Stick Design Test on the assessment of older adults with low formal education: evidences of construct, criterion-related and ecological validity. Int Psychogeriatr 2013; 25:2057-65. [PMID: 23905545 DOI: 10.1017/s1041610213001282] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The assessment of visuospatial abilities is usually performed by drawing tasks. In patients with very low formal education, the use of these tasks might be biased by their cultural background. The Stick Design Test was developed for the assessment of this population. We aim to expand the test psychometric properties by assessing its construct, criterion-related and ecological validity in older adults with low formal education. METHOD Healthy older adults (n = 63) and Alzheimer's disease patients (n = 92) performed the Stick Design Test, Mini-Mental State Examination, Digit Span Forward and the Clock Drawing Test. Their caregivers answered Personal Care and Instrumental Activities of Daily Living). Construct validity was assessed by factor analysis, convergent correlations (with the Clock Drawing Test), and divergent correlations (with Digit Span Forward); criterion-related validity by receiver operating characteristic curve analysis and binary logistic regression; and Ecological validity by correlations with ADL. RESULTS The test factor structure was composed by one component (R 2 = 64%). Significant correlations with the Clock Drawing Test and Digit Span Forward were found, and the relationship was stronger with the first measure. The test was less associated with formal education than the Clock Drawing Test. It classified about 76% of the participants correctly and had and additive effect with the Mini-Mental State Examination (84% of correct classification). The test also correlated significantly with measures of ADL, suggesting ecological validity. CONCLUSIONS The Stick Design Test shows evidence of construct, criterion-related and ecological validity. It is an interesting alternative to drawing tasks for the assessment of visuospatial abilities.
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Functional disability in Alzheimer disease: a validation study of the Brazilian version of the Disability Assessment for Dementia (DAD-Br). Alzheimer Dis Assoc Disord 2011; 24:291-5. [PMID: 20473140 DOI: 10.1097/wad.0b013e3181cfc878] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The assessment of activities of daily living (ADL) is important both for the diagnosis and staging of dementia. The objective of this study was to verify the applicability and validity of the Brazilian version of the Disability Assessment for Dementia (DAD-Br). METHODS The DAD was applied to caregivers of 89 patients with probable Alzheimer disease (AD) and to 40 elderly individuals without cognitive impairment (controls). We assessed the construct validity of the scale and its diagnostic accuracy (sensitivity, specificity, and predictive value). In addition, intergroup and intragroup analyses were conducted to characterize patient performance on basic and instrumental ADL and to determine underlying deficits (initiation, planning, or effective execution). RESULTS AD patients and controls had mean ages of 76.4+/-6.9 years and 74.5+/-7.3 years (P=0.08), respectively. Mean Mini-Mental State Examination scores were 17.4+/-5.0 and 26.1+/-5.1 (P<0.001) and scores on the DAD were 68.4+/-19.0 and 99.8+/-0.9 (P<0.001), for patients and controls, respectively. The DAD scale showed good internal consistency (Cronbach alpha=0.77) and correlation with the Mini-Mental State Examination (r=0.44; P<0.001). The AD group did better on basic ADL than on instrumental ADL (P<0.001). As expected, controls did not exhibit significant deficits on the items evaluated. CONCLUSION The Brazilian version of the DAD is an adequate and reliable tool for assessing functional ability in AD patients.
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Abstract
Progressive posterior cortical dysfunction (PPCD) is an insidious syndrome
characterized by prominent disorders of higher visual processing. It affects
both dorsal (occipito-parietal) and ventral (occipito-temporal) pathways,
disturbing visuospatial processing and visual recognition, respectively. We
report a case of a 67-year-old woman presenting with progressive impairment of
visual functions. Neurologic examination showed agraphia, alexia, hemispatial
neglect (left side visual extinction), complete Balint’s syndrome and visual
agnosia. Magnetic resonance imaging showed circumscribed atrophy involving the
bilateral parieto-occipital regions, slightly more predominant to the right. Our
aim was to describe a case of this syndrome, to present a video showing the main
abnormalities, and to discuss this unusual presentation of dementia. We believe
this article can contribute by improving the recognition of PPCD.
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Affiliation(s)
- Fábio Henrique de Gobbi Porto
- MD, Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC); Hospital das Clínicas of the University of São Paulo, São Paulo SP, Brazil
| | | | - Lilian Schafirovits Morillo
- MD, MSc, Behavioral and Cognitive Neurology Unit, Department of Neurology, and Cognitive Disorders Reference Center (CEREDIC); Hospital das Clínicas of the University of São Paulo, School of Medicine, São Paulo SP, Brazil. Discipline of Geriatric Medicine, Hospital das Clínicas of the University of São Paulo, School of Medicine, São Paulo SP, Brazil
| | - Sonia Maria Dozzi Brucki
- MD, PhD, Neurologist from the Cognitive and Behavioral Neurology Group (University of São Paulo); Psychobiology Department (Federal University of São Paulo); Hospital Santa Marcelina, São Paulo SP, Brazil
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Castro S, Damin AE, Porto CS, Caramelli P, Nitrini R. The abbreviated form of the Brief Cognitive Battery in the diagnosis of dementia in Alzheimer's disease. Dement Neuropsychol 2009; 3:327-331. [PMID: 29213648 PMCID: PMC5619420 DOI: 10.1590/s1980-57642009dn30400011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Brief Cognitive Battery (BCB) developed by our group for cognitive assessment
of low educated individuals has also shown to be highly accurate in diagnosing
dementia of individuals with medium or high levels of education, making it a
useful tool for populations with heterogeneous educational background. The
application of BCB takes around eight minutes, a rather long period for a
screening test.
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Affiliation(s)
- Stephanie Castro
- MD, Undergraduate Student, Departments of Neurology, School of Medicine, University of São Paulo, São Paulo SP, Brazil
| | - Antonio Eduardo Damin
- PhD, MD, Departments of Neurology, School of Medicine, University of São Paulo, São Paulo SP, Brazil
| | - Cláudia Sellitto Porto
- PhD, Departments of Neurology, School of Medicine, University of São Paulo, São Paulo SP, Brazil
| | - Paulo Caramelli
- MD, Department of Neurology, Federal University of Minas Gerais, Belo Horizonte MG, Brazil
| | - Ricardo Nitrini
- PhD, MD, Departments of Neurology, School of Medicine, University of São Paulo, São Paulo SP, Brazil
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Serafini AJ, Fonseca RP, Bandeira DR, Parente MADMP. Panorama nacional da pesquisa sobre avaliação neuropsicológica de linguagem. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2008. [DOI: 10.1590/s1414-98932008000100004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Apesar da grande difusão de instrumentos internacionais de avaliação da linguagem no contexto neuropsicológico, no Brasil, verifica-se uma importante demanda de técnicas adequadas à realidade sócio-lingüístico-cultural nas áreas clínica e de pesquisa. O objetivo deste estudo é apresentar um panorama nacional das pesquisas que envolvem a avaliação de linguagem no contexto da neuropsicologia. Para tanto, foram realizadas buscas relativas a estudos brasileiros nos bancos de Teses e Dissertações da CAPES, IBICT Teses e Index Psi Teses, e nos bancos de periódicos LILACS, SciELO e Index Psi Periódicos Técnico-Científicos. Ccomo resultado, verificou-se um número reduzido de pesquisas sobre avaliação neuropsicológica da linguagem, sendo que a maior parte das publicações foi encontrada em periódicos de áreas médicas. Poucos estudos faziam referência a algum tipo de instrumento, e raros foram os que visaram a fins psicométricos. Entretanto, observou-se um aumento do número de artigos científicos sobre avaliação de linguagem no contexto neuropsicológico, predominantemente nos últimos seis anos.
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