RESUMEN
OBJECTIVE: This study aimed to generate updated normative data for commonly used tests in neuropsychological assessment applied to older monolingual Spanish-speaking adults: Verbal fluency tests, the Trail Making Test (TMT), and the Rey-Osterrieth complex figure test (ROCF). METHOD: To obtain normative data, 382 cognitively healthy 60- to 90-year-old Spanish monolingual participants from the Autonomous Community of Madrid (Spain) with 0-22 years education were assessed using an overlapping interval strategy that involved cell and midpoint techniques, and that assessed the influence of age, education, and sex. RESULTS: Age and education were associated with the scores in the verbal fluency tests, TMT, and ROCF, whereas sex only significantly affected the TMT results. Age-adjusted scaled scores (SSA) based on percentile ranks were also converted into age-education scaled scores (SSAE) using a linear regression model. In addition, tables with the relevant adjustments for sex are provided for TMT-A and TMT-B. CONCLUSIONS: Thus, this study provides updated, uniform normative data for widely used neuropsychological tests on older Spanish adults. The normative procedure followed helps to make consistent comparisons when using these neuropsychological tests, which will improve the interpretation of the data obtained when these tools are employed, reducing the risk of misdiagnosing cognitive impairment in older adults.
Asunto(s)
Disfunción Cognitiva , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/diagnóstico , Escolaridad , Humanos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Valores de Referencia , Prueba de Secuencia AlfanuméricaRESUMEN
In the field of neuropsychology, it is essential to determine which neuropsychological tests predict Alzheimer's disease (AD) in people with mild cognitive impairment (MCI) and which cut-off points should be used to identify people at greater risk for converting to dementia. The aim of the present study was to analyse the predictive value of the cognitive tests included in a neuropsychological battery for conversion to AD among MCI participants and to analyse the influence of some sociodemographic variables - sex, age, schooling - and others, such as follow-up time and emotional state. A total of 105 participants were assessed with a neuropsychological battery at baseline and during a 3-year follow-up period. For the present study, the data were analysed at baseline. During the follow-up period, 24 participants (22.85%) converted to dementia (2.79 ± 1.14 years) and 81 (77.14%) remained as MCI. The logistic regression analysis determined that the long delay cued recall and the performance time of the Rey figure test were the best predictive tests of conversion to dementia after an MCI diagnosis. Concerning the sociodemographic factors, sex had the highest predictive power. The results reveal the relevance of the neuropsychological data obtained in the first assessment. Specifically, the data obtained in the episodic verbal memory tests and tests that assess visuospatial and executive components may help to identify people with MCI who may develop AD in an interval not longer than 4 years, with the masculine gender being an added risk factor.
Asunto(s)
Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/etiología , Disfunción Cognitiva/complicaciones , Pruebas Neuropsicológicas , Anciano , Anciano de 80 o más Años , Progresión de la Enfermedad , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Curva ROC , Estadísticas no Paramétricas , Aprendizaje Verbal/fisiologíaRESUMEN
Neuropsychological assessment allows the appraisal of the cognitive state of people with Mild Cognitive Impairment (MCI) by means of tests that are related to diverse cognitive functions. Most of the tests refer to more than one cognitive function, and the analysis of the individual's performance should take this into account. We analyzed the possible grouping of the tests of a neuropsychological battery into diverse cognitive dimensions, and the weight of the tests in each dimension. Participants were 223, 179, and 145 individuals (healthy and MCI) from a longitudinal study on MCI, who were assessed with a battery of neuropsychological tests on one, two, or three occasions, respectively. By means of exploratory factor analysis, the tests were found to be grouped into diverse factors. Although the three-factor solution was also analyzed, the two-factor solution was the best one, with a factor that included the memory tests, and the other factor comprising the executive function and praxis tests. Factor analysis allowed us to detect two clear cognitive dimensions with high convergence in all three assessments and, as a consequence, the reduction of the battery is proposed, selecting the tests with a greater weight in each dimension.