RESUMEN
OBJECTIVE: Verbal fluency tests are sensitive to various disorders affecting the central nervous system and are commonly included in neuropsychological evaluations. We aimed to develop normative data for two verbal fluency tests in a sample of native Spanish-speakers living in the US-Mexico border region. METHOD: Participants included 254 adults from the Neuropsychological Norms for the US-Mexico Border Region in Spanish (NP-NUMBRS) Project (Age: range = 19-60; Education: range = 0-20, 59% female). Participants completed two verbal fluency tests (i.e., letter [PMR] and semantic/category fluency [Animal Naming]) as part of a larger neuropsychological test battery. We examined linear and nonlinear effects of demographic factors (age, education, and gender) on verbal fluency raw scores, and developed T-scores using fractional polynomial equations controlling for demographics. We also calculated the rates of "impairment" (T-scores < 40) that would be obtained by applying the newly developed norms and available norms for non-Hispanic English-speakers on comparable tests. RESULTS: There were positive small effects of age and medium effects of education on verbal fluency raw scores. The normalized distribution of T-scores with the new norms showed expected psychometric properties. However, rates of impairment for both letter and semantic fluency were significantly higher when applying non-Hispanic White norms, and significantly lower when applying non-Hispanic Black norms. CONCLUSIONS: We provide norms for Spanish-speakers living along the US-Mexico border region for two verbal fluency tests that are co-normed with a more extensive neuropsychological battery. These regional norms will improve interpretation of verbal fluency test performance in Spanish-speakers living in the US-Mexico borderland.
Asunto(s)
Pruebas Neuropsicológicas , Semántica , Niño , Femenino , Humanos , Lenguaje , Masculino , México , Valores de ReferenciaRESUMEN
BACKGROUND: The Categorization Working Memory Span Task (CWMS task) is a complex working memory (WM) span test that has been used previously to assess age and individual differences in WM as well as the relationship between WM and complex aspects of cognition such as listening comprehension. Two alternate versions of the task have been developed to be used as outcome variables in WM training protocol, which mirrors the task involved in the CWMS task. OBJECTIVES: (1) To translate and adapt the CWMS task for Brazilian Portuguese; (2) to test the equivalence of its 2 alternate versions; (3) to examine temporal stability; (4) to examine the influence of age and schooling on CWMS task; (5) to establish its relationship with other tests of WM. METHODS: Eighty-one older adults completed version A, and 86 completed version B of the CWMS task. After 6 months, a subsample (n = 85) completed the same version of the task. RESULTS: Versions A and B of the task generated comparable scores. Both versions had adequate temporal stability, which was higher for the CWMS total recall, which is the classical variable in this task to represent WM performance, when compared to the other variables generated by the test. The CWMS task variables were moderately correlated with schooling and other cognitive tests (Mini Mental State Examination, Letter-Number Sequencing, Spatial Span Backward, Digit Span Forward). CONCLUSIONS: The 2 versions of the CWMS task were equivalent and stable temporally. The task was influenced by schooling and global cognition.
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Evaluación Geriátrica/métodos , Memoria a Corto Plazo , Pruebas Neuropsicológicas , Factores de Edad , Anciano , Brasil , Cognición , Comprensión , Comparación Transcultural , Escolaridad , Femenino , Humanos , Lenguaje , Masculino , Recuerdo Mental , Persona de Mediana Edad , Pruebas Neuropsicológicas/normas , TraducciónRESUMEN
BACKGROUND: Several cognitive tools have been developed aiming to diagnose dementia. The cognitive battery Addenbrooke's Cognitive Examination - Revised (ACE-R) has been used to detect cognitive impairment; however, there are few studies including samples with low education. The aim of the study was to provide ACE-R norms for seniors within a lower education, including illiterates. An additional aim was to examine the accuracy of the ACE-R to detect dementia and cognitive impairment no dementia (CIND). METHODS: Data originated from an epidemiological study conducted in the municipality of Tremembé, Brazil. The Brazilian version of ACE-R was applied as part of the cognitive assessment in all participants. Of the 630 participants, 385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia, and 135 were classified as having CIND. RESULTS: ACE-R norms were provided with the sample stratified into age and education bands. ACE-R total scores varied significantly according to age, education, and sex. To distinguish CN from dementia, a cut-off of 64 points was established (sensitivity 91%, specificity 76%) and to differentiate CN from CIND the best cut-off was 69 points (sensitivity 73%, specificity 65%). Cut-off scores varied according to the educational level. CONCLUSIONS: This study offers normative and accuracy parameters for seniors with lower education and it should expand the use of the ACE-R for this population segment.
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Cognición , Disfunción Cognitiva/diagnóstico , Demencia/diagnóstico , Tamizaje Masivo , Pruebas Neuropsicológicas , Anciano , Anciano de 80 o más Años , Brasil , Disfunción Cognitiva/psicología , Estudios Transversales , Demencia/psicología , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Curva ROC , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: The aims of this study were (1) to describe and compare the performance of illiterate and low-educated older adults, without evidence of cognitive impairment, on different versions of the Boston Naming Test (BNT) original, Brazilian adapted, abbreviated 30-item (even and odd) and 15-item from the CERAD (Consortium to Establish a Registry for Alzheimer's Disease) battery; (2) to compare performance on the original versus adapted versions of the BNT. METHODS: A total of 180 healthy older adults (60 years or older) were stratified according to educational level (0, 1-2, and 3-4 years), and age (60-69, 70-79, and ≥ 80 years). The protocol comprised the following instruments: Mini-Mental State Examination (MMSE), Brief Cognitive Screening Battery (BCSB), Functional Activities Questionnaire (FAQ), Geriatric Depression Scale (GDS), and the BNT. RESULTS: The illiterate participants had poorer performance than the educated participants. The performance of the two educated groups was similar on all versions of the BNT. A higher number of correct responses were observed on the adapted BNT than on the original BNT in all three education groups. CONCLUSIONS: The adapted BNT appears to be the most suitable for use in the low-educated Brazilian population. The present study provided normative data for low-educated elderly on several different versions of the BNT, which may be helpful in diagnosing naming deficits among elderly in these strata of the population.
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Envejecimiento/psicología , Disfunción Cognitiva/diagnóstico , Pruebas del Lenguaje/normas , Alfabetización , Anciano , Anciano de 80 o más Años , Brasil , Escolaridad , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Valores de ReferenciaRESUMEN
BACKGROUND: It is necessary to continue to explore the psychometric characteristics of key cognitive screening tests such as the Montreal Cognitive Assessment (MoCA) to diagnose cognitive decline as early as possible and to attend to the growing need of clinical trials involving mild cognitive impairment (MCI) participants. The main aim of this study was to assess which MoCA subtests could best discriminate between healthy controls (HC), participants with MCI, and Alzheimer's disease (AD). METHODS: Cross-sectional analysis of 136 elderly with more than four years of education. All participants were submitted to detailed clinical, laboratory, and neuroimaging evaluation. The MoCA, Mini-Mental State Examination (MMSE), the Cambridge Cognitive Examination (CAMCOG), Geriatric Depression Scale (GDS), and Functional Activities Questionnaire (FAQ) were applied to all participants. The MoCA test was not used in the diagnostic procedure. RESULTS: Median MoCA total scores were 27, 23 and 18 for HC, MCI, and AD, respectively (p < 0.001). Word repetition, inverse digits, serial 7, phrases, verbal fluency, abstraction, and word recall discriminated between MCI and HC participants (p < 0.001). The clock drawing, the rhino naming, delayed recall of five words and orientation discriminated between patients with MCI and AD (p < 0.001). A reduced version of the MoCA with only these items did not improve accuracy between MCI and HC (p = 0.076) or MCI and AD (p = 0.119). CONCLUSIONS: Not all MoCA subtests might be fundamental to clinical diagnosis of MCI. The reduced versions of MoCA did not add diagnostic accuracy.
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Enfermedad de Alzheimer/diagnóstico , Cognición , Disfunción Cognitiva/diagnóstico , Pruebas Neuropsicológicas , Psicometría/normas , Anciano , Anciano de 80 o más Años , Brasil , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Recuerdo Mental , Neuroimagen , Escalas de Valoración Psiquiátrica , Curva ROCRESUMEN
OBJECTIVE: To evaluate neurocognitive test results and symptom reporting after sports-related concussion in a group of female cheerleaders. STUDY DESIGN: Junior and senior high school female cheerleaders (n = 138) underwent preparticipation baseline testing and repeated the ImPACT (Immediate Postconcussion Assessment and Cognitive Testing) evaluation within 7 days of concussive injury (range, 0-7 days; mean, 3.9 days). Postinjury neurocognitive and symptom scores were compared with preinjury (baseline) scores. "Abnormal" test performance was determined statistically using Reliable Change Index scores and self-reported symptoms. Main outcome variables included the composite scores indices from the ImPACT test, as well as symptoms reported by participants. Preinjury baseline and postinjury test results were compared using MANOVA. RESULTS: As a group, cheerleaders with concussion evaluated within 7 days of injury performed poorly on the ImPACT test battery relative to their own baseline (F = 6.5; P = .00). In addition, 61% of the cheerleaders with concussions reported an increase in symptoms compared with baseline. The groups did not differ significantly by position on the squad (F = 0.37; P = .96). Of the group of cheerleaders who did not report increased symptoms at the time of postinjury evaluation, 37% had at least 1 abnormal ImPACT composite score result, suggesting some residual cognitive decline compared with baseline. CONCLUSION: The diagnosis and management of concussion in cheerleaders should not consist solely of self-reported symptoms. Neurocognitive test results represent an important component of the evaluation process and may identify athletes with residual neurocognitive deficits who report being clinically asymptomatic.
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Traumatismos en Atletas/diagnóstico , Conmoción Encefálica/diagnóstico , Trastornos del Conocimiento/diagnóstico , Pruebas Neuropsicológicas , Deportes , Adolescente , Atletas , Traumatismos en Atletas/fisiopatología , Conmoción Encefálica/fisiopatología , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/fisiopatología , Femenino , Humanos , Instituciones Académicas , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
OBJECTIVE: To identify predictors of prolonged symptoms in athletes who sustain concussions. STUDY DESIGN: This was a multicenter prospective cohort study of patients in 2 sport concussion clinics. Possible predictors of prolonged symptoms from concussion were compared in 2 groups, those whose symptoms resolved within 28 days and those whose symptoms persisted beyond 28 days. Candidate predictor variables were entered into a logistic regression model that was used to generate aORs. RESULTS: A total of 182 patients met the inclusion criteria during the study period. The mean patient age was 15.2 ± 3.04 years. More than one-third of the patients (n = 65) underwent computerized neurocognitive testing on their initial visit. On univariate analyses, Post-Concussion Symptom Scale (PCSS) score and all composite scores on computerized neurocognitive testing were apparently associated with prolonged symptom duration. Sex, age, loss of consciousness at time of injury, and amnesia at time of injury were not associated with prolonged symptom duration. After adjusting for potential confounding, only total PCSS score was associated with the odds of suffering prolonged symptoms. CONCLUSION: Further efforts to develop clinical tools for predicting which athletes will suffer prolonged recoveries after concussion should focus on initial symptom score.