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1.
Appl Neuropsychol Child ; : 1-29, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39089403

RESUMO

Executive functions (EFs) are a set of cognitive processes that enable individuals to manage and coordinate their thoughts and actions toward achieving specific goals. EFs include planning, organizing, initiating, and monitoring actions, and have been found to improve with age due to the maturation of the brain, especially during childhood. Therefore, our correlational study sought to determine the relationship between the performance in executive functions and age in 79 children (36 girls, 45.6%) throughout development, between the ages of 6 and 12 (mean = 9.25; SD = 2.05), using a battery designed in Chile: BEFE (Batería de Evaluación de las Funciones Ejecutivas: Executive Function Assessment Battery) based on traditional neuropsychological tests to evaluate Working Memory, Inhibitory Control, Cognitive Flexibility, and Planning skills. Our results showed various correlations between the variables age and performance in various behavioral parameters, demonstrating an increase in the number of correct responses (positive correlation) and/or a decrease in errors (negative correlation) with age (6-12) in the subtests that correspond to dimensions of Cognitive Flexibility (Semantic and Phonological Fluency, Card Sorting Game, and Tracing Tasks), Inhibitory Control (ENA-F and Sentence Completion), Working Memory (Audio-verbal WM Forward and Ordering, and Visuospatial WM Forward and Backward), and Planning (La Portada de Antofagasta and FISA Maps). These results are consistent with previous empirical evidence and support the notion of a developmental relationship between EF performance and age. Additionally, this study contributes to understanding EF development in culturally specific contexts, highlighting the importance of contextually relevant assessment tools in evaluating cognitive development.

2.
Psychogeriatrics ; 24(5): 1111-1119, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39039430

RESUMO

BACKGROUND: Falls are directly related to morbidity and mortality of older people. Multifactorial approaches that are individualised and based on fall risk factors are necessary. This study aims to verify the effects of a case management-based intervention on non-motor risk factors for falls in community-dwelling older people with a history of falls. METHODS: The intervention applied a multidimensional assessment of risk factors for falls, a discussion about the identified risk factors, the preparation of an individualised plan with the participant, and the application, monitoring and review of the plan. RESULTS: There was a significant interaction between groups and assessments only in the visuospatial domain (P = 0.031). After simple main effects analysis, differences between groups and assessments were not significant, although there was a tendency of worse visuospatial performance in the control group in the follow-up assessment (P = 0.099). There were no significant differences between groups or between assessments in other variables. CONCLUSION: The intervention has the potential to maintain non-motor risk factors for falls in community-dwelling older people with a history of falls. However, more clinical trials are needed to prove its effects.


Assuntos
Acidentes por Quedas , Administração de Caso , Vida Independente , Humanos , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Masculino , Feminino , Fatores de Risco , Idoso de 80 Anos ou mais , Avaliação Geriátrica/métodos
3.
J Alzheimers Dis ; 100(s1): S45-S55, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39031367

RESUMO

Background: The Addenbrooke's Cognitive Examination-Revised (ACE-R) is an accessible cognitive tool that supports the early detection of mild cognitive impairment (MCI), Alzheimer's disease (AD), and behavioral variant frontotemporal dementia (bvFTD). Objective: To investigate the diagnostic efficacy of the ACE-R in MCI, AD, and bvFTD through the identification of novel coefficients for differentiation between these diseases. Methods: We assessed 387 individuals: 102 mild AD, 37 mild bvFTD, 87 with amnestic MCI patients, and 161 cognitively unimpaired controls. The Mokken scaling technique facilitated the extraction out of the 26 ACE-R items that exhibited a common latent trait, thereby generating the Mokken scales for the AD group and the MCI group. Subsequently, we performed logistic regression, integrating each Mokken scales with sociodemographic factors, to differentiate between AD and bvFTD, as well as between AD or MCI and control groups. Ultimately, the Receiver Operating Characteristic curve analysis was employed to assess the efficacy of the coefficient's discrimination. Results: The AD-specific Mokken scale (AD-MokACE-R) versus bvFTD exhibited an Area Under the Curve (AUC) of 0.922 (88% sensitivity and specificity). The AD-MokACE-R versus controls achieved an AUC of 0.968 (93% sensitivity, 94% specificity). The MCI-specific scale (MCI-MokACE-R) versus controls demonstrated an AUC of 0.859 (78% sensitivity, 79% specificity). Conclusions: The ACE-R's capacity is enhanced through statistical methods and demographic integration, allowing for accurate differentiation between AD and bvFTD, as well as between MCI and controls. This new method not only reinforces its clinical value in early diagnosis but also surpasses traditional approaches noted in prior studies.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Demência Frontotemporal , Testes Neuropsicológicos , Humanos , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Feminino , Masculino , Disfunção Cognitiva/diagnóstico , Demência Frontotemporal/diagnóstico , Demência Frontotemporal/psicologia , Idoso , Testes Neuropsicológicos/estatística & dados numéricos , Pessoa de Meia-Idade , Diagnóstico Diferencial , Sensibilidade e Especificidade
4.
Clin Neuropsychol ; : 1-23, 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38914594

RESUMO

Objective: Multiple sclerosis (MS) may include not only severe neurological signs and symptoms, but also cognitive and psychiatric disturbances. When psychiatric symptoms precede or are comorbid with MS, it poses a clinical challenge, because it may lead to a mistaken diagnosis of MS as a psychiatric disorder, delaying proper treatment. We describe the neuropsychological profile of a female patient with MS whose diagnosis was delayed due to neuropsychiatric symptoms. Method: A comprehensive analysis of the medical history and the results of a teleneuropsychological assessment of a 36-year-old Mexican woman with a diagnosis of relapsing--remitting MS (RRMS) was performed. Results: The patient indicates a long history of psychotic, anxious, and depressive features years before the first neurological symptom that led to MS going unnoticed for several years. Language, attentional, perceptual, motor, and learning skills were found to be preserved. Short-term memory and spatial orientation problems were identified, with decreased processing speed and executive dysfunction, including working memory and planning deficits. Conclusions: The patient has a non-typical presentation of neuropsychological alterations with cognitive and behavioral symptoms that resemble dorsolateral frontal lobe syndrome. This case study highlights the importance of considering MS in differential diagnosis of patients with psychiatric symptoms, even in the absence of obvious neurological signs.

5.
Appl Neuropsychol Adult ; : 1-10, 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38781515

RESUMO

This study compared the neuropsychological performance of two post-stroke groups, one undergoing rehabilitation and the other not receiving any intervention, on the acute and chronic stroke phases, and explored sociodemographic and neurological variables associated with changes in performance over time. Sixty-three adults underwent neuropsychological assessment with the Cognitive Screening Instrument (TRIACOG) less than thirty days after having a stroke and were reassessed three to six months after stroke. Thirty-eight participants did not undertake rehabilitation and twenty-five did physiotherapy and/or speech therapy between the two time points. The frequency of cognitive deficits (between groups) and the range of cognitive assessment scores over time (between and within groups) were analyzed. There was a significant decrease in the frequency of neuropsychological deficits and improvement on neuropsychological assessment scores over time only in the group undergoing rehabilitation. Severity of the neurological condition, years of education and being in rehabilitation explained the longitudinal changes in several cognitive domains measured by TRIACOG. Engaging in rehabilitation within three to six months post-stroke is crucial for enhancing the recovery of neuropsychological deficits. Cognitive screening instruments like TRIACOG can be used by health professionals to identify stroke-related neuropsychological changes and plan interventions.

6.
Psicol Reflex Crit ; 37(1): 17, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38709384

RESUMO

BACKGROUND: Prospective memory is the ability to engage in an intention to be performed in the future. The main objective of this study was to identify instruments that assess both time-based and event-based prospective memory in children and adolescents and that have the potential to be clinically applicable. METHOD: Three databases (PubMed, Scopus, and PsycINFO) were searched to identify existing PM measures in original articles published until 2022. Literature searches were conducted using the following terms: (prospective memor* OR memor* for intentions) AND (neuropsychological assessment) AND (test* OR instrument* OR questionnaire* OR task*) AND (psychometric properties) AND (child* OR adolescen*). Relevant studies identified in the reference lists were also included in the review. RESULTS: Ten instruments were identified and classified into three categories: (a) test batteries, (b) experimental procedures, and (c) questionnaires. All the instruments identified were described concerning their content and the psychometric properties available. Some of the instruments presented empirical evidence regarding validity and reliability, but no one provided normative data. CONCLUSION: Besides the recent progress regarding studies publishing the development of a variety of novel measures, there are still many limitations surrounding the assessment of PM in the youth population because of the yet incipient psychometric properties presented by the majority of the PM instruments. Recommendations for a gold-standard PM instrument for assessing children and adolescents are provided.

7.
Genes (Basel) ; 15(5)2024 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-38790224

RESUMO

The 22q11.2 deletion syndrome (22q11.2DS) is associated with a heterogeneous neurocognitive phenotype, which includes psychiatric disorders. However, few studies have investigated the influence of socioeconomic variables on intellectual variability. The aim of this study was to investigate the cognitive profile of 25 patients, aged 7 to 32 years, with a typical ≈3 Mb 22q11.2 deletion, considering intellectual, adaptive, and neuropsychological functioning. Univariate linear regression analysis explored the influence of socioeconomic variables on intellectual quotient (IQ) and global adaptive behavior. Associations with relevant clinical conditions such as seizures, recurrent infections, and heart diseases were also considered. Results showed IQ scores ranging from 42 to 104. Communication, executive functions, attention, and visuoconstructive skills were the most impaired in the sample. The study found effects of access to quality education, family socioeconomic status (SES), and caregiver education level on IQ. Conversely, age at diagnosis and language delay were associated with outcomes in adaptive behavior. This characterization may be useful for better understanding the influence of social-environmental factors on the development of patients with 22q11.2 deletion syndrome, as well as for intervention processes aimed at improving their quality of life.


Assuntos
Síndrome de DiGeorge , Humanos , Masculino , Adolescente , Feminino , Síndrome de DiGeorge/genética , Síndrome de DiGeorge/psicologia , Criança , Brasil/epidemiologia , Adulto , Adulto Jovem , Testes Neuropsicológicos , Fatores Socioeconômicos , Inteligência , Qualidade de Vida , Classe Social
8.
Gac Med Mex ; 2024 Apr 08.
Artigo em Espanhol | MEDLINE | ID: mdl-38588518

RESUMO

Background: Age and HIV are synergistic risk factors for conditions such as HIV-associated neurocognitive disorders (HAND). Yet, it is unclear whether OAWH display different cognitive profiles for HAND. Objective: To describe the cognitive patterns of OAWH treated with combined antiretroviral therapy (cART). Methods: Cross-sectional study that included 330 participants with HIV, aged 50 years or older, cared for at a tertiary care hospital in Mexico City. A short neuropsychological test battery was used to assess a wide spectrum of cognitive functions. The optimal number of cognitive clusters was determined by the silhouette method and a minimization of the Bayesian information criterion. Results: Participants' mean age was 58.8 years (SD = 6.6), and 12.1% were women. A 3-cluster solution yielded stable Jaccard coefficients (p > 0.70). Cluster 1 showed more significant impairment in visual and verbal memory domains, whereas participants in cluster 3 showed significant impairment in language, and abstraction. Cluster 2 showed no predominance of any domain for alterations. Conclusions: There are different cognitive profiles among OAWH with HAND. These differences may be due to individual patterns of HIV-related and non-HIV-related factors.


Antecedentes: La edad y el VIH constituyen factores de riesgo sinérgicos de afecciones como los trastornos neurocognitivos asociados al VIH (TNAV). No se ha esclarecido si las personas mayores con VIH presentan perfiles cognitivos diferentes en caso de padecer TNAV. Objetivo: Describir los patrones cognitivos de adultos mayores con VIH tratados con terapia antirretroviral combinada (TARc). Métodos: Estudio transversal que incluyó a 330 participantes con VIH, de 50 años o más, atendidos en un centro hospitalario de tercer nivel en la Ciudad de México. Se utilizó una batería neuropsicológica corta estandarizada a fin de evaluar un amplio espectro de funciones cognitivas. Se determinó el número óptimo de grupos de dominios cognitivos a partir del método de la silueta y minimización del criterio de información bayesiano. Resultados: La edad promedio de los participantes fue de 58.8 años; las mujeres constituyeron 12.1 %. Una solución de tres grupos produjo coeficientes de Jaccard estables (p > 0.70). El grupo 1 mostró deterioro más significativo en la memoria visual y verbal, en tanto que el grupo 3 mostró deterioro significativo en el lenguaje y la abstracción. En el grupo 2 no se registró predominio de ningún dominio en cuanto a alteraciones. Conclusiones: Existen perfiles cognitivos diferentes entre las personas mayores con VIH y TNAV. Estas diferencias pueden deberse a patrones individuales de factores relacionados o no con el VIH.

9.
Rev. Psicol., Divers. Saúde ; 13(1)abr. 2024. tab, ilus
Artigo em Espanhol, Português | LILACS | ID: biblio-1551270

RESUMO

OBJETIVO: A avaliação neuropsicológica tem alta relevância na adolescência e em situação de conflito com a lei, com privação de liberdade em instituições socioeducativas, pode auxiliar, compondo abordagens psicossociais que identifiquem as funções neuropsicológicas, situando-as a partir da historicidade do indivíduo. Deste modo, para compreender esse problema, foi objetivo desse estudo avaliar e descrever as funções neuropsicológicas de adolescentes meninas privadas de liberdade em instituição socioeducativa. MÉTODOS: As participantes foram 19 meninas avaliadas com os instrumentos: Barratt Scale, Inventário de Expressão de Raiva, teste Wisconsin de classificação de cartas, protocolo neuropsicológico, questionário para uso de drogas e Hare Psychopathy Checklist Revised. RESULTADOS: O uso de drogas na vida ocorreu em 80,0% dos casos. Verificaram-se altos escores de impulsividade total (M=75,8, DP=5,4), traço de raiva (M=24,5, DP=7,3) e respostas perseverativas (M =38,5, DP =19,9). Em conjunto com PCL-R total (M=17,5, DP=3,6) e com QI total (M=79,1, DP=16,2), esses níveis auxiliaram na caracterização das funções de autocontrole. CONCLUSÕES: Os dados foram interpretados como indicativos de baixo funcionamento executivo, altos níveis de raiva, de impulsividade, de uso de drogas e de traços de psicopatia. Foram relatadas adversidades durante a infância, o que pode ter contribuído para um desempenho prejudicado nas funções cognitivas e emocionais dessas meninas.


OBJECTIVE: Neuropsychological assessment is highly relevant in adolescence and in situations of conflict with the law, with deprivation of liberty in socio-educational institutions, it can help, composing psychosocial approaches that identify neuropsychological functions, situating them based on the individual's historicity. Therefore, to understand this problem, the objective of this study was to evaluate and describe the neuropsychological functions of adolescent girls deprived of liberty in a socio-educational institution. METHODS: The participants were 19 girls evaluated with the following instruments: Barratt Scale, Anger Expression Inventory, Wisconsin Card Sorting Test, Neuropsychological protocol, drug use questionnaire and Hare Psychopathy Checklist Revised. RESULTS: Lifetime drug use occurred in 80.0% of cases. There were high scores for total impulsivity (M=75.8, SD=5,4), trait anger (M=24.5, SD=7.3) and perseverative responses (M=38.5, SD=19.9). Together with total PCL-R (M=17.5, SD=3.6) and total IQ (M=79.1, SD=16), these levels helped to characterize self-control functions. CONCLUSIONS: The data were interpreted as indicating low executive functioning, high levels of anger, impulsivity, drug use and psychopathic traits. Adversities were reported during childhood, which may have contributed to impaired performance in the cognitive and emotional functions of these girls.


OBJETIVO: La evaluación neuropsicológica es de gran relevancia en la adolescencia y en las situaciones de conflicto con la ley, con privación de libertad en instituciones socioeducativas, puede ayudar, componiendo enfoques psicosociales que identifiquen funciones neuropsicológicas, las situando en función de la historicidad del individuo. Por tanto, para comprender esta problemática, el objetivo de este estudio fue evaluar y describir las funciones neuropsicológicas de niñas adolescentes privadas de libertad en una institución socioeducativa. MÉTODOS: Las participantes fueron 19 niñas evaluadas con los siguientes instrumentos: Escala de Barratt, Inventario de Expresión de Ira, Test de clasificación de cartas de Wisconsin, protocolo neuropsicológico, cuestionario de consumo de drogas y Lista de Verificación de Psicopatía de Hare Revisada. RESULTADOS: El consumo de drogas durante la vida ocurrió en el 80,0% de los casos. Hubo puntuaciones altas en impulsividad total (M = 75,8, DE = 5,4), rasgo de ira (M = 24,5, DE = 7,3) y respuestas perseverativas (M = 38,5, DE = 19,9). Junto con el PCL-R total (M=17,5, DE=3,6) y el CI total (M=79,1, DE=16,2), estos niveles ayudaron a caracterizar las funciones de autocontrol. CONCLUSIONES: Se interpretó que los datos indicaban un bajo funcionamiento ejecutivo, altos niveles de ira, impulsividad, consumo de drogas y rasgos psicopáticos. Se informaron adversidades durante la infancia, que pueden haber contribuido al deterioro del desempeño en las funciones cognitivas y emocionales de estas niñas.


Assuntos
Neuropsicologia , Mulheres , Comportamento
10.
BMC Psychol ; 12(1): 236, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38671529

RESUMO

BACKGROUND: Studying individuals with varying symptoms, from mild to severe, can provide valuable insights into the spectrum of cognitive outcomes after COVID-19. We investigated the cognitive performance of adults who recovered from the novel coronavirus disease (COVID-19) without prior cognitive complaints, considering mild (not hospitalized), moderate (ward), and severe (intensive care unit) symptoms. METHODS: This cross-sectional study included 302 patients who recovered from COVID-19 (mild, n = 102; moderate, n = 102; severe, n = 98). We assessed intellectual quotient (IQ), attention, memory, processing speed, visual-constructive ability, as well as symptoms of depression, anxiety, and stress, at least eighteen months after infection. The mean length of hospitalization was Mdays=8.2 (SD = 3.9) and Mdays=14.4 (SD = 8.2) in the moderate and severe groups, respectively. RESULTS: Cognitive difficulties were present in all three groups: mild (n = 12, 11.7%), moderate (n = 40, 39.2%), and severe (n = 48, 48.9%). Using Multinomial Logistic Regression and considering the odds ratio, our results indicated that a one-point increase in sustained attention, visual memory, and working memory might decrease the odds of being categorized in the severe group by 20%, 24%, and 77%, respectively, compared to the mild group. CONCLUSIONS: Our findings provide empirical evidence regarding the long-term cognitive effects of COVID-19, particularly in individuals experiencing severe manifestations of the disease. We also highlighted the need for a comprehensive, multidimensional approach in rehabilitation programs to address the enduring cognitive impacts of COVID-19.


Assuntos
COVID-19 , Cognição , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Masculino , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Índice de Gravidade de Doença , Idoso , Atenção , Disfunção Cognitiva/psicologia , SARS-CoV-2 , Depressão/psicologia , Ansiedade/psicologia , Testes Neuropsicológicos
11.
Clin Neuropsychol ; : 1-20, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38627924

RESUMO

Objective: The Visual Short-Term Memory Binding (VSTMB) Test is a useful tool in the assessment of Alzheimer's disease (AD). Research has suggested that short-term memory binding is insensitive to the sociocultural characteristics of the assessed individuals. Such earlier studies addressed this influence by considering years of education. The current study aims to determine the influence of sociocultural factors via a measure of Socioeconomic Status (SES) which provides a more holistic approach to these common confounders. Methods: A sample of 126 older adults, both with (n = 59) and without (n = 67) amnestic mild cognitive impairment (aMCI), underwent assessment using a neuropsychological protocol including VSTMB test. All participants were classified as either high SES or low SES, employing the Standard Demographic Classification from the European Society for Opinion and Marketing Research. Results: ANOVA/ANCOVA models confirmed that performance of healthy and aMCI participants on traditional neuropsychological tests were sensitive to SES whereas the VSTMB Test was not. The results add to the growing array of evidence suggesting that there are cognitive abilities which are unaffected by socioeconomic factors, regardless of clinical condition. Conclusions: The lack of sensitivity to sociocultural factors previously reported for the VSTMB test is accompanied by a lack of sensitivity to socioeconomic factors thus broadening the scope of this test to aid in the detection of dementia across populations with different backgrounds. Future studies should take these findings forward and explore the potential influences of AD biomarkers (A/T/N) on the association between cognitive functions and demographic variables.

12.
Neurosurg Rev ; 47(1): 129, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38532178

RESUMO

Despite great advancements and the diffusion of awake surgery for brain tumors, the literature shows that the tests applied during the procedure are heterogeneous and non-standardized. This prospective, observational, descriptive study collected data on intraoperative brain mapping and the performance of multiple neurocognitive tests in 51 awake surgeries for diffuse low-grade glioma. Frequency of use and rate of intraoperative findings of different neurocognitive tests were analyzed. Patients mean age at the time of surgery was 35.1 (20-57) years. We performed 26 (51.0%) surgeries on the left hemisphere (LH) and 25 (49.0%) on the right hemisphere (RH). Significant differences were observed between the total number of functional findings (cortical and subcortical) identified in the LH and RH (p = 0.004). In subcortical findings alone, the differences remained significant (p = 0.0004). The RH subcortical region showed the lowest number of intraoperative findings, and this was correlated with functional outcome: Karnofsky performance scale at five days (p = 0.022), three months (p = 0.002) and one year (p = 0.002) post-surgery. On average, more tests were used to map the RH, with a lower frequency of both cortical and subcortical functional findings. Even though subcortical findings were less frequent than cortical findings, they were crucial to defining the resection margins. Based on the intraoperative findings, frequency of use, and rate of findings per use of the tests analyzed, the most relevant tests for each hemisphere for awake brain mapping were identified.


Assuntos
Neoplasias Encefálicas , Glioma , Humanos , Adulto , Pessoa de Meia-Idade , Neoplasias Encefálicas/cirurgia , Vigília , Estudos Prospectivos , Glioma/cirurgia , Mapeamento Encefálico/métodos , Testes de Estado Mental e Demência
13.
Schizophr Res Cogn ; 36: 100302, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38323136

RESUMO

Background: Cognitive alterations have been reported in early stages of psychosis including people with First Episode Psychosis (FEP), Clinical High-Risk Mental State (CHR), and Psychotic-Like Experience (PLE). This study aimed to compare the cognitive function in early stages of psychosis using the Montreal Cognitive Assessment (MoCA), a low-cost and brief assessment tool of cognitive functions. Methods: A total of 154 individuals, including 35 with FEP, 38 CHR, 44 PLE, and 37 healthy controls (HC), were evaluated with the MoCA in Santiago, Chile. We calculated the mean total score of the MoCA and the standard deviation of the mean. Groups were assessed for a trend to lower scores in a pre-determined sequence (HC > PLE > CHR > FEP) using the Jonckheere-Terpstra test (TJT). Results: The mean total MoCA scores were 24.8 ± 3.3 in FEP, 26.4 ± 2.4 in CHR, 26.4 ± 2.3 in PLE, and 27.2 ± 1.8 in HC. The analyses revealed a significant trend (p < 0.05) toward lower MoCA individual domain scores and MoCA total scores in the following order: HC > PLE > CHR > FEP. The mean total scores of all groups were above the cut-off for cognitive impairment (22 points). Conclusions: The MoCA describes lower scores in cognition across early stages of psychosis and may be a useful low-cost assessment instrument in early intervention centers of poorly resourced settings.

14.
Appl Neuropsychol Adult ; : 1-13, 2024 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-38241781

RESUMO

Repeated neuropsychological assessments are often conducted in clinical and research settings to track cognitive changes over single or multiple intervals in patients with Parkinson's disease (PD). Yet few studies have documented test-retest reliability in PD. To address this gap, we used data from the Parkinson's Progression Markers Initiative (PPMI) to investigate the reliability of five well-known neuropsychological tests over a 3-year follow-up assessment in early-stage PD with either normal (PD-NC; N = 158) or abnormal (PD-AC; N = 39) cognitive screening, categorized based on recommended cutoffs for the Montreal Cognitive Assessment (MoCA), and healthy older adults (HOA; N = 102). All participants analyzed maintained the same cognitive status category across the assessment points. Intraclass correlation coefficients (ICCs) estimated reliability. The overall ICCs calculated across time points were as follows: Judgment of Line Orientation (PD-NC = .47, PD-AC = .50, HOA = .59); Letter-Number Sequencing (PD-NC = .64, PD-AC = .64, HOA = .65); Semantic Fluency (PD-NC = .69, PD-AC = .89, HOA = .77); Symbol Digit Modalities Test (PD-NC = .67, PD-AC = .83, HOA = .71). For the two primary components of the Hopkins Verbal Learning Test-Revised, we found the following ICCs: immediate recall (PD-NC = .46, PD-AC = .57, HOA = .58); delayed recall (PD-NC = .42, PD-AC = .57, HOA = .54). Findings from this study provide useful information for clinicians and researchers toward selecting suitable neuropsychological tests to monitor cognition at two or more time points among newly diagnosed individuals with PD and HOA.

15.
Artigo em Inglês | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1564848

RESUMO

Abstract: Reading anxiety can hinder involvement and performance. This study aimed to present the adaptation and validity evidence of the Reading Anxiety Scale (RAS-20) for parents and guardians. A total of 240 parents and guardians with children aged from eight to 12 years ( M = 9.73; SD = 1.41) took part in the study. A sociodemographic and health conditions questionnaire, the Child Behavior Checklist (CBCL) and the Reading Anxiety Scale (RAS) version for parents and guardians were applied. The results of the confirmatory factor analysis indicated good adjustment rates for the three dimensions assessed by the scale (enjoyment, independence, and difficulty). Convergent validity evidence supported the hypothesis of anxiety as a specific phenomenon, different from general anxiety. The RAS-Version for parents and guardians showed adequate psychometric properties and can contribute to the development of interventions in the clinical, family, and school context.


Resumo: A ansiedade de leitura pode gerar dificuldades de engajamento e desempenho. O estudo teve como objetivo apresentar a adaptação e evidências de validade da Reading Anxiety Scale (RAS-20) para pais e cuidadores. Participaram 240 cuidadores com filhos de idades entre 8 e 12 anos ( M = 9,73; DP = 1,41). Foi utilizado um questionário sociodemográfico e de condições de saúde, a lista de verificação comportamental para crianças ou adolescentes - Child Behavior Checklist (CBCL) e a Reading Anxiety Scale (RAS) versão para pais e cuidadores. Os resultados da análise fatorial confirmatória indicaram bons índices de ajustes para as três dimensões avaliadas pela escala (interesse, independência e dificuldade). As evidências de validade convergente reforçaram a hipótese da ansiedade de leitura como um fenômeno específico, diferente da ansiedade geral. A RAS-versão para pais e cuidadores possui adequadas propriedades psicométricas e pode contribuir com o desenvolvimento de intervenções no âmbito clínico, familiar e escolar.


Resumen: La ansiedad por la lectura puede generar dificultades de compromiso y rendimiento. Este estudio tuvo como objetivo presentar la adaptación y las evidencias de validez de la Reading Anxiety Scale (RAS-20) para padres y cuidadores. Participaron 240 cuidadores con hijos de entre 8 y 12 años de edad ( M = 9,73; DE = 1,41). Se utilizó un cuestionario sociodemográfico y de estado de salud, la lista de control conductual para niños o adolescentes - Child Behavior Checklist (CBCL) - y la Reading Anxiety Scale (RAS), versión para padres y cuidadores. Los resultados del análisis factorial confirmatorio indicaron buenos índices de ajuste para las tres dimensiones evaluadas por la escala (interés, independencia y dificultad). La evidencia de validez convergente reforzó la hipótesis de la ansiedad lectora como un fenómeno específico, diferente de la ansiedad general. La versión RAS para padres y cuidadores tiene propiedades psicométricas adecuadas y puede contribuir al desarrollo de intervenciones en el ámbito clínico, familiar y escolar.

16.
Arq. neuropsiquiatr ; Arq. neuropsiquiatr;82(8): s00441788585, 2024. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1568869

RESUMO

Abstract Background Age is the most important risk factor for develop dementia, and the recommendation is that older adults are cognitively tested to detect impairment in the initial stage for adequate treatment. The demand for the care of these older adults is great, drawing attention to the need for rapid tests, with good accuracy and simple application to identify cognitive impairment. Objective To develop and validate the Brazilian Mini-Addenbrooke Cognitive Examination (M-ACE BR) as a short screening test for cognitive impairment in older adults. Methods The M-ACE BR was developed using the Mokken scaling analysis in 352 participants (cognitively unimpaired [CU] = 232, cognitive impairment no dementia [CIND] = 82; and dementia = 38) and validated in an independent sample of 117 participants (CU = 25; CIND = 88; and dementia = 4). Results The Mokken scaling analysis derived 9 items (spatial orientation, anterograde memory, retrograde memory, delayed recall, recognition [name and address], letter verbal fluency, repetition of 4 words, naming of 10 items, and comprehension) with a maximum score of 51 points and an average duration time of 7 minutes. The cut-off score ≤ 43/51 for CIND had a sensitivity of 59.09% and a specificity of 80%. For a screening test in which sensitivity is prioritized for further investigation, we suggest using a cutoff of ≤ 47 (sensitivity 85.23% and specificity 24%), maintaining a good positive predictive value (79.8%). Conclusion The M-ACE BR is a brief and adequate instrument to detect cognitive impairment in older Brazilian adults. However, screening for CIND and for different educational levels should be further explored.


Resumo Antecedentes A idade é o fator de risco mais importante para o desenvolvimento de demência, e a recomendação é que os idosos sejam testados cognitivamente para detectar comprometimento na fase inicial para o tratamento adequado. A demanda pelo atendimento desses idosos é grande, chamando atenção para a necessidade de testes rápidos, com boa acurácia e de simples aplicação para identificar o comprometimento cognitivo. Objetivo Desenvolver e validar a versão brasileira do Mini-Addenbrooke's Cognitive Examination (M-ACE BR) como um teste rápido para rastreio de comprometimento cognitivo em idosos. Métodos A M-ACE BR foi desenvolvida usando análise da escala de Mokken em 352 participantes (cognitivamente saudáveis [CS] = 232, comprometimento cognitivo sem demência [CCSD] = 82; e demência = 38) e validado em uma amostra independente de 117 participantes (CS = 25; CCSD = 88; e demência = 4). Resultados A análise de escala de Mokken derivou 9 itens (orientação espacial, memória anterógrada, memória retrógrada, evocação tardia, reconhecimento [nome e endereço], fluência verbal de letras, repetição de 4 palavras, nomeação de 10 itens e compreensão) com pontuação máxima de 51 pontos e tempo médio de duração de 7 minutos. O escore de corte ≤ 43/51 para CCSD teve sensibilidade de 59,09% e especificidade de 80%. Para um teste de rastreio, em que a sensibilidade é priorizada para investigação posterior, sugerimos utilizar um ponto de corte ≤ 47 (sensibilidade 85,23% e especificidade 24%), mantendo um bom valor preditivo positivo (79,8%). Conclusão A M-ACE BR é um instrumento breve e adequado para detectar comprometimento cognitivo em idosos brasileiros. No entanto, o rastreio para a identificação de CCSD e para diferentes níveis de escolaridade deve ser melhor explorado.

17.
Psicol. Estud. (Online) ; 29: e55746, 2024. graf
Artigo em Português | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1569420

RESUMO

RESUMO. O objetivo deste estudo foi apresentar os resultados da reabilitação de um adolescente com dano cerebral precoce no hemisfério direito e cerebelo por acidente vascular cerebral com evolução superior a dez anos e sem histórico de tratamento formal. O método utilizado foi o estudo de caso único, com avaliação pré e pós-aplicação de um programa de reabilitação neuropsicológica. Os resultados obtidos evidenciaram a melhora do funcionamento dos sistemas funcionais para as ações práticas, lúdicas, gráficas e verbais do paciente. Mudanças positivas também foram observadas no aspecto motor, no tônus muscular e no equilíbrio. O paciente mostrou-se mais independente, houve aumento nos interesses, maior nível de regulação, de responsabilidade e participação ativa em sua vida cotidiana. A avaliação neuropsicológica deve considerar a causa psicofisiológica das dificuldades do paciente, juntamente com a atividade orientadora da idade psicológica. Os resultados deste tipo de avaliação permitem a elaboração e aplicação de programas efetivos de reabilitação, inclusive depois de longos períodos sem um tratamento formal. A teoria neuropsicológica de Luria, juntamente com a teoria do desenvolvimento psicológico, representa uma base sólida para a avaliação e organização do processo de reabilitação em casos de pacientes com dano cerebral, mesmo depois de vários anos após o evento traumático.


RESUMEN. El objetivo de este estudio es presentar los resultados de la rehabilitación de un adolescente con daño cerebral temprano en hemisferio derecho y cerebelo por evento cerebrovascular con evolución mayor a diez años y sin historial de tratamiento formal. El método usado fue el estudio de caso único, con una evaluación pre y post aplicación de un programa de rehabilitación neuropsicológica. Los resultados obtenidos evidenciaron la mejoría en el funcionamiento de los sistemas funcionales para las acciones prácticas, lúdicas, gráficas y verbales del paciente. Cambios positivos también fueron observados en la esfera motora, el tono muscular y el balance. El paciente se mostró más independiente, sus intereses se incrementaron, evidenció un mayor nivel de regulación, responsabilidad y participación en su vida cotidiana. La evaluación neuropsicológica debe considerar la causa psicofisiológica de las dificultades del paciente, junto con la actividad rectora de la edad psicológica. Los resultados de este tipo de evaluación permiten la elaboración y aplicación de programas efectivos de rehabilitación, incluso después de largos períodos sin un tratamiento formal. La teoría neuropsicológica de Luria, junto con la teoría del desarrollo psicológico, representa una base sólida para la evaluación y organización del proceso de rehabilitación en casos de pacientes con daño cerebral, aún después de varios años desde el evento.


ABSTRACT. The objective of this study is to present results of the rehabilitation of an individual case of an adolescent patient with early brain damage in right hemisphere and the cerebellum because of a stroke with an evolution of more than ten years without any formal treatment. The method of the individual case study was used in this research, performing a pre-and-post qualitative assessment before and after of the application of the neuropsychological rehabilitation program. The results obtained in the study allowed to point out an improvement in the functioning of functional systems for practical, ludical, graphic and verbal actions of the patient. Positive changes were obtained in the motor sphere, muscle tone and balance. The patient became more independent in his general behavior, his interests were increased, he showed a higher level of regulation, responsibility, and active participation in his day-to-day life. Neuropsychological assessment should consider the psychophysiological cause of the patient's difficulties together with the guiding activity of psychological age. Results of such assessment lead to elaboration and application of effective programs for rehabilitation even after long periods without formal treatment. Luria's neuropsychological theory together with the theory of psychological development represents a solid background for the assessment and organization of the rehabilitation process in cases of patients with brain damage after several years since the event.

18.
Rev. Assoc. Med. Bras. (1992, Impr.) ; Rev. Assoc. Med. Bras. (1992, Impr.);70(8): e20240429, 2024. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1569457

RESUMO

SUMMARY OBJECTIVE: To compare the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests for the identification of cognitive deficit (CD) in elderly patients with heart failure (HF). METHODS: This was a cross-sectional study with an observational design involving 43 elderly patients with HF of both sexes, treated by the Unified Health System, who were able to understand and follow the study instructions. A sociodemographic and clinical questionnaire and the MMSE and MoCA neurocognitive tests were applied. RESULTS: The mean age of the patients was 67 years; 67.44% were male; 53.49% were white; 58.14% had 1-4 years of schooling; 58.14% had an income of half to one minimum wage; 55.81% were married; 53.49% had a family history of HF; 90.7% denied smoking; 83.72% denied alcohol intake; 65.12% did not practice physical activity; 83.72% were hypertensive; 30.23% were diabetic; 57.89% had LVEF ≥ 50%; 39.53% have NYHA II; and 88.37% did not have a pacemaker. In the identification of CD, the MMSE test detected it in 25.58% of the patients, while the MoCA test identified it in 23.26% (p=0.043). CONCLUSION: It was concluded that the MMSE test performed better than the MoCA test in the identification of CD in elderly patients with HF.

19.
Arch Gerontol Geriatr ; 117: 105206, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-37742393

RESUMO

BACKGROUND: Increased interindividual variability in cognitive performance during aging has been proposed as an indicator of cognitive reserve. OBJECTIVE: To determine if interindividual variability performance in episodic memory (PAL), working memory (SWM), reaction time (RTI), and sustained attention (RVP) could differentiate clusters of differential cognitive performance in healthy young and older adults and search for cognitive tests that most contribute to these differential performances. METHODS: We employed hierarchical cluster and canonical discriminant function analyses of cognitive scores using the Cambridge Neuropsychological Test Automated Battery (CANTAB) to identify cognitive variability in older and young adults using the coefficient of variability of cognitive performances between and within groups. We also analyzed potential influences of age, education, and physical activity. RESULTS: Cluster analysis distinguished groups with differential cognitive performance and correlation analysis revealed coefficient of variability and cognitive performance associations. The greater the coefficient of variability the poorer was cognitive performance in RTI but not in PAL and SWM. Older adults showed diverse trajectories of cognitive decline, and better education or higher percentage of physically active individuals exhibited better cognitive performance in both older and young adults. CONCLUSION: PAL and SWM are the most sensitive tests to investigate the wide age range encompassing older and young adults. In older adults' intragroup analysis PAL showed greater discriminatory capacity, indicating its potential for clinical applications late in life. Our data underscore the importance of studying variability as a tool for early detection of subtle cognitive declines and for interpreting results that deviate from normality.


Assuntos
Disfunção Cognitiva , Humanos , Idoso , Adolescente , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Envelhecimento/psicologia , Memória de Curto Prazo , Testes Neuropsicológicos , Cognição , Função Executiva
20.
Dement Neuropsychol ; 17: e20220050, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38053644

RESUMO

With the technological advancement and democratization of electronic devices, computerized cognitive tests have been increasingly used in the clinical context to evaluate cognitive performance in individuals. Objective: This study aimed to propose a brief digital cognitive test based on the paradigm of stimulus equivalence and assess its convergent validity by comparing it with traditionally applied tests. Methods: The study was carried out with a non-probabilistic sample of 50 older adults selected from a public call through the communication media, health units, and day centers of a city in the countryside of São Paulo. Participants were assessed by the brief digital cognitive test, Mini-Mental State Examination, Brief Cognitive Screening Battery, and the Five Digit Test. Results: Participants had a mean age of 71.23 years (standard deviation [SD]: ±9.36) and a mean of 7.15 years of schooling (SD: ±5.34). The mean time to answer the test was 5.33 minutes (SD: ±1.92). There were statistically significant correlations between traditional and digital tests in most domains evaluated. In addition, considering the total score of the digital test, the test could discriminate participants with and without cognitive impairment: area under the ROC curve=0.765; 95%CI 0.630-0.901. Conclusion: The brief digital cognitive test, using the stimulus equivalence paradigm, is an easy-to-apply and valid instrument for the investigation of cognitive impairment in older adults.


Com o avanço tecnológico e a democratização de dispositivos eletrônicos, os testes cognitivos computadorizados vêm sendo cada vez mais utilizados no contexto clínico para avaliar o desempenho cognitivo de indivíduos. Objetivo: Este estudo teve como objetivo propor um Teste Cognitivo Digital Breve baseado no paradigma de equivalência de estímulos e avaliar sua validade convergente comparando-o com testes aplicados tradicionalmente. Métodos: O estudo foi realizado com uma amostra não probabilística de 50 idosos selecionados por chamada pública pelos meios de comunicação, unidades de saúde e centros dia de uma cidade do interior de São Paulo. Os participantes foram avaliados pelo Teste Cognitivo Digital Breve, Miniexame do Estado Mental, Bateria Breve de Rastreio Cognitivo e Teste dos Cinco Dígitos. Resultados: Os participantes tinham média de idade de 71,23 anos (desvio padrão ­ DP: ±9,36) e média de anos de estudo de 7,15 anos (DP: ±5,34). O tempo médio para a realização do teste foi de 5,33 minutos (DP: ±1,92). Houve correlações estatisticamente significativas entre os testes tradicionais e o Teste Digital na maioria dos domínios avaliados. Além disso, considerando o escore total do teste digital, o teste foi capaz de discriminar participantes com e sem comprometimento: área sob a curva ROC=0,765; IC95% 0,630­0,901. Conclusão: O teste digital cognitivo breve com o uso do paradigma de equivalência de estímulos é um instrumento de fácil aplicação e válido para a investigação de comprometimento cognitivo em idosos.

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