Phonemic verbal fluency tests assess the production of words beginning with specific letters. Of these letters, the most frequently used are F, A and S. It is a sensitive test for assessing frontal lobe functions.ObjectiveTo provide normative data for the elderly Brazilian population on the FAS test and to investigate the effects of age and schooling on test performance.MethodsThe individuals were divided into three age groups (60–69, 70–79 and =80 years), and into four groups according to education (1–3, 4–7, 8–11 and 12 years). All subjects were assessed by the Mini Mental State Examination and the FAS. Data were analyzed with Student’s t test, ANOVA, simple linear regression and Spearman’s correlation.ResultsWe evaluated 345 cognitively healthy volunteers, 66.66% being female, aged 60 to 93 years, with an educational level ranging from one to 24 years. The average (number of items) ±SD for the whole sample was 28.28±11.53. No significant effect of gender was observed (p=0.5). Performance on the MMSE and education exerted a direct influence on FAS scores (p<0.001), with education being the most significant factor. A positive correlation was found between FAS and the MMSE (r=0.404; p<0.001).ConclusionThe performance of Brazilian elderly on the phonemic verbal fluency tests-FAS is significantly influenced by education, where individuals with higher educational level present better performance than those with fewer years of schooling. Age and gender did not prove significant with the FAS.
Cognitive decline, particularly executive dysfunction, is observed in normal aging. In Brazil, the elderly population presents broad educational diversity. Category verbal fluency tests are frequently used to detect cognitive impairment, assessing executive function, language and semantic memory.ObjectiveTo investigate the effects of age and education on category animal fluency task (CAF) in healthy elderly.MethodsWe evaluated 319 healthy elderly from outpatient care units of two university reference centers of Rio de Janeiro and São Paulo. The sample was divided into two age, and five schooling subgroups. To be included participants had to demonstrate preservation of global cognitive functioning, independence for activities of daily living and not fulfill diagnostic criteria for dementia. All participants were submitted to neurological and neuropsychological evaluations.ResultsThere was a correlation between age and CAF performance (r= –0.26, p<0.01), which was not confirmed when years of education were included as a covariant in univariate ANCOVA. Significant differences were found in CAF performance among the different educational level groups on correlation analysis (r=0.42, p<0.01) and ANCOVA analysis (F=18.8, p<0.05). Illiteracy was associated with worst CAF performance, while university level was associated with best performance.ConclusionThe best CAF performance was found in the first years of schooling (literacy learning process) compared to illiteracy, and when finishing high school and starting university courses compared to all other educational levels. These stages are associated with significant gains in semantic memory and executive function which are critical for verbal fluency performance.
The Rey Auditory Verbal Learning Test (RAVLT) is an episodic memory test that is influenced by demographic variables, such as age, education, and gender. Classic word list learning has also been well documented to be an experimental cognitive paradigm that is very useful for the detection of Alzheimer's disease. The present study analyzed the performance of healthy elderly subjects on the RAVLT, describing the effects of age, education, and gender. To verify its construct validity, the RAVLT was compared with delayed recall and recognition scores on the Brief Cognitive Screening Battery (DR-BCSB). The sample comprised 183 cognitively healthy elderly subjects from outpatient care units of two university reference centers in Rio de Janeiro and São Paulo, Brazil. All participants were subjected to physical and neurological evaluation and neuropsychological assessment. Pearson's correlation and Student's t-test were used to investigate the influence of demographic variables on RAVLT performance. To verify convergent-type construct validity, a correlation between RAVLT and DR-BCSB scores was calculated. Significant correlations were found between age and ∑A1-A5 (r = -.383, p < .01), A5-A1 (r = -.054, p < .01), A7 (r = -.361, p < .01), and REC A (r = -.288, p < .01). Educational level correlated with ∑A1-A5 (r = .405, p < .01), A5-A1 (r = .184, p < .01), A7 (r = .334, p < .01), and REC A (r = .329, p < .01). No correlation was found between gender and RAVLT performance. A significant correlation was also found between RAVLT and DR-BCSB performance (r = .5, p < .01). These results revealed some normative data and convergent-type construct validity of the RAVLT for a Brazilian elderly population.
The diagnosis of early signs of Alzheimer’s disease (AD) is a major challenge in a heterogeneous population. Objective To investigate the use of the Brief Cognitive Screening Battery (BCSB) for the diagnosis of mild AD in a geriatric outpatient unit of a public hospital in the city of Rio de Janeiro. Method BCSB was administered to 51 elderly adults with a clinical diagnosis of probable AD and 123 older adults without dementia (non-AD). Results AD patients performed worse than non-AD group in all BCSB tests, except Clock Drawing (p = 0.10). The ROC curves and Logistic Regression analysis indicated that delayed recall in the figure memory test was the best predictor, screening mild AD patients with sensibility and specificity superior to 80%. Conclusion The BCSB was accurate in identifying people with AD in a geriatric outpatient clinic at a public hospital, including elderly people with chronic diseases, physical frailty and cognitive impairment
Resumo Os critérios que subsidiaram o diagnóstico do autismo passaram por diversas mudanças ao longo dos anos, acompanhando os pressupostos conceituais hegemônicos no período. O objetivo deste estudo é analisar a evolução do diagnóstico do autismo no século XXI, a partir dos domínios e subdomínios em que se baseiam as categorizações nosológicas. Adicionalmente, são sinalizados instrumentos auxiliares utilizados e algumas tecnologias diagnósticas em desenvolvimento, além de modelos conceituais que tratam do perfil neuropsicológico. Trata-se de pesquisa documental, tendo como referência os manuais diagnósticos existentes no período. Os domínios de interação social, comunicação e padrão restrito e repetitivo de comportamento foram mantidos nos diferentes manuais diagnósticos abordados. Os subdomínios de interação social e comunicação foram reduzidos, enquanto o padrão restrito e repetitivo teve consolidação no DSM-5. Compreender a evolução dos critérios diagnósticos tende a promover o desenvolvimento da clínica, potencializando a antecipação do diagnóstico e as intervenções necessárias para um melhor prognóstico.
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