Verbal fluency (VF) is a widely used tool in neuropsychological assessment.Objective:We aimed to investigate the influence of age and educational level on clustering and switching in three VF modalities: phonemic (PVF), semantic (SVF) and unconstrained (UVF). We evaluated type of cluster, mean cluster size, and quantity of clusters, intersections, and returns. A total of 260 healthy subjects were assessed.Methods:Participants were divided into three age groups: young adults (18 to 39 years), middle-aged adults (40 to 59 years) and older adults (60 to 80 years) and into two groups of educational level: 1-8 years (low), 9 years or more (high). A two-way ANOVA analysis was conducted to analyze the effect of age and educational level and its interactions. A repeated measures ANOVA was performed to verify the performance during the task.Results:A main effect of age was detected on the UVF and SVF scores for total switches, taxonomic clusters, and for the total semantic clusters on the SVF. There was a greater effect of educational level on total switches (UVF, PFV and SVF), taxonomic clusters (UVF and SVF), thematic clusters and total semantic cluster (UVF), phonemic and mixed clusters (PVF), mean cluster size (UVF and SVF) and intersections (SVF). Educational level had a greater effect on all three VF tasks.

Introduction: Semantic and phonemic verbal fluency tasks are the most used verbal fluency versions to evaluate dementia patients, while unconstrained and action fluencies have been poorly investigated in aging. This study aimed to evaluate if the factors diagnosis, age, and reading and writing habits can predict the performance of four types of verbal fluency in healthy elderly (HE), mild cognitive impairment (MCI), and Alzheimer’s disease (AD) participants. Method: Eighty participants were included in this study (21 mild AD, 32 MCI, and 27 HE). The participants performed a reading and writing habits questionnaire, neuropsychological evaluation, and semantic, phonemic, unconstrained, and action verbal fluency tasks. Diagnosis, age, and reading and writing habits were entered as predictors in a stepwise linear regression model for each of the four verbal fluency tasks. Results: The stepwise procedure eliminated age for all models as being nonsignificant. Unconstrained and semantic verbal fluency were better predicted by the diagnosis followed by reading and writing habits. On the other hand, phonemic and action verbal fluency were better predicted by reading and writing habits followed by diagnosis. Conclusion: Reading and writing habits contributed to the prediction of all verbal fluency tasks, highlighting their role in cognitive function. The sensitivity of these verbal fluency tasks to sociocultural and clinical factors should be considered in the neuropsychological assessment.

The first cluster replicated findings of previous studies on TBI EF profiles. IT is suggested that TBI rehabilitation studies of EF must select participants by their EF profile rather than for clinical or demographical variables.

Estabelecer o continuum de declínio cognitivo e funcional no envelhecimento normal para o patológico é desafi ador. Nesta transição está o Comprometimento Cognitivo Leve (CCL), defi nido por prejuízo sutil na cognição e funcionalidade. Quando o prejuízo funcional aumenta preenche critérios para demência. Assim, determinar a acurácia diagnóstica da avaliação funcional é imprescindível. Com isso o objetivo foi comparar o desempenho funcional através da avaliação direta versus indireta e avaliar a acurácia do desempenho destas avaliações entre controles, pacientes com CCL e com doença de Alzheimer (DA). Participaram 90 indivíduos (n=27 controles, n=35 pacientes com CCL e n=28 com DA). Foram utilizadas a Activities of Daily Living Questionnaire (ADL-Q) e a Direct Assessment of Functional Status (DAFS-R). Foram realizadas MANCOVA para comparar o desempenho funcional direto entre os participantes e curvas ROC para verifi car a acurácia diagnóstica das escalas entre os grupos. O desempenho da avaliação direta demonstrou diferenciar controles de CCL e CCL de DA. Ambas as escalas mostraram diferenciar CCL e DA, e a DAFS-R controles de CCL. Assim, a DAFS-R evidenciou melhor acurácia do desempenho funcional nestes grupos.

ABSTRACT.Background:White matter hyperintensities (WMH) are commonly associated with vascular dementia and poor executive functioning. Notwithstanding, recent findings have associated WMH with Alzheimer's disease as well as other cognitive functions, but there is no consensus.Objective:This study aimed to verify the relationship between WMH and cognitive performance in Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) patients. The study also sought to identify cognitive and demographic/cultural factors that might explain variability of WMH.Methods:The sample was composed of 40 participants (18 MCI and 22 AD patients) aged ≥ 65 years. Spearman's correlation was performed among cognitive performance (memory, language, visuospatial ability, and executive function) and WMH evaluated by the Fazekas and ARWMC scales. Two stepwise linear regressions were carried out, one with cognitive and the other with demographic/cultural variables as predictors.Results:Only naming showed significant correlation with ARWMC. Fazekas score exhibited significant correlation with all cognitive domains evaluated. Fazekas score was better predicted by episodic visual memory and age.Conclusion:This study found that the most relevant cognitive profile in MCI and AD patients with WMH was related to episodic memory. And, without taking clinical aspects into consideration, age was the best predictor of WMH.

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Studies of mild cognitive impairment (MCI) still describes executive functions (EF) in a general way rather than focusing on the multiple executive components and their differences. EF entail multiple higher cognitive components, such as cognitive flexibility (CF) and inhibitory control (IC). It is still unclear which specific EF components are impaired in MCI patients, and how best to assess and discriminate those components whether they are verbal, visual or multiple input/outputs. Therefore, we aimed to evaluate if elderly controls and single- and multiple-domain MCI differ as to CF and IC executive components. Additionally, we aimed to verify which instrument used to evaluate these components is more discriminative. A total of 64 elderly adults (14 controls, 19 single-domain MCI, and 31 multiple-domain MCI) were evaluated using the Trail Making Test (TMT), Five-Digit Test, and Hayling Test. We performed a multivariate analysis of covariance to compare the groups regarding cognitive performance. Receiver operating characteristic curves were used to establish which test was more discriminative between control and MCI groups. The groups differed in IC (Time B) and in CF (Time B – Time A) of the TMT, with multiple-domain MCI group having worse performance than the control one. TMT proved to be the most discriminative among the three instruments for elderly with MCI. No differences were found between single- and multiple-domain in CF and IC executive components, probably due to interindividual heterogeneity even in their subtypes. Visuospatial executive skills appear to have greater impact on MCI.

RESUMO Avaliação das praxias construtivas, embora tradicional, tem sido insuficientemente explorada no exame neurocognitivo. O objetivo foi verificar efeito de idade e escolaridade, assim como interação entre os itens de praxias construtivas no Instrumento de Avaliação Neuropsicológica Breve-NEUPSILIN, obtendo-se normas de referência por desempenho. Participaram 613 adultos e idosos entre 19 até 90 anos. Realizou-se quatro tarefas, três de cópia (quadrado, margarida e cubo) e uma produção espontânea (relógio). Conduziu-se MANCOVA para avaliar efeito da idade e escolaridade nos grupos; post hoc Bonferroni para normas nos desenhos. Houve efeito de idade no quadrado e no relógio e efeito de escolaridade no relógio. Ocorreu interação entre idade e escolaridade no cubo e na margarida em que o desempenho aumentou nos grupos de maior escolaridade e diminuíram com aumento da idade. Percebe-se a influência da idade e escolaridade como variáveis relevantes para dados normativos de desempenho em praxias construtivas.