Brazilian version of the Frontal Assessment Battery (FAB): Preliminary data on administration to healthy elderly

Abstract

The Frontal Assessment Battery (FAB) has been proposed as a diagnostic tool for patients with frontal lobe syndrome.ObjectivesTo present the Brazilian version of the FAB and to show preliminary data on the performance of healthy elderly in the battery, correlating with age, education and scores in the Mini- Mental State Examination (MMSE).MethodsForty-eight healthy elderly individuals (34 female/14 male) were evaluated, aged 69.3±6.1 years and with educational level=8.0±5.6 years. The subjects were submitted to the MMSE, the Cornell depression scale and the FAB, in which scores were determined for each item and for the total scale. All individuals had to attain above education adjusted cut-off scores in the MMSE and =7 points on the Cornell depression scale. Correlations were calculated between FAB total scores and age, educational level and MMSE scores, as well as between FAB items and education.ResultsThe mean score ±SD in the FAB was 13.0±2.3(7 to 18). Total FAB scores correlated significantly with education (r=0.37; p=0.01) and MMSE scores (r=0.46; p=0.001). No correlation emerged between FAB scores and age. The mean score ±SD of the MMSE was 27.4 ± 1.8. Considering the six FAB items separately, two of them (similarities and conflicting instructions) correlated significantly with educational.ConclusionsIn this group of healthy elderly, the Brazilian version of the FAB proved to be influenced by education, but not age.

Screening for Executive Dysfunction with the Frontal Assessment Battery: Psychometric Properties Analysis and Representative Normative Data for Brazilian Older Adults

“…On this normatization sample, the 50 percentile of illiterate and low educated groups is below the usually adopted cut off score for frontal lobe dysfunction of 10/11 (case/non case) (Kim et al, 2010). The effect of education on test performance is a relevant factor for clinical use and was found in two previous Brazilian studies using the FAB (Beato et al, 2007;2012). The normative study conducted by Beato et al (2012) stratified FAB performance on four groups based on education: 1-3, 4-7, 8-11 and 12 or more years, but had no age stratification, a different pattern than the one found in our study.…”

“…The FAB is usually associated with general measures of cognitive functioning, such as the Dementia Rating Scale (Dubois et al, 2000) and the MMSE (Beato et al, 2007), with moderate or large effect sizes. The cognitive impairment in mild AD is usually not very pronounced, and is more expressive on episodic memory deficits, which may explain the moderate accuracy of the FAB alone in diagnosing AD.…”

“…Only four Brazilian studies found in this review used the FAB in AD patients (Pedroso et al, 2012;de Paula et al, 2012a;de Paula, Miranda, Moraes & Malloy-Diniz, in press;de Paula & Malloy-Diniz, 2013). Only two studies aimed at the performance of healthy older adults in (Beato et al, 2007;2012). They found significant influences of age and education on test performance in the first study (2007); however, in a greater sample (2012), only education was associated with FAB scores.…”

“…It was proposed by Dubois, Slachevsky, Litvan & Pillon (2000) as a short bedside cognitive battery for patients with frontal lobe dysfunction. Two Brazilian versions were proposed, one by Beato, Nitrini, Formigoni & Caramelli (2007) with preliminary data for the administration in healthy elderly patients and subsequent norms (Beato et al, 2012) and the other, slightly different, exposed in a dissertation, in which the validity and normative values of three screening tests including the FAB were developed in a representative sample of a Brazilian city (Moura, 2008).The test has been used in different clinical populations that usually present frontal lobe dysfunction, such as frontotemporal dementia, Parkinson's disease dementia, corticobasal degeneration, progressive supranuclear palsy, and multiple system atrophy (Dubois et al, 2000). Some studies have proposed its use for the differential diagnosis of Alzheimer's disease (AD) from frontotemporal dementia and found good (Slachevsky et al, 2004); however, these findings were inconsistent (Castiglione et al, 2008).…”

Dementia in Parkinson's disease: a Brazilian sample

“…The neuropsychological assessment battery included screening tools (Mini Mental State Examination (MMSE) and Beck Depression Inventary) 13,14 , short-term and working memory for verbal and spatial materials (Digit span 15 , Corsi blocks tapping, forward span and backward span 16 ), episodic memory (Logical Memory, Visual Reproduction 17 , Figure Complex of Rey 18 and Rey Auditory Verbal Learning tests (RAVLT) 19 ), executive functions (Trail Making part B 20 , Frontal Assessment Battery (FAB) 21 , Phonemic Fluency verbal and FAS 22 ), attention (Trail Making part A) 23 and semantic fluency verbal 24 . To avoid fatigue in the PD patients, neuropsychological assessment was conducted over two visits, each one lasting approximately one and a half hours in duration.…”