Cognitive and functional dementia assessment tools: Review of Brazilian literature

Abstract

The diagnosis of dementia is based on cognitive and functional evaluation. One of the difficulties in ascertaining the number of people with dementia in developing countries is the population’s lack of formal education. Independent effects of age, sex and education have been identified on scores for most but not all cognitive tests.ObjectivesIdentify the most-used cognitive and functional assessment tools in Brazil, related to dementia diagnosis and treatment outcome; and identify adaptations or normative data, when available.MethodsData were generated from PubMed, LILACS and Portal Periodicos CAPES (thesis database) databases using the search terms ‘dementia’ and ‘Alzheimer’. Data collection criteria were a. Articles with abstract; b. Brazilian abstracts, related to adult Brazilian population; c. Clear mention of assessment tool in the abstract text. A total of 108 abstracts were selected for the main analysis: a. to identify the instruments used b. to determine how many of the selected abstracts mentioned each tool and c. to search in the mentioned databases for respective test adaptations or normative data.ResultsSome 52 different assessment tools, 41 cognitive instruments and 11 functional instruments were identified. The most cited assessment tests were the Mini Mental State Examination (64 abstracts) and Pfeffer Functional Activities Questionnaire (4 abstracts).DiscussionMany of the instruments used only have the description of the translation process into Portuguese, along with some suggestions of validation or normative data. Few of these followed the recommended procedures of validation, replication, normalization or transcultural adaptation.

Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people

“…They are, however, vulnerable to subjective bias. 5 According to the results of a Brazilian review of cognitive and functional assessment tools, 6 only a few measures of functional status have undergone formal adaptation and validation procedures for the older population. The Pfeffer Functional Activities Questionnaire seems to be one of the most commonly used tools for functional assessment aiming at the investigation of IADL performance.…”

Miniexame do Estado Mental: evidências de validade baseadas na estrutura interna

“…Atualmente, é um instrumento de rastreio de declínio cognitivo amplamente utilizado (Kim et al, 2014). Entretanto, pesquisadores brasileiros (Vasconcelos, Brucki, & Bueno, 2007;Melo & Barbosa, 2015) e de outros países (Beyermann et al, 2013;Hoops et al, 2009;Spencer et al, 2013) têm questionado suas propriedades psicométricas. É preciso salientar que instrumentos que medem um construto psicológico, como o MEEM, precisam preencher requisitos mínimos, entre eles, apresentar evidências de validade, fidedignidade ou confiabilidade e padronização (AERA, APA, & NCME, 2004).…”

Ecological validity of the five digit test and the oral trails test

“…However, the interference effect of the SCWT could be inaccurate for specific populations such as preschoolers, illiterates or even individuals with low formal schooling since reading efficiency moderates the time of the task execution 10 . The Five Digit Test (FDT) was design to overcome some of these limitations requiring to test-takers to read or count Arabic numerals (1)(2)(3)(4)(5) or count stars 11 . Four parts compose the FDT: reading, counting, choosing (selective attention), and switching (alternate attention) 11 .…”