screening for cognitive impairment in late onset depression in a Brazilian sample using the BBRC-edu

ABSTRACT Depression and dementia are the most prevalent neuropsychiatric disorders in the elderly population. Alzheimer's disease is the leading cause of dementia in most countries, being responsible for more than half of all dementia cases. Late-onset depression is a frequent cause of cognitive decline in the elderly. Differentiating between cognitive impairment secondary to depression and incipient dementia poses a challenge in the clinical setting. Objective: To evaluate the performance of elderly depressed patients using the BBRC-Edu. Methods: We studied 25 patients with late onset depression (mean age: 73.6 y (6.6); schooling: 9.1 y (5.7)) and 30 patients with mild AD (mean age 76.6 y (5.4); schooling: 7.5 y (7.1)), who were compared to a control group of 30 healthy elderly (mean age 73.8 y (5.8); schooling: 9.1 y (5.4)) using the CERAD and BBRC-Edu batteries. Results: For the CERAD battery, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Constructional Praxis (p>0.05), and performed poorer than controls on verbal fluency (animals) and Word List Recall tasks (p<0.0001). For the BBRC-Edu, depressed patients performed better than AD patients on all tasks (p<0.0001) except for Digit Span (direct order) (p=0.076) and Incidental Memory (p>0.05), and performed worse than controls on Learning (second presentation) and verbal fluency (fruits) tasks (p<0.0001). Conclusion: Overall performance on the BBRC-Edu allowed differentiation of controls and depressed patients from AD patients.

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Training of executive functions in healthy elderly: Results of a pilot study

Dementia & Neuropsychologia ◽

10.1590/s1980-57642012dn06010006 ◽

2012 ◽

Vol 6 (1) ◽

pp. 35-41

Author(s):

Thaís Bento Lima-Silva ◽

Aline Teixeira Fabrício ◽

Laís dos Santos Vinholi e Silva ◽

Glaúcia Martins de Oliveira ◽

Wesley Turci da Silva ◽

...

Keyword(s):

Executive Functions ◽

Verbal Fluency ◽

Digit Span ◽

Depression Scale ◽

Cognitive Intervention ◽

Control Group ◽

Cross Sectional ◽

Healthy Elderly ◽

Post Test ◽

The Impact

ABSTRACT Executive functions (EF) refer to the cognitive skills necessary to formulate a goal, plan, execute plans effectively, and to perform self-monitoring and self-correction. Several aspects of EF change during the normal aging process. Objectives: To train skills associated with executive functions in the elderly and to detect possible impact on objective EF tests and self-reports of functional status. Methods: A cross-sectional study involving an intervention and pre and post testing was carried out. Study participants included 26 seniors assigned to an experimental group (EG) and given six sessions of cognitive intervention, and 17 seniors assigned to a control group (CG) who completed pre and post testing only. All participants were enrolled in an Open University for the Third Age. The following tests were used to measure outcome: the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS), the Story subtest of the Rivermead Behavioral Memory Test (RBMT) (versions A and B), semantic verbal fluency fruit category, and verbal fluency with phonological constraints (FAS), WAIS-III Digit Span, Clock Drawing Test (CDT), Trail Making Part A and the Pfeffer Functional Assessment Questionnaire (PFAQ). Delta scores were calculated (post-test score minus pretest score) to assess the impact of the intervention. Results: In the post test, the CG showed significant improvement on the RBMT Story recall and Digit Span but a decline in verbal fluency. The EG remained stable in terms of pre and post test scores. Conclusions: The intervention did not enhance performance on the EF tests. It is noteworthy that the EG received only a small number of sessions which may not have been sufficient to generate improvement. Alternatively, the lack of group differences observed could be associated to participation in other workshops offered at the university.

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Sensitivity and specificity of neuropsychological tests for dementia and mild cognitive impairment in a sample of residential elderly in South Africa

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v20i4.558 ◽

2014 ◽

Vol 20 (4) ◽

pp. 7 ◽

Cited By ~ 3

Author(s):

Suvira Ramlall ◽

Jennifer Chipps ◽

Ahmed I Bhigjee ◽

Basil J Pillay

Keyword(s):

South Africa ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sensitivity And Specificity ◽

Neuropsychological Tests ◽

Word Association ◽

Digit Span ◽

The Elderly ◽

Elderly Persons ◽

Healthy Elderly

Background. Neuropsychological tests can successfully distinguish between healthy elderly persons and those with clinically significant cognitive impairment. Objectives. A battery of neuropsychological tests was evaluated for their discrimination validity of cognitive impairment in a group of elderly persons in Durban, South Africa. Method. A sample of 117 English-speaking participants of different race groups (9 with dementia, 30 with mild cognitive impairment (MCI) and 78 controls) from a group of residential homes for the elderly was administered a battery of 11 neuropsychological tests. Kruskal-Wallis independent sample tests were used to compare performance of tests in the groups. Sensitivity and specificity of the tests for dementia and MCI were determined using random operating curve (ROC) analysis. Results. Most tests were able to discriminate between participants with dementia or MCI, and controls (p<0.05). Area under the curve (AUC) values for dementia v. non-dementia participants ranged from 0.519 for the digit span (forward) to 0.828 for the digit symbol (90 s), with 14 of the 29 test scores achieving significance (p<0.05). AUC values for MCI participants ranged from 0.754 for controlled oral word association test (COWAT) Animal to 0.507 for the Rey complex figure test copy, with 17 of the 29 scores achieving significance (p<0.05). Conclusions. Several measures from the neuropsychological battery had discrimination validity for the differential diagnosis of cognitive disturbances in the elderly. Further studies are needed to assess the effect of culture and language on the appropriateness of the tests for different populations.

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EXECUTIVE FUNCTION PERFORMANCE OF A BRAZILIAN SAMPLE OF MILD COGNITIVE IMPAIRMENT AND HEALTHY ELDERLY

10.5327/1980-5764.rpda035 ◽

2021 ◽

Author(s):

Geise Silva ◽

Isabella Avolio ◽

Camila Dias ◽

Maíra Oliveira ◽

Ricardo Nitrini ◽

...

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Verbal Fluency ◽

Healthy Aging ◽

Brazilian Sample ◽

Part C ◽

Healthy Elderly ◽

Trail Making ◽

Multiple Domains

Background: Mild cognitive impairment (MCI) is associated with cognitive alterations, usually related to memory, but can affect other domains such as executive functions (EFs), which are less explored in the literature. It is an intermediate condition between healthy aging and dementia and does not significantly affect an individual’s activities of daily living (ADL). Objectives: This study aimed to investigate executive function performance of a Brazilian sample of elderly people with multiple domains MCI (mdMCI) compared to healthy controls (HC) using EFs tasks. Methods: We included 54 subjects, 36 mdMCI and 18 HC. The EFs tasks were extracted from a comprehensive neuropsychological assessment (CAPpesq 11264) and involved the Trail Making Test (TMT), Stroop Test part C (ST), Phonemic Verbal Fluency (FAS), Semantic Verbal Fluency (SVF). Results: We observed significant differences between the groups (p <0.05) in the following task: SVF (t(25.7)= -2.582; p 0.016). Conclusions: mdMCI patients obtained a lower cognitive performance in EFs related to SVF task which is usually implicated in the cognitive fenotype of Alzheimer’s Disease continuum. These findings corroborate the international literature in mdMCI patients.

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An Informant Questionnaire for Detecting Alzheimer's Disease: Are Some Items Better Than Others?

Journal of the International Neuropsychological Society ◽

10.1017/s1355617711000543 ◽

2011 ◽

Vol 17 (4) ◽

pp. 674-681 ◽

Cited By ~ 2

Author(s):

Sietske A.M. Sikkes ◽

Dirk L. Knol ◽

Mark T. van den Berg ◽

Elly S.M. de Lange-de Klerk ◽

Philip Scheltens ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Structural Equation ◽

Structural Model ◽

The Elderly ◽

Equation Modeling ◽

Or Education ◽

Healthy Elderly ◽

Patient Groups ◽

Better Than

AbstractA decline in everyday cognitive functioning is important for diagnosing dementia. Informant questionnaires, such as the informant questionnaire on cognitive decline in the elderly (IQCODE), are used to measure this. Previously, conflicting results on the IQCODEs ability to discriminate between Alzheimer's disease (AD), mild cognitive impairment (MCI), and cognitively healthy elderly were found. We aim to investigate whether specific groups of items are more useful than others in discriminating between these patient groups. Informants of 180 AD, 59 MCI, and 89 patients with subjective memory complaints (SMC) completed the IQCODE. To investigate the grouping of questionnaire items, we used a two-dimensional graded response model (GRM).The association between IQCODE, age, gender, education, and diagnosis was modeled using structural equation modeling. The GRM with two groups of items fitted better than the unidimensional model. However, the high correlation between the dimensions (r=.90) suggested unidimensionality. The structural model showed that the IQCODE was able to differentiate between all patient groups. The IQCODE can be considered as unidimensional and as a useful addition to diagnostic screening in a memory clinic setting, as it was able to distinguish between AD, MCI, and SMC and was not influenced by gender or education. (JINS, 2011, 17, 674–681)

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The Clock Drawing Test: Performance differences between the free-drawn and incomplete-copy versions in patients with MCI and dementia

Dementia & Neuropsychologia ◽

10.1590/s1980-5764-2016dn1003009 ◽

2016 ◽

Vol 10 (3) ◽

pp. 227-231 ◽

Cited By ~ 2

Author(s):

Bárbara Costa Beber ◽

Renata Kochhann ◽

Bruna Matias ◽

Márcia Lorena Fagundes Chaves

Keyword(s):

Cognitive Impairment ◽

Test Performance ◽

Diagnostic Value ◽

Control Group ◽

Cognitive Screening ◽

Scoring Method ◽

Clock Drawing Test ◽

Clock Drawing ◽

Healthy Elderly ◽

Drawing Test

ABSTRACT Background: The Clock Drawing Test (CDT) is a brief cognitive screening tool for dementia. Several different presentation formats and scoring methods for the CDT are available in the literature. Objective: In this study we aimed to compare performance on the free-drawn and "incomplete-copy" versions of the CDT using the same short scoring method in Mild Cognitive Impairment (MCI) and dementia patients, and healthy elderly participants. Methods: 90 participants (controlled for age, sex and education) subdivided into control group (n=20), MCI group (n=30) and dementia group (n=40) (Alzheimer's disease - AD=20; Vascular Dementia - VD=20) were recruited for this study. The participants performed the two CDT versions at different times and a blinded neuropsychologist scored the CDTs using the same scoring system. Results: The scores on the free-drawn version were significantly lower than the incomplete-copy version for all groups. The dementia group had significantly lower scores on the incomplete-copy version of the CDT than the control group. MCI patients did not differ significantly from the dementia or control groups. Performance on the free-drawn copy differed significantly among all groups. Conclusion: The free-drawn CDT version is more cognitively demanding and sensitive for detecting mild/early cognitive impairment. Further evaluation of the diagnostic value (accuracy) of the free-drawn CDT in Brazilian MCI patients is needed.

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Normative data for healthy elderly on the phonemic verbal fluency task - FAS

Dementia & Neuropsychologia ◽

10.1590/s1980-57642009dn30100011 ◽

2009 ◽

Vol 3 (1) ◽

pp. 55-60 ◽

Cited By ~ 61

Author(s):

Thais Helena Machado ◽

Helenice Charchat Fichman ◽

Etelvina Lucas Santos ◽

Viviane Amaral Carvalho ◽

Patrícia Paes Fialho ◽

...

Keyword(s):

Test Performance ◽

Educational Level ◽

Verbal Fluency ◽

Normative Data ◽

Age Groups ◽

The Elderly ◽

Verbal Fluency Task ◽

Healthy Elderly ◽

Phonemic Verbal Fluency ◽

Student’S T

Abstract 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. Objective: To provide normative data for the elderly Brazilian population on the FAS test and to investigate the effects of age and schooling on test performance. Methods: The individuals were divided into three age groups (60-69, 70-79 and ³80 years), and into four groups according to education (1-3, 4-7, 8-11 and ³12 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. Results: We 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). Conclusion: The 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.

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Effects of health education in the elderly with mild cognitive impairment

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2017-0032 ◽

2018 ◽

Vol 71 (suppl 2) ◽

pp. 801-810 ◽

Cited By ~ 4

Author(s):

Francine Golghetto Casemiro ◽

Diana Monteiro Quirino ◽

Maria Angélica Andreotti Diniz ◽

Rosalina Aparecida Partezani Rodrigues ◽

Sofia Cristina Iost Pavarini ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Health Education ◽

The Elderly ◽

Anxiety Symptoms ◽

Control Group ◽

Controlled Clinical Trial ◽

Cognitive State ◽

Paired Samples ◽

Education Group

ABSTRACT Objective: to analyze the effects of health education on both cognition and depressive/anxiety symptoms in the elderly with Mild Cognitive Impairment (MCI). Method: this is a randomized and controlled clinical trial. Participants (n=22) were recruited from a specialized outpatient clinic, and assigned into two groups: a Health Education Group (HEG) (n=10) and a Control Group (CG) (n=12). The participants were evaluated before and after the intervention, which was composed of classes and dynamics. The intervention consisted of 20 meetings, over a period of five months. The assessment was performed by means of the Addenbrooke’s Cognitive Examination – Revised (ACER), the Mini-Mental State Examination to access participant’s cognitive state, and the Beck’s Scale to access depressive/anxiety symptoms. A Memory Complaints Scale (EQM) was also used. The analysis was carried out using the Student’s t test for paired samples. Results: the HEG group demonstrated an improvement in attention/orientation (p= 0,026), memory (p=0.001), language (p= 0.033), and ACE-R (p= 0.003). On the other hand, the CG did not present improvement. Conclusion: the results highlight the importance of non-pharmacological interventions in older adults with MCI to reduce cognitive deficits.

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32 Effect of Dual Task Training Regarding to Postural Stability in the Healthy Elderly

Age and Ageing ◽

10.1093/ageing/afz164.32 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv9-iv12

Author(s):

Anyamanee Yingyongyudha ◽

Thanakorn Ramrong ◽

Piyatip Yodkue ◽

Korawit Jamjit ◽

Pawaris Suchart ◽

...

Keyword(s):

Dual Task ◽

Postural Stability ◽

The Elderly ◽

Postural Instability ◽

Control Group ◽

Healthy Elderly ◽

Before And After ◽

Task Training ◽

Dual Task Training ◽

Experimental Group

Abstract Introduction Postural instability problem in the elderly is associated the cognitive impairment. The ageing process is directly linked to impairments in postural stability. Dual task activity is a commonplace to most activities of daily living. The elderly who has a postural instability and cognitive decline that are mechanisms which lead to an increased risk of falls in the elderly. Objective To investigate the effect of dual task training on postural stability in the healthy elderly. Methods The sixty-six healthy elderly were selected based on the inclusion criteria. With randomized 33 participants in each experimental and control group. The experimental group received dual task training for 6 weeks delivered three days per week. The control group received education for postural stability and aerobic exercise. Their postural stability was assessed using the Mini-BESTest in before and after training. Results The score of the Mini-BESTest compare between before and after 6 weeks were significantly different in postural stability and cognitive from that before in experimental group (p<0.001). Conclusions The finding support the dual task training program can improve postural stability in the elderly. Therefore, the dual task training program should be implemented with the elderly to be a choice of exercises for the elderly with postural instability.

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Performance of a sample of patients with Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD) and healthy elderly on a lexical decision test (LDT) as a measure of pre-morbid intelligence

Dementia & Neuropsychologia ◽

10.1590/1980-57642015dn93000009 ◽

2015 ◽

Vol 9 (3) ◽

pp. 265-269 ◽

Cited By ~ 1

Author(s):

Valéria Trunkl Serrao ◽

Sônia Maria Dozzi Brucki ◽

Kenia Repiso Campanholo ◽

Letícia Lessa Mansur ◽

Ricardo Nitrini ◽

...

Keyword(s):

Cognitive Impairment ◽

Lexical Decision ◽

Test Methods ◽

Elderly Subjects ◽

Boston Naming Test ◽

Brazilian Sample ◽

Healthy Elderly ◽

Matrix Reasoning ◽

Naming Test ◽

Healthy Elderly Subjects

Objective: The objective of this study was to describe the performance of healthy elderly patients with aging-related pathologies (MCI) and patients with AD on a lexical decision test. Methods: The study included 38 healthy elderly subjects, 61 MCI and 26 AD patients from the Neurology Department of the Hospital das Clinicas, Behavioral and Cognitive Neurology Group. The neuropsychological instruments included the episodic memory test (RAVLT), subtests from the WAIS-III (Matrix Reasoning and Vocabulary) to determine estimated IQ, the Boston naming test (BNT) and Lexical Decision Test (LDT). Results: All groups differed on the MMSE, as expected according to their pathologies, memory tests, naming and estimated IQ. For the vocabulary and the LDT - measures of crystalized intelligence no differences were found. Conclusion: The LDT demonstrated that lexical decision can be used as a measure of pre-morbid IQ among the individuals assessed in a Brazilian sample.

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Effect of cortisol levels on working memory performance in elderly subjects with Alzheimer's disease

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2008000500003 ◽

2008 ◽

Vol 66 (3b) ◽

pp. 619-624 ◽

Cited By ~ 7

Author(s):

Juliana Nery de Souza-Talarico ◽

Paulo Caramelli ◽

Ricardo Nitrini ◽

Eliane Corrêa Chaves

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Working Memory ◽

Digit Span ◽

Memory Performance ◽

Elderly Subjects ◽

Control Group ◽

Acute Administration ◽

Healthy Elderly ◽

Cortisol Levels

BACKGROUND: Subjects with Alzheimer's disease (AD) have elevated cortisol levels as a result of hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Acute administration of hydrocortisone has been associated with working memory (WM) performance in young adults. OBJECTIVE: To investigate whether cortisol levels are associated with WM performance in subjects with AD. METHOD: Eighty subjects were included, comprising 40 patients with mild AD and 40 healthy elderly controls. WM was assessed using the Digit Span Backward test (DSB). Saliva samples were collected to determine cortisol levels. RESULTS: AD subjects had poorer performance on the DSB than controls (p=0.002) and also presented higher levels of cortisol than control group (p=0.04). No significant correlation was observed between the DSB and cortisol levels in both groups (r= -0.29). CONCLUSION: In this study, elevated cortisol levels were not associated with poorer WM performance in patients with AD or in healthy elderly subjects.

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