RESUMO
The objective of this study was to examine the diagnostic accuracy of a primary care screening procedure for identifying cognitive impairment in elderly veterans, in comparison with 4 brief standardized neuropsychological tests. The sample included 100 primary care patients who met age and other criteria requiring screening for cognitive impairment. The results indicated that 3 of the tests significantly discriminated normal from mildly impaired status on the Dementia Rating Scale, but the existing procedure failed to correctly identify any cases in the entire sample. Correct classification rates were near 80% for the Mini-Mental State Exam, Clock Drawing Test, and both Trail Making Test (TMT)-A and TMT-B, with high specificity but variable sensitivity. TMT-B produced good results across eight predictive validity indicators when a cutoff of 3 minutes to completion (1 SD) was used to identify cases. There was no evidence to support the current interview-based screening procedure. Additional research with brief standardized screening is encouraged.
Assuntos
Doença de Alzheimer/diagnóstico , Transtornos Cognitivos/diagnóstico , Programas de Rastreamento , Veteranos/psicologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/psicologia , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Entrevista Psiquiátrica Padronizada/estatística & dados numéricos , Testes Neuropsicológicos/estatística & dados numéricos , New York , Atenção Primária à Saúde , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Veteranos/estatística & dados numéricosRESUMO
Form and motion coherence thresholds can provide comparable measures of global visual processing in the ventral and dorsal streams respectively. Normal development of thresholds was tested in 360 normally developing children aged 4-11 and in normal adults. The two tasks showed similar developmental trends, with some greater variability and a slight delay in motion coherence compared to form coherence performance, in reaching adult levels. To examine the proposal of dorsal stream vulnerability related to specific developmental disorders, we compared 24 children with hemiplegic cerebral palsy with the normally developing group. Hemiplegic children performed significantly worse than controls on the motion coherence task for their age, but not on the form coherence task; however, within this group no specific brain area was significantly associated with poor motion compared to form coherence performance. These results suggest that extrastriate mechanisms mediating these thresholds normally develop in parallel, but that the dorsal stream has a greater, general vulnerability to early neurological impairment.