Development of the Brazilian version of the Mini-Addenbrooke Cognitive Examination (M-ACE BR) to screen for cognitive impairment in older adults.

BACKGROUND: Age is the most important risk factor for develop dementia, and the recommendation is that older adults are cognitively tested to detect impairment in the initial stage for adequate treatment. The demand for the care of these older adults is great, drawing attention to the need for rapid tests, with good accuracy and simple application to identify cognitive impairment. OBJECTIVE: To develop and validate the Brazilian Mini-Addenbrooke Cognitive Examination (M-ACE BR) as a short screening test for cognitive impairment in older adults. METHODS: The M-ACE BR was developed using the Mokken scaling analysis in 352 participants (cognitively unimpaired [CU] = 232, cognitive impairment no dementia [CIND] = 82; and dementia = 38) and validated in an independent sample of 117 participants (CU = 25; CIND = 88; and dementia = 4). RESULTS: The Mokken scaling analysis derived 9 items (spatial orientation, anterograde memory, retrograde memory, delayed recall, recognition [name and address], letter verbal fluency, repetition of 4 words, naming of 10 items, and comprehension) with a maximum score of 51 points and an average duration time of 7 minutes. The cut-off score ≤ 43/51 for CIND had a sensitivity of 59.09% and a specificity of 80%. For a screening test in which sensitivity is prioritized for further investigation, we suggest using a cutoff of ≤ 47 (sensitivity 85.23% and specificity 24%), maintaining a good positive predictive value (79.8%). CONCLUSION: The M-ACE BR is a brief and adequate instrument to detect cognitive impairment in older Brazilian adults. However, screening for CIND and for different educational levels should be further explored.

ANTECEDENTES: A idade é o fator de risco mais importante para o desenvolvimento de demência, e a recomendação é que os idosos sejam testados cognitivamente para detectar comprometimento na fase inicial para o tratamento adequado. A demanda pelo atendimento desses idosos é grande, chamando atenção para a necessidade de testes rápidos, com boa acurácia e de simples aplicação para identificar o comprometimento cognitivo. OBJETIVO: Desenvolver e validar a versão brasileira do Mini-Addenbrooke's Cognitive Examination (M-ACE BR) como um teste rápido para rastreio de comprometimento cognitivo em idosos. MéTODOS: A M-ACE BR foi desenvolvida usando análise da escala de Mokken em 352 participantes (cognitivamente saudáveis [CS] = 232, comprometimento cognitivo sem demência [CCSD] = 82; e demência = 38) e validado em uma amostra independente de 117 participantes (CS = 25; CCSD = 88; e demência = 4). RESULTADOS: A análise de escala de Mokken derivou 9 itens (orientação espacial, memória anterógrada, memória retrógrada, evocação tardia, reconhecimento [nome e endereço], fluência verbal de letras, repetição de 4 palavras, nomeação de 10 itens e compreensão) com pontuação máxima de 51 pontos e tempo médio de duração de 7 minutos. O escore de corte ≤ 43/51 para CCSD teve sensibilidade de 59,09% e especificidade de 80%. Para um teste de rastreio, em que a sensibilidade é priorizada para investigação posterior, sugerimos utilizar um ponto de corte ≤ 47 (sensibilidade 85,23% e especificidade 24%), mantendo um bom valor preditivo positivo (79,8%). CONCLUSãO: A M-ACE BR é um instrumento breve e adequado para detectar comprometimento cognitivo em idosos brasileiros. No entanto, o rastreio para a identificação de CCSD e para diferentes níveis de escolaridade deve ser melhor explorado.

Development and validation of a novel Context-Based Prospective Memory Task among neurotypical adults.

PURPOSE: To address the paucity and potential of context-based prospective memory (PM) assessment tasks suitable to Indian ethnicity, the study aimed to develop a novel context-based PM task and determine its psychometric properties among neurotypical adults. METHODS: Rendered images in 2-D were extracted from a 3-D shopping mall, where PM and ongoing tasks were embedded within them to provide participants with a semi-immersive experience. The design and scoring of the novel task were constructed in alignment with the Memory for Intentions Screening Test. Fifty neurotypical adults in and around Mangaluru were recruited. The Memory of Intentions Test (MIST) and novel context-based PM task were administered. RESULTS: The validity of the novel task was established with a Content Validity Index of 0.98. The intraclass correlation for the test-retest reliability of the novel context-based PM task was 0.92 (p<0.001) and the inter-rater reliability was 0.98 (p<0.001). The internal consistency of the six subscales was high (Cronbach's α= 0.86), and the Spearman-Brown coefficient indicated a strong split-half reliability of 0.87. Spearman's correlation showed that the trials exhibited strong connections to the dichotomic characteristics of the subscales to which they belonged. Further, McNemar's test suggested similar profiles of the participants for the MIST and novel task. CONCLUSION: The results of the present study suggest that the novel context-based PM task offers good validity and reliability measures, providing valuable insight into the mechanisms of PM, and therefore, could be ideal for inclusion in a battery of cognitive assessments.

Evidence of validity and reliability of the Colombian version of Addenbroke's Cognitive Examination Revised (ACE-R).

OBJECTIVE: The purpose of this study is to provide evidence that supports the validity and reliability of the Colombian version of the Addenbrooke's Cognitive Examination Revised (ACE-R) in comparison to the MMSE at assessing and finding patients with Mild Cognitive Impairment (MCI). Additionally, the study aims to determine the optimal cut-off scores based on the age of a population with a low education level. METHOD: This study included 314 individuals (235 participants diagnosed with MCI and 79 cognitively healthy) who live in two different rural departments (states) in Colombia. The participants were recruited for this study through community clubs for the older adults. Most of the individuals were female (236), the average age was 65.95 years of age (SD= 7.8), and the average education level was of 3.78 years (SD = 1.79). It is important to note that the sample only included people with a maximum of 6 years of schooling. RESULTS: A ROC analysis indicated that the ACE-R is more effective than the MMSE at evaluating and finding MCI individuals within the three groups. The cut-off points for the Under 60 years of age group was 83.50 (sensitivity 0.880% and specificity 0.632%); 61-69 years of age 80.50 (sensitivity 0.714% and specificity 0.677%); and Over 70 years of age was 79.50 (sensitivity 0.750% and specificity 0.659%). The internal consistency analysis with MacDonald's Ω determined reliability indicators ≥70 in the ACE-R, except for the age range of 61 to 69 years. CONCLUSION: The Colombian version of the ACE-R demonstrates to be a valid and reliable global cognitive screening tool. It is effective at discerning MCI individuals from healthy within a group of participants with a low education level.

Norms, convergent validity, test-retest reliability, and practice effects for verbal fluency overall performance, clustering, and switching in Spanish-speaking children.

OBJECTIVE: We conducted two empirical studies (in a cross-sectional and a longitudinal design) with the aim at establishing normative data (including norms for strategy use [i.e., clustering and switching strategies] and performance over time), and examining the convergent validity, the test-retest reliability (3-4 wks interval) and the changes in performance with practice (1 year interval) of the different verbal fluency (VF) quantitative and qualitative scores in Spanish-speaking children and adolescents. METHOD: In S1 (n = 620 6- to 15-year-old Spanish-speaking children and adolescents), MANCOVA and Pearson's correlations were employed. In S2 (n = 148 6- to 12-year-old Spanish-speaking children), intraclass correlation coefficient (ICC), paired t-tests, and Confirmatory Factor Analysis (CFA) were used. RESULTS: S1 results showed an age effect on all VF measures (quantitative and qualitative). The number of switches/clusters was more related to total word productivity and to executive functions (EF) than the mean cluster size. In S2, a significant increase in phonological VF performance was observed on number of switches and word productivity scores from baseline (Time 1) to repeat testing at Time 2. Practice effects were observed at Time 3 on all measures except for semantic and phonological mean cluster size. Test-retest reliability coefficients at Time 2 for number of clusters and switches, but not for mean cluster size, fell in the moderate range, ranging from ICCs .61 to ICCs .81. Test-retest reliability coefficients for total word productivity were higher (ICCs above .80) and stronger when testing as a unity with CFA methods (ϕ=.94, p < .001). CONCLUSIONS: These data may be relevant for informing the neuropsychological assessment of spontaneous cognitive flexibility in children with typical development (TD) and those with developmental or acquired disorders.

Factores de riesgo neuropsicológico y de personalidad asociados en la poliaccidentalidad laboral / Associated neuropsychological and personality risk factors in occupational polyaccidentality

Introducción: El bienestar y la salud de cada uno de los trabajadores son primordiales en el Departamento de Salud Ocupacional de la Fundación Hospital Universitario Metropolitano. Es importante que el personal goce de un nivel de vida saludable para cumplir satisfactoriamente con todas sus obligaciones y las metas planeadas de la organización. Objetivo: Analizar los factores neuropsicológicos y de personalidad asociados en un grupo de personas que se han accidentado dos o más veces (poliaccidentados). Métodos: Se desarrolló un diseño metodológico de casos y controles. Se tomó como población las bases de datos del departamento de seguridad y salud en el trabajo, con 50 trabajadores accidentados en dos o más ocasiones (poliaccidentados). Se aplicaron como técnicas de recolección de datos la escala abreviada de inteligencia Reynolds (Rist) para apreciar el coeficiente de inteligencia de los sujetos y el cuestionario de personalidad de Cattell (16 Pf), que midió 16 factores primarios y cuatro secundarios. Se utilizó la Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales (BANFE) para evaluar los factores neuropsicológicos. Resultados: fue procesados mediante el paquete estadístico Statistical package Social Science (Spss) versión 21.0 que permitió realizar la prueba de hipótesis para las variables estudiadas, se utilizó la prueba U de Mann Whitney, con un criterio alfa de 0,05 y un nivel de confianza del 95 por ciento. Conclusiones: El grupo de poliaccidentados presentó alteraciones en las áreas orbito-medial, ventromedial y dorso-laterales lo que los predispone a una mayor posibilidad de realizar actividades riesgosas y presentar menor consciencia del riesgo(AU)

Introduction: The well-being and health of each of the workers are paramount in the Department of Occupational Health at Fundación Hospital Universitario Metropolitano. It is important that the staff enjoy a healthy standard of living in order to satisfactorily fulfil all their obligations and the planned goals of the organization. Objective: To look at the neuropsychological and personality factors associated in a group of individuals who have been injured two or more times (poly-accidented). Methods: A case-control methodological design was developed. The databases of the Department of Labor Safety and Health were taken as the population, with 50 workers injured on two or more occasions (poly-accidents). The abbreviated Reynolds Intelligence Scale (Rist) was applied as data collection techniques to assess the intelligence coefficient of the subjects and Cattell personality questionnaire (16 Pf), to measured 16 primary factors and four secondary factors. The Neuropsychological Battery of Executive Functions and Frontal Lobes (BANFE) was used to evaluate neuropsychological factors. Results: They were processed using the Statistical Package Social Science (Spss) version 21.0 that allowed the hypothesis test to be carried out for the variables studied, Mann Whitney U test was used, with 0.05 alpha criterion and 95 percent level of confidence. Conclusions: The group of poly-accidented patients showed alterations in the orbito-medial, ventromedial and dorso-lateral areas, which predisposes them to greater possibility of carrying out risky activities and presenting less risk awareness(AU)

Demencia frontotemporal desde una mirada neuropsicológica / Frontotemporal dementia from a neuropsychological point of view

Introducción: La riqueza de las manifestaciones neuropsicológicas de la demencia frontotemporal, ha permitido la identificación de diferentes variantes de la enfermedad, sin embargo, existen pacientes en los que se entrelazan las características clínicas de más de una variante, lo que ha llevado a cuestionar lo relativo de las clasificaciones vigentes. Objetivo: Caracterizar el funcionamiento cognitivo de un paciente donde concomitan alteraciones conductuales y del lenguaje, típicas de la demencia frontotemporal. Caso clínico: Mujer diestra, de 50 años de edad, con cambios conductuales marcados, a los cuales, de forma progresiva, se sumaron alteraciones del lenguaje, en un periodo de evolución de aproximadamente un año y seis meses. Por imágenes de tomografía axial computarizada, se confirma atrofia cortical a predominio frontal. Se emplearon para la evaluación la batería neuropsicológica breve NEUROPSI, la escala Hasegawa y la batería de evaluación frontal de Litvan; se constata predominio de alteraciones en el lenguaje impresivo y expresivo, las funciones ejecutivas y en la memoria verbal. Conclusiones: Las alteraciones detectadas, confirman la coexistencia de manifestaciones de la variante conductual (con tendencia a la desinhibición) y la variante semántica de la demencia frontotemporal(AU)

Introduction: The richness of the neuropsychological manifestations of frontotemporal dementia has allowed the identification of different variants of the disease. However, there are patients in whom the clinical characteristics of more than one variant are intertwined, which has led to question the current classifications. Objective: To characterize the cognitive functioning of a patient with concomitant behavioral and language disorders, typical of frontotemporal dementia. Case presentation: Right-handed female, 50 years old, affected by marked behavioral changes, to which language alterations were progressively added in a period of evolution of approximately one year and six months. Images of Computerized Axial Tomography that confirm cortical atrophy mainly frontal. The Neuropsychological Battery abbreviated NEUROPSI, the Hasegawa Scale and the Litvan Frontal Evaluation Battery were used for the evaluation, with a predominance of alterations in printed and expressive language, executive functions and verbal memory. Conclusions: The alterations detected confirm the coexistence of manifestations of the behavioral variant (with a tendency to disinhibition) and the semantic variant of frontotemporal dementia(AU)

Cognitive Assessment in Patients with Traumatic Brain Injury

Traumatic brain injury (TBI) is a major public health problem inWestern countries. ATBI brings many negative consequences, including behavioral and cognitive changes, which affect social adjustment and the performance of functional activities. Cognitive evaluation after TBI is a complex issue in what pertains to definition of the most appropriate questionnaires for clinical use in a comprehensive analysis of the condition of the patient. In this paper, we described a critical review of the main cognitive assessment tests currently used in clinical and research settings in patients with TBI.

Inattention Symptoms are Predictors of Neuropsychological Functioning in Children from 3rd and 4th Grades.

Symptoms of inattention and hyperactivity/impulsivity, arranged along a continuum, are commonly associated with neuropsychological and academic deficits, even in the general population. The aim of this study is to analyze how Attention Deficit Hyperactivity Disorder (ADHD) symptoms are associated with the performance in neuropsychological and academic abilities (phonological processing, processing speed/automatic attention, executive functions, reading, and spelling) in school-age children. The sample consisted of 216 children from 3rd and 4th grades (M = 8.94 years old, SD =.71) from public elementary schools of two Brazilian capitals. Pearson correlation and Multiple Linear Regression analysis were performed. Inattention symptoms were the only predictors of performance in phonological processing (phoneme suppression and rapid automatized naming of letters), processing speed/automatic attention, executive functions, such as inhibitory control and cognitive flexibility, and reading fluency. Beta values ranged from .14 to .27, and the largest value was related to an inhibitory control task. Inattention, and not hyperactivity/impulsivity symptoms, seems to affect neuropsychological functions even in non-clinical diagnosed children. Contributions and future directions are discussed.

Two Case Reports of Neuropsychological Functioning in Congenital Insensitivity to Pain with Anhidrosis (CIPA).

Individuals with congenital insensitivity to pain with anhidrosis (CIPA) are reported to have intellectual disability but to our knowledge, no detailed study about neuropsychological functioning of this condition has ever been published. The present study assessed neuropsychological outcomes of two children with CIPA using standardized neuropsychological tests. The neuropsychological assessment revealed difficulties in a wide range of cognitive, executive, and integrative functions, such as a behavioral and adaptive level. Both children with CIPA functioned in the intellectual disability range with symptoms related to an executive dysfunction and negative-oriented personal emotional processing, and limitations in academic and self-care skills.

Neurocognitive Impairment in Bipolar Disorder and Associated Factors: Using Population-based Norms and a Strict Criterion for Impairment Definition.

BACKGROUND: Cognitive impairment is often identified in individuals with bipolar disorder and is associated with their functional impairment. However, there is controversy surrounding potential classification methods for impairment in cognitive measures. OBJECTIVE: To examine the proportion of cognitive measures indicating impairment of attention, processing speed, memory, visuoconstructional abilities, and executive functions in individuals with bipolar disorder type I (euthymic) and healthy controls, using a strict criterion for defining impairment. METHODS: We gave 43 individuals with bipolar disorder type I and 17 healthy controls a comprehensive clinical and neuropsychological assessment. All scores were standardized using means and standard deviations according to age. Impaired performance in all cognitive measures was determined using a distribution-based threshold of z=±1645. The effects of the sociodemographic and clinical variables on cognitive performance were examined using multiple stepwise backward regression analyses. RESULTS: Clinically significant cognitive impairment was observed more frequently in the bipolar disorder group, compared to controls, on all measures. From participant factors, we found that level of education and number of manic episodes predicted variation in more cognitive measure scores. DISCUSSION: The use of population-based norms to standardize cognitive measures, and a strict criterion to define cognitive impairment, in individuals with bipolar disorder type 1 and healthy controls resulted in a prevalence of impairment in cognitive domains' frequencies of deficits that fell within the ranges previously reported in meta-analyses. CONCLUSIONS: Clinically introducing population norms and a stringent cognitive impairment criterion can facilitate more accurate measures of cognitive impairment in individuals with bipolar disorder.

Normative data for test of learning and memory in an ecuadorian adult population.

OBJECTIVE: The objective of this study was to develop norms for two neuropsychological tests of learning and memory in an Ecuadorian adult population. METHOD: 322 healthy individuals, ages between 18 and 84, were enrolled in the Metropolitan District of Quito. Participants were administered a comprehensive neuropsychological evaluation that included tests of learning and memory (Rey-Osterrieth Complex Figure Test [ROCF] and Hopkins Verbal Learning Test-Revised [HVLT-R]). Backward stepwise multiple linear regression analyses were used to examine the influence of demographic variables age, education, and gender on test performance. Normative data were developed adjusting for demographic variables found to be significant in the final regression models. RESULTS: The final multiple linear models revealed performance on tests of learning and memory worsened with age and improved as a function of education. A user-friendly Excel-based calculator is presented to calculate the z score and percentile automatically based on raw score and sociodemographic information. CONCLUSION: This is the first study that presents normative data for tests of learning and memory for an adult population in Ecuador. It is expected that these norms will help to improve the clinical practice of neuropsychology in Ecuador by limiting erroneous raw score interpretation and incrementing diagnostic accuracy.

Brazilian version of the European Cross-Cultural Neuropsychological Test Battery (CNTB-BR): diagnostic accuracy across schooling levels

Objective: To translate, establish the diagnostic accuracy, and standardize the Brazilian Portuguese version of the European Cross-Cultural Neuropsychological Test Battery (CNTB) considering schooling level. Methods: We first completed an English-Brazilian Portuguese translation and back-translation of the CNTB. A total of 135 subjects aged over 60 years - 65 cognitively healthy (mean 72.83, SD = 7.71; mean education 9.42, SD = 7.69; illiterate = 25.8%) and 70 with Alzheimer's disease (AD) (mean 78.87, SD = 7.09; mean education 7.62, SD = 5.13; illiterate = 10%) - completed an interview and were screened for depression. The receiver operating characteristic (ROC) analysis was used to verify the accuracy of each CNTB test to separate AD from healthy controls in participants with low levels of education (≤ 4 years of schooling) and high levels of education (≥ 8 years of schooling). The optimal cutoff score was determined for each test. Results: The Recall of Pictures Test (RPT)-delayed recall and the Enhanced Cued Recall (ECR) had the highest power to separate AD from controls. The tests with the least impact from schooling were the Rowland Universal Dementia Assessment Scale (RUDAS), supermarket fluency, RPT naming, delayed recall and recognition, and ECR. Conclusions: The Brazilian Portuguese version of the CNTB was well comprehended by the participants. The cognitive tests that best discriminated patients with AD from controls in lower and higher schooling participants were RPT delayed recall and ECR, both of which evaluate memory.

Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in a Colombian Population.

BACKGROUND: Cognitive impairment has been recognized as an important factor in multiple sclerosis (MS) in the past few years. One brief, reliable and valid tool to assess cognition in MS is the BICAMS, which encompasses the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test (CVLT II), and the Brief Visuospatial Memory Test - Revised (BVMT-R). Continuing with the international initiative to validate the BICAMS in different countries, here we present the results obtained from the efforts in validating such test in the Colombian population. METHOD: 100 healthy controls and 50 MS patients participated in the study, group matched for age, education and gender. Subjects completed all three tests of the BICAMS. Instead of the CVLT-II, the Colombian validated form PAMCL (Prueba de Aprendizaje y Memoria con Codificación Libre) was used. Test-retest measures were obtained for 16 patients in order to test for reliability. RESULTS: Evidence of criterion validity was obtained, MS group performing significantly worse than HC group in all three tests (SDMT: p= .001, d= 0.59; PAMCL: p= .03, d= 0.38; BVMT-R: p<.001, d= 0.58). Test-retest was also obtained, finding significant correlations for all three tests (SDMT: r=0.932, p<.00; BVMT-R: r=0.863, p<.001; PAMCL: r=0.889, p<.001). Standardization of raw scores to uncontrolled scaled scores was done and these scores were then adjusted for age and years of schooling using a multiple linear regression. CONCLUSIONS: The BICAMS proved to be a valid and sensitive tool to screen for cognitive impairment in MS patients.

Construct validity of the Motor Development Scale (MDS).

OBJECTIVE: Construct validity for the Motor Development Scale (MDS) has not been established. The aim of this study was to examine whether the unidimensional model of MDS would be appropriate for children aged 4 to 6 years-old and provide construct validity for the items concerning this age group in Brazil. METHODS: A total of 938 children participated in the study (214 4-year-olds, 643 5-year-olds, and 81 6-year-olds). Confirmatory factor analysis (CFA) was used to evaluate construct validity of the MDS using a unidimensional model. RESULTS: The CFA for the unidimensional model showed excellent adequacy indices for age 4: χ2(2) = 0.581, p = 0.748, comparative fit index (CFI) = 1.000, Tucker-Lewis index (TLI) = 1.090, root mean square error of approximation (RMSEA) = 0.000 (90% confidence interval [90%CI] = 0.000 to 0.093, close fit [Cfit] = 0.841); age 5: χ2(2) = 2.669, p = 0.263, CFI = 0.993, TLI = 0.980, RMSEA = 0.023 (90%CI = 0.000 to 0.085, Cfit = 0.682), weighted root mean square residual (WRMR) = 0.407; and age 6: χ2(9) = 8.275, p = 0.506, CFI = 1.000, TLI = 1.010, RMSEA = 0.000 (90%CI = 0.000 to 0.118, Cfit = 0.653), WRMR = 0.495. Reliability was good: ω = 0.87 (95%CI = 0.81 to 0.92). CONCLUSION: The proposed unidimensional solution for the MDS provides a concise, parsimonious and reliable way to assess motor development in children aged 4 to 6 years.

Psychometric Properties of the Patient Assessment of Own Functioning Inventory Following Aneurysmal Subarachnoid Hemorrhage.

BACKGROUND AND PURPOSE: The purpose of this study was to examine the psychometric properties of the Patient Assessment of Own Functioning Inventory (PAOFI) following aneurysmal subarachnoid hemorrhage (aSAH). METHODS: The PAOFI was completed by 182 participants 3 months after verified aSAH. Exploratory factor analysis was used to evaluate the underlying factor structure of the PAOFI and reliability and concurrent validity were evaluated for each subscale. RESULTS: A three-factor structure accounted for 58.9% of the extracted variance. Cronbach's alpha coefficients for extracted factors ranged from .867 to .924. The PAOFI subscales demonstrated concurrent validity with neuropsychological tests measuring similar constructs. CONCLUSION: There is evidence of reliability and validity of the PAOFI following aSAH. Further studies are needed to confirm these results.

Brazilian version of the European Cross-Cultural Neuropsychological Test Battery (CNTB-BR): diagnostic accuracy across schooling levels.

OBJECTIVE: To translate, establish the diagnostic accuracy, and standardize the Brazilian Portuguese version of the European Cross-Cultural Neuropsychological Test Battery (CNTB) considering schooling level. METHODS: We first completed an English-Brazilian Portuguese translation and back-translation of the CNTB. A total of 135 subjects aged over 60 years - 65 cognitively healthy (mean 72.83, SD = 7.71; mean education 9.42, SD = 7.69; illiterate = 25.8%) and 70 with Alzheimer's disease (AD) (mean 78.87, SD = 7.09; mean education 7.62, SD = 5.13; illiterate = 10%) - completed an interview and were screened for depression. The receiver operating characteristic (ROC) analysis was used to verify the accuracy of each CNTB test to separate AD from healthy controls in participants with low levels of education (≤ 4 years of schooling) and high levels of education (≥ 8 years of schooling). The optimal cutoff score was determined for each test. RESULTS: The Recall of Pictures Test (RPT)-delayed recall and the Enhanced Cued Recall (ECR) had the highest power to separate AD from controls. The tests with the least impact from schooling were the Rowland Universal Dementia Assessment Scale (RUDAS), supermarket fluency, RPT naming, delayed recall and recognition, and ECR. CONCLUSIONS: The Brazilian Portuguese version of the CNTB was well comprehended by the participants. The cognitive tests that best discriminated patients with AD from controls in lower and higher schooling participants were RPT delayed recall and ECR, both of which evaluate memory.

Symbol Digit Modalities Test-Oral Version: An Analysis of Culture Influence on a Processing Speed Test in Argentina, Mexico, and the USA.

The Symbol Digit Modalities Test (SDMT) is an information processing speed test. The aim of this study was to compare the SDMT across three samples: the USA, Mexico, and Argentina. The hypothesis is that performance will vary based on native language and cultural differences between these countries. The SDMT was administered to 129 healthy volunteers. Participants from the USA performed better than participants from Argentina and Mexico (p < .01), and no differences were observed between the latter groups (p = .15). Processing speed differs between the studied populations of Latin America and Anglo-America. Possible interpretations of this result are presented.

Riesgos prenatales, perinatales y neonatales asociados a signos neurológicos blandos / Prenatal, perinatal and neonatal risks associated with soft neurological signs

Introducción: Los signos neurológicos blandos se han asociado con dificultades motoras, alteraciones comportamentales menores e incluso como factores de vulnerabilidad para la aparición de afecciones como, esquizofrenia, trastorno de déficit de atención e hiperactividad, trastorno disocial y episodios psicóticos. Aunque la investigación sobre los signos ha venido aumentando, no se tiene claridad sobre qué puede predisponer su aparición. Objetivo: Describir la asociación entre factores de riesgo prenatales, perinatales y neonatales y la aparición de los signos neurológicos blandos en niños con estos factores riesgo y en niños sin ellos. Métodos: Estudio de tipo descriptivo comparativo, de corte transversal, con diseño no experimental. La población en estudio se conformó por 550 niños y niñas, con edades entre seis y ocho años organizados. en cuatro grupos: los que presentaban riesgos prenatales, perinatales, neonatales, y el grupo que no presentaba ningún riesgo. Las aplicaciones se llevaron a cabo durante el primer semestre de 2017. Los datos se tomaron de las historias clínicas y los. signos neurológicos blandos se evaluaron a través del apartado de la Evaluación Neuropsicológica Infantil. Resultados: La mayoría de los signos neurológicos blandos presentaron diferencias significativas y valores altos en la comparación de los rendimientos en cada uno de los grupos con riesgo. Conclusiones: la presencia de riesgos prenatales, perinatales y neonatales producen una serie de alteraciones en el desarrollo del niño que se van acumulando y pueden estar asociados con la aparición de los signos neurológicos blandos(AU)

Introduction: The soft neurological signs have been associated with motor difficulties, lower behavioural alterations and even with vulnerability factors for the appearance of conditions such as schizophrenia, attention deficit disorder and hyperactivity, disocial disorder and psychotic episodes. Although research on the signs has been increasing, it is not clear what may predispose their appearance. Objective: To describe the association between prenatal, perinatal and neonatal risk factors and the appearance of the soft neurological signs in children with these risk factors and in children without them. Methods: Descriptive, comparative, cross-sectional non-experimental design´s study. The study´s population was formed by 550 boys and girls between the ages of six and eight years organized in four groups: with prenatal risks, with perinatal risks, with neonatal risks, and the group that did not present any risks. The tests were carried out during the first semester of 2017. The data were taken from the medical records and the soft neurological signs were evaluated through the item called Neuropsychological Assessment of Children. Results: Most of the soft neurological signs showed significant differences and high values in the performance comparison in each of the groups with risks. Conclusions: The presence of prenatal, perinatal and neonatal risks produce a series of alterations in the development of the child that are accumulated and may be associated with the appearance of the soft neurological signs(AU)

Construct validity of the Motor Development Scale (MDS)

Abstract Objective Construct validity for the Motor Development Scale (MDS) has not been established. The aim of this study was to examine whether the unidimensional model of MDS would be appropriate for children aged 4 to 6 years-old and provide construct validity for the items concerning this age group in Brazil. Methods A total of 938 children participated in the study (214 4-year-olds, 643 5-year-olds, and 81 6-year-olds). Confirmatory factor analysis (CFA) was used to evaluate construct validity of the MDS using a unidimensional model. Results The CFA for the unidimensional model showed excellent adequacy indices for age 4: χ2(2) = 0.581, p = 0.748, comparative fit index (CFI) = 1.000, Tucker-Lewis index (TLI) = 1.090, root mean square error of approximation (RMSEA) = 0.000 (90% confidence interval [90%CI] = 0.000 to 0.093, close fit [Cfit] = 0.841); age 5: χ2(2) = 2.669, p = 0.263, CFI = 0.993, TLI = 0.980, RMSEA = 0.023 (90%CI = 0.000 to 0.085, Cfit = 0.682), weighted root mean square residual (WRMR) = 0.407; and age 6: χ2(9) = 8.275, p = 0.506, CFI = 1.000, TLI = 1.010, RMSEA = 0.000 (90%CI = 0.000 to 0.118, Cfit = 0.653), WRMR = 0.495. Reliability was good: ω = 0.87 (95%CI = 0.81 to 0.92). Conclusion The proposed unidimensional solution for the MDS provides a concise, parsimonious and reliable way to assess motor development in children aged 4 to 6 years.

A meta-analysis on verbal working memory in children and adolescents with ADHD.

Objective: Previous meta-analyses have demonstrated verbal working memory (WM) dysfunction in children and adolescents with attention deficit/hyperactivity disorder (ADHD); however, the findings are inconsistent. The main objective of this meta-analysis was to investigate the performance of children and adolescents with ADHD in the Digit Span Backwards (DSB) subtest from the Wechsler Intelligence Scale for Children or Wechsler Adult Intelligence Scale. We also sought to provide an updated meta-analysis on WM in children and adolescents with ADHD.Method: PubMed, PsyINFO, Scopus, and Web of Science were searched to locate studies published between 1990 and 2016 that report DSB scores both of children and adolescents with ADHD and matched controls. Potential moderator variables were also analyzed.Results: Forty-nine studies comparing children and adolescents with ADHD (n = 4956) against healthy controls (n = 3249) generated a medium-sized effect (Hedges' g) of 0.56 (95% CI [0.49, 0.64]), indicating poorer verbal WM performance in those with ADHD. A subgroup meta-analysis of studies with participants aged 8-16 years only demonstrated low heterogeneity (I2 = 17.06, cf. 55.50 for the main analysis). Moreover, the meta-regression showed a negative association (ß = -.05, p = .02) between DSB performance differences and increasing age, indicating that for every one year increase in age the effect size decreased by .05.Conclusion: These results, which emanated from the largest meta-analysis concerning verbal WM in ADHD reported to date, reinforce WM as a key domain of cognitive dysfunction in ADHD, and point to age as the main variable influencing DSB performance difficulties.