Executive and attentional functions in patients with migraine / Funções executivas e atencionais em pacientes com enxaqueca

INTRODUCTION: Migraine is a disease that affects the overall performance of the patient, especially attention and executive functions (EF), with a direct impact on the person's functionality, highlighting the importance of studies in order to minimize its damage. OBJECTIVE: The objective of this study was to evaluate if there is a link between migraine and executive and attentional functions. METHODOLOGY: Observational study (44 subjects; 29 migraineurs and 15 non-migraineurs) on attentional and executive functioning changes in migraine. Subjects over 18 years of age were included in the study, regardless of gender, recruited for convenience at CAM FAME, FAME and Centro AMA, primary recruitment centers, following the criteria of the International Classification of Headache Disorders (ICHD-3). The participants underwent neuropsychological tests that estimated executive and attentional functioning. For attention, the Psychological Attention the Assessment Battery (AAB) was used, and for EF, the Five-Digit Test (FDT) was used. Student's t test, ANOVA, Mann-Whitney and/or Kruskal-Wallis U test were used, whose analyzes fixed the type I error at 0.05. RESULTS: All AAB subtests pointed to a reduction in the attentional potential in migraineurs when compared to the control group. The FDT showed lowering in the migraineurs group subjects, when compared with the non- migraineurs group. Multivariate analysis identified a relationship between EF, Attention and migraine (p<0.05). CONCLUSION: migraineurs present a decrease in executive functioning and attentional skills and an increase in execution time when compared to non-migraineurs individuals

INTRODUÇÃO: A enxaqueca é uma doença que afeta o desempenho global do paciente, principalmente a atenção e as funções executivas (FE), com impacto direto na funcionalidade da pessoa, destacando a importância de estudos a fim de minimizar seus danos. OBJETIVO: O objetivo deste estudo foi avaliar se existe ligação entre enxaqueca e funções executivas e atencionais. METODOLOGIA: Estudo observacional (44 indivíduos; 29 com enxaqueca e 15 sem enxaqueca) sobre alterações de atenção e funcionamento executivo na enxaqueca. Foram incluídos no estudo indivíduos maiores de 18 anos, independente do sexo, recrutados por conveniência no CAM FAME, FAME e Centro AMA, centros primários de recrutamento, seguindo os critérios da Classificação Internacional de Cefaleias (ICHD-3). Os participantes foram submetidos a testes neuropsicológicos que estimaram o funcionamento executivo e atencional. Para atenção foi utilizada a Bateria de Avaliação da Atenção Psicológica (AAB) e para FE foi utilizado o Teste de Cinco Dígitos (FDT). Foram utilizados teste t de Student, ANOVA, Mann-Whitney e/ou teste U de Kruskal-Wallis, cujas análises fixaram o erro tipo I em 0,05. RESULTADOS: Todos os subtestes da AAB apontaram redução do potencial atencional em enxaquecosos quando comparados ao grupo controle. O FDT apresentou redução nos indivíduos do grupo com enxaqueca, quando comparado com o grupo sem enxaqueca. A análise multivariada identificou relação entre FE, Atenção e enxaqueca (p<0,05). CONCLUSÃO: enxaquecosos apresentam diminuição do funcionamento executivo e das habilidades de atenção e aumento no tempo de execução quando comparados a indivíduos não enxaquecosos

Perfil neurocognitivo asociado al trastorno límite de personalidad: creación de índices específicos de función ejecutiva / Neurocognitive profile associated with borderline personality disorder: building specific indices of executive function

Introducción. El objetivo de este trabajo es la creación de índices específicos de las distintas funciones ejecutivas (FE), que permitan comprender de forma más completa y no mediante pruebas aisladas el rendimiento ejecutivo asociado al trastorno límite de la personalidad (TLP). Metodología. 118 pacientes con TLP y 81 controles fueron evaluados con una batería neuropsicológica. Se crearon tres índices de atención, memoria y FE. Las pruebas que forman el índice ejecutivo se agruparon en cuatro índices ejecutivos diferentes: flexibilidad cognitiva, planificación, memoria de trabajo e inhibición de respuesta. Las puntuaciones para cada dominio se obtuvieron a través de las puntuaciones estandarizadas de las pruebas que los componían. Resultados. Los resultados mostraron diferencias significativas en los índices de memoria, atención y FE, así como en los diferentes índices ejecutivos de flexibilidad cognitiva, planificación, memoria de trabajo e inhibición de respuesta, entre los pacientes con TLP y los controles. Conclusiones. Este estudio ha permitido la creación de cuatro índices ejecutivos, siendo el primero hasta la fecha en hacerlo. Estos resultados establecen un perfil neurocognitivo del TLP caracterizado por un deterioro ejecutivo específico de la flexibilidad cognitiva, la planificación, la memoria de trabajo y la inhibición de la respuesta. Estos hallazgos avalan que los pacientes con TLP podrían beneficiarse de la aplicación de programas neuropsicológicos, especialmente enfocados en mejorar determinadas FE, y sientan las bases para la investigación de la relación entre estos déficits ejecutivos específicos y ciertas características clínicas del TLP, como diferentes tipos de comportamiento impulsivo y diferentes errores de mentalización. (AU)

Introduction. The objective of this work is the creation of specific indices of the different executive functions (EF), which allow a more complete understanding of the executive performance associated with borderline personality disorder (BPD) and not through isolated tests. Methodology. 118 patients with BPD and 81 controls were evaluated with a neuropsychological battery. Three indices of attention, memory and FE were created. The tests that make up the executive domain were grouped into four different executive indices: cognitive flexibility, planning, working memory, and response inhibition. The batteries for each domain were compared through the standardized batteries of the tests that comprised them. Results. The results showed differences in the memory, attention, and EF indices, as well as in the different executive indices of cognitive flexibility, planning, working memory, and response inhibition, between BPD patients and controls. Conclusions. This study has allowed the creation of four executive indexes, being the first to do so. These results established a neurocognitive profile of BPD characterized by executive-specific impairment of cognitive flexibility, planning, working memory, and response inhibition. These findings support that patients with BPD will benefit from the application of neuropsychological programs, especially focused on improving a certain EF, and lay the foundations for the investigation of the relationship between these specific executive deficits and certain clinical characteristics of BPD, such as different types of Impulsive behavior and different mentalization errors. (AU)

Development of the dog executive function scale (DEFS) for adult dogs.

Executive functions (EFs) are cognitive processes that are used to effortfully self-regulate behaviour and might be important for dogs' success in working and pet roles. Currently, studies are assessing dogs' EF skills through often laborious cognitive measures, leading to small sample sizes and lacking measures of reliability. A complementary method is needed. The aim of this study was to develop a dog executive function scale (DEFS) for adult dogs. Focus groups were held with people working with dogs professionally to refine a pool of items describing dog behaviours related to EF. A survey was distributed online to a convenience sample of N = 714 owners of adult dogs. Exploratory and confirmatory factor analysis identified six distinguishable factors named behavioural flexibility, motor inhibition, attention towards owner, instruction following, delay inhibition and working memory. These factors appear similar to factors identified in human EF scales. Working dogs exhibit higher EF scores on the DEFS than non-working dogs. Dogs sourced from breeders exhibited higher DEFS scores than dogs sourced from shelters, and the amount of training received positively correlated with dogs' DEFS scores. The DEFS requires further validation with cognitive measures. The DEFS could then be used by researchers to complement assessment of dogs' EF skills through cognitive measures or assess dogs' EF skills in large samples.

Executive functions form a single construct and are associated with schooling: Evidence from three low- and middle- income countries.

Measuring executive function (EF) among adults is important, as the cognitive processes involved in EF are critical to academic achievement, job success and mental health. Current evidence on measurement and structure of EF largely come from Western, Educated, Industrialized, Rich and Democratic (WEIRD) countries. However, measuring EF in low-and-middle-income countries (LMICs) is challenging, because of the dearth of EF measures validated across LMICs, particularly measures that do not require extensive training, expensive equipment, or professional administration. This paper uses data from three LMIC cohorts to test the feasibility, validity and reliability of EF assessment in adults using three sub-tests (representing key components of EF) of the NIH Toolbox Cognitive battery. For each cohort, all three EF measures (inhibition, flexibility and working memory) loaded well onto a unidimensional latent factor of EF. Factor scores related well to measures of fluid intelligence, processing speed and schooling. All measures showed good test-retest reliability across countries. This study provides evidence for a set of sound measures of EF that could be used across different cultural, language and socio-economic backgrounds in future LMIC research. Furthermore, our findings extend conclusions on the structure of EF beyond those drawn from WEIRD countries.

EF Train: development of an executive function training program for preschool and school-aged children with ADHD

Executive functions are involved in the manifestation of ADHD symptoms. These functions have been proven to predict academic achievement and performance promoting school readiness and social functioning, thus training programs are essential. The current study focused on the development of an executive function training program "EF Train" and assessed its effect on the enhancement of three core executive functions, i.e. working memory, inhibitory control and sustained attention. A group of 52 children with ADHD ranging from 4 to 7 years of age were assigned to either a training group who performed 20 sessions of the executive function training program or a control group that received no training. The assessment of executive function improvement was carried out before, immediately after and three months after the completion of the "EF Train". Data analysis revealed that the training program led to significant improvements of the core executive functions, as well as diminished ADHD symptoms. The findings indicate that executive function programs may assist on the attenuation of ADHD symptomatology providing additional non-invasive approaches for executive function improvement

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Data-driven identification of subtypes of executive function across typical development, attention deficit hyperactivity disorder, and autism spectrum disorders.

BACKGROUND: Impairment of executive function (EF), the goal-directed regulation of thoughts, actions, and emotions, drives negative outcomes and is common across neurodevelopmental disorders including attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). A primary challenge to its amelioration is heterogeneity in symptom expression within and across disorders. Parsing this heterogeneity is necessary to attain diagnostic precision, a goal of the NIMH Research Domain Criteria Initiative. We aimed to identify transdiagnostic subtypes of EF that span the normal to impaired spectrum and establish their predictive and neurobiological validity. METHODS: Community detection was applied to clinical parent-report measures in 8-14-year-old children with and without ADHD and ASD from two independent cohorts (discovery N = 320; replication N = 692) to identify subgroups with distinct behavioral profiles. Support vector machine (SVM) classification was used to predict subgroup membership of unseen cases. Preliminary neurobiological validation was obtained with existing functional magnetic resonance imaging (fMRI) data on a subsample (N = 84) by testing hypotheses about sensitivity of EF subgroups versus DSM categories. RESULTS: We observed three transdiagnostic EF subtypes characterized by behavioral profiles that were defined by relative weakness in: (a) flexibility and emotion regulation; (b) inhibition; and (c) working memory, organization, and planning. The same tripartite structure was also present in the typically developing children. SVM trained on the discovery sample and tested on the replication sample classified subgroup membership with 77.0% accuracy. Split-half SVM classification on the combined sample (N = 1,012) yielded 88.9% accuracy (this SVM is available for public use). As hypothesized, frontal-parietal engagement was better distinguished by EF subtype than DSM diagnosis and the subgroup characterized with inflexibility failed to modulate right IPL activation in response to increased executive demands. CONCLUSIONS: The observed transdiagnostic subtypes refine current diagnostic nosology and augment clinical decision-making for personalizing treatment of executive dysfunction in children.

Functioning of cognitive memory inhibition processesin people with Down syndrome: an empirical study

Cognitive inhibition is part of executive functions. When it exercises control over memory processes, it has the function of regulating the accessibility of memories and allows interference to be resolved. The impairment of its functioning has been related to the presence of forgetfulness of relevant information. In this research, we study the functioning of cognitive memory inhibition processes in people with intellectual disabilities in tasks of delayed visual recognition and analyze the influence of age. For this purpose, 36 people with Down syndrome (mean age = 33.44, standard deviation = 7.54, 50% females) and 36 people with neurotypical development (mean age = 33.55, standard deviation = 7.52, 50% females) participated. The results reflected a lower effectiveness in the group of people with Down syndrome, F(1, 68) = 159.09, p < .001, = .70. The people in the group with Down syndrome had difficulties in interference resolution, both in the subgroup of young people (p = .014, = 0.88) and in the subgroup of older people (p = .022, = 0.67). The impairment of cognitive inhibition in people with Down syndrome warrants the need to develop specific intervention programs for this process

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Cognitive stimulations effects and Taigeiko in elderly women's cognition: an intervention.

OBJECTIVE: To evaluate the effectiveness of an intervention through cognitive stimulation associated with Taigeiko practice in memory performance and executive function of elderly women, compared to a group exposed to Taigeiko alone. METHOD: A quasi-experimental study was performed with 16 elderly women. 10 were allocated to the experimental group (EG) submitted to 16 sessions of cognitive stimulation and Taigeiko, and 6 elderly women in the control group (CG) submitted to Taigeiko alone. Cognition was assessed before and after intervention by the tests: Rey Auditory-Verbal Learning (RAVLT); Rey-Osterrieth Complex Figure Test; Trail-Making Test; Stroop Effect; Digit Span Test and Semantic Verbal Fluency Test. RESULTS: Both groups presented differences in RAVLT domains (EG p=0.004, CG p=0.005) and Stroop Effect (EG p=0.012; CG p=0.024). However, in EG, better scores were shown in the tests, although not statistically significant. CONCLUSION: Taigeiko has been shown to be a potential activity in obtaining cognitive gains, independently of the associated cognitive stimulation.

The bilingualism wars: Is the bilingual advantage out of (executive) control? / ¿Está el desacuerdo sobre la ventaja bilingüe fuera de control (ejecutivo)?

Whether bilingualism has an effect on the executive function of non-verbal representations is probably one of the most controversial issues in cognitive psychology and cognitive neuroscience. As bilinguals have to alternate between two languages that compete for selection in their daily lives, they make use of selection, inhibition, and monitoring (i.e., components of executive function) more often than monolinguals. Thus, it would not be surprising that these highly trained abilities at selecting and monitoring the linguistic processes would also help the processing of non-linguistic representations. Although the "bilingual advantage" in executive control (Bialystok, 1999) has been repeatedly demonstrated, a number of recent studies-in particular since the publication of the Paap and Greenberg (2013) study-have questioned this effect. Both positive and null findings are currently being published from each of the two sides, thus making it difficult to reach consensus in the scientific community. Here, we propose a plausible solution to this debate: a group of independent researches should carry out a carefully planned large-scale study

Uno de los temas actuales más controvertidos en psicología cognitiva y neurociencia cognitiva es si el bilingüismo tiene un efecto sobre el control ejecutivo de las representaciones no verbales. En su vida diaria, los bilingües tienen que alternar entre dos (o más) idiomas que compiten por su selección, por lo que han de seleccionar, monitorizar e inhibir (es decir, emplear componentes de la función ejecutiva) con más frecuencia que los monolingües. Por lo tanto, no sería sorprendente que estas habilidades empleadas para seleccionar/monitorear los procesos lingüísticos en bilingües también ayudaran al procesamiento de representaciones no lingüísticas. Aunque la "ventaja bilingüe" en control ejecutivo (Bialystok, 1999) se ha demostrado repetidamente, varios estudios recientes, especialmente desde la publicación del estudio de Paap y Greenberg (2013), han cuestionado este efecto. En la actualidad, tanto resultados positivos como resultados nulos se están publicando por cada una de ambas partes, lo que dificulta el consenso en la comunidad científica. Proponemos una solución plausible a este debate: que un grupo de investigadores independientes lleve a cabo un estudio cuidadosamente planificado a gran escala

Motor differentiation's and cognitive skill in pre-scholar age / Diferenciación motora y habilidades cognitivas en la edad preescolar / Diferenciação motora e habilidade cognitiva na idade pré-escolar

Little research has been produced about literacy readiness in Kindergarten children at risk for Developmental Coordination Disorder (DCD), despite this age being one of the most important epoch of motor and cognitive development. In this study we compared pre-literacy skills in Kindergarten children at risk for Developmental Coordination Disorder (DCD) with Typically Developing (TD) children. Participants were 26 Italian children, who had a mean age of 5.1 years, 13 at risk for DCD and 13 TD attending kindergarten schools. Pre-literacy abilities were measured trough tasks derived by the Italian PRCR-2 battery: Semi-circles (A and B), Letter identification and Object Naming Time. Children at risk for DCD showed worse performance on all these pre-literacy assessments compared to TD children. Significant differences were found between children at risk for DCD and TD children on tasks of visual memory of printed signs, visual analysis ability, visual discrimination and attention and sequentiality of eye movements. Findings suggest the need to implement pre-school cognitively challenging motor activities programs to enhance manual dexterity, aiming and catching skills as well as static and dynamic balance at early age

Existe escasa literatura científica sobre la preparación para la alfabetización en niños de Educación Infantil con riesgo de Trastorno o Desorden del Desarrollo de la Coordinación (DCD), a pesar de que esta edad es una de las etapas más importantes para el desarrollo motor y cognitivo. En este estudio, comparamos las habilidades de pre- alfabetización entre niños de infantil con riesgo de DCD y niños con desarrollo típico (TD). La muestra estuvo formada por 26 niños italianos, con una edad media de 5,1 años, de los cuales, 13 con riesgo de DCD y 13 TD que asistían a diferentes escuelas de Educación Infantil. Las habilidades de pre-alfabetización se midieron a través de diversas tareas derivadas de la batería italiana PRCR-2: semicírculos (A y B), identificación de letras y tiempo de nomenclatura de objetos. Los niños en riesgo de DCD mostraron un peor desempeño en todas estas evaluaciones de pre-alfabetización en comparación con los niños con TD. Se encontraron diferencias significativas en tareas de memoria visual de signos impresos, capacidad de análisis visual, discriminación visual y atención y secuencialidad de los movimientos oculares entre los niños con riesgo de DCD y TD. Los hallazgos sugieren la necesidad de implementar programas de actividades motoras cognitivamente desafiantes adaptadas a estas edades con el fin de mejorar la destreza manual, las habilidades de apuntar y atrapar, así como el equilibrio estático y dinámico a estas edades tempranas

Poucas pesquisas foram produzidas sobre a prontidão para a alfabetização em crianças do jardim de infância sob risco de Transtorno do Desenvolvimento da Coordenação (TDC), apesar de essa idade ser uma das mais importantes do desenvolvimento motor e cognitivo. Neste estudo, comparamos as habilidades de pré-alfabetização em crianças do Jardim de Infância com risco de Desordem de Coordenação do Desenvolvimento (DCD) com crianças com Desenvolvimento Típico (DT). Os participantes foram 26 crianças italianas, que tinham uma idade média de 5,1 anos, 13 em risco de DCD e 13 TD frequentando escolas de jardim de infância. As habilidades de pré- alfabetização foram medidas através de tarefas derivadas da bateria italiana do PRCR-2: Semi-círculos (A e B), identificação de letras e tempo de nomeação de objetos. Crianças em risco de DCD apresentaram pior desempenho em todas essas avaliações de pré-alfabetização em comparação com crianças com DT. Diferenças significativas foram encontradas entre crianças com risco de DCD e TD em tarefas de memória visual de sinais impressos, habilidade de análise visual, discriminação visual e atenção e sequencialidade dos movimentos oculares. Os resultados sugerem a necessidade de implementar programas de atividades motoras cognitivamente desafiadoras da pré-escola para melhorar a destreza manual, apontar e captar habilidades, bem como equilíbrio estático e dinâmico na idade precoce

Cognitive stimulations effects and Taigeiko in elderly women's cognition: an intervention / Los efectos de estímulos cognitivos y Taigeiko en la cognición de idosas: una intervención / Efeitos de estímulos cognitivos e Taigeiko na cognição de idosas: uma intervenção

ABSTRACT Objective: To evaluate the effectiveness of an intervention through cognitive stimulation associated with Taigeiko practice in memory performance and executive function of elderly women, compared to a group exposed to Taigeiko alone. Method: A quasi-experimental study was performed with 16 elderly women. 10 were allocated to the experimental group (EG) submitted to 16 sessions of cognitive stimulation and Taigeiko, and 6 elderly women in the control group (CG) submitted to Taigeiko alone. Cognition was assessed before and after intervention by the tests: Rey Auditory-Verbal Learning (RAVLT); Rey-Osterrieth Complex Figure Test; Trail-Making Test; Stroop Effect; Digit Span Test and Semantic Verbal Fluency Test. Results: Both groups presented differences in RAVLT domains (EG p=0.004, CG p=0.005) and Stroop Effect (EG p=0.012; CG p=0.024). However, in EG, better scores were shown in the tests, although not statistically significant. Conclusion: Taigeiko has been shown to be a potential activity in obtaining cognitive gains, independently of the associated cognitive stimulation.

RESUMEN Objetivo: Evaluar la efectividad de una intervención por medio de estímulos cognitivos asociados a la práctica de Taigeiko en el desempeño de la memoria y función ejecutiva de ancianas, comparado a un grupo expuesto al Taigeiko aisladamente. Método: Estudio casi experimental con 16 ancianas, siendo 10 asignadas en el grupo experimental (GE) y sometidas a 16 sesiones de estimulación cognitiva y Taigeiko; y 6 ancianas en el grupo control (GC), sometidas al Taigeiko aisladamente. La cognición fue evaluada antes y después de la intervención por medio de las pruebas: Aprendizaje Aditivo-Verbal de Rey (RAVLT); Figuras Complejas de Rey; Rutas; Efecto Stroop; Span de Dígitos y Fluidez Verbal Semántica. Resultados: Los dos grupos presentaron diferencias en los dominios del RAVLT (GE p=0,004; GC p=0,005) y en el Efecto Stroop (GE p=0,012; GC p=0,024). Sin embargo, en el GE se evidenciaron mejores puntuaciones en las pruebas, aunque sin significancia estadística. Conclusión: El Taigeiko demostró ser una potencial actividad en la obtención de ganados cognitivos, independientemente de la estimulación cognitiva asociada.

RESUMO Objetivo: Avaliar a efetividade de uma intervenção por meio de estímulos cognitivos associados à prática de Taigeiko no desempenho da memória e função executiva de idosas, comparado a um grupo exposto ao Taigeiko isoladamente. Método: Estudo quase-experimental com 16 idosas, sendo 10 alocadas no grupo experimental (GE) submetidas a 16 sessões de estimulação cognitiva e Taigeiko, e 6 idosas no grupo controle (GC) submetidas ao Taigeiko isoladamente. A cognição foi avaliada pré e pós-intervenção pelos testes: Aprendizagem Aditivo-Verbal de Rey (RAVLT); Figuras Complexas de Rey; Trilhas; Stroop; Span de Dígitos e Fluência Verbal Semântica. Resultados: Ambos os grupos apresentaram diferenças em domínios do RAVLT (GE p=0,004; GC p=0,005) e do Teste Stroop (GE p=0,012; GC p=0,024). No entanto, no GE foram evidenciados melhores escores nos testes, embora sem significância estatística. Conclusão: O Taigeiko demonstrou ser uma potencial atividade na obtenção de ganhos cognitivos, independente da estimulação cognitiva associada.

Traducción y adaptación de la escala Disability Assessment for Dementia en población española / Translation and adaptation of the Disability Assessment for Dementia scale in the Spanish population

Antecedentes y objetivo La evaluación funcional es relevante en pacientes con deterioro cognitivo (DC). La escala Disability Assessment for Dementia (DAD) mide la capacidad funcional y su uso está cada vez más extendido. El objetivo es realizar una traducción y adaptación cultural de la escala DAD para generar una versión española: DAD-E. Pacientes y método: Se ha desarrollado un proceso de doble traducción y traducción inversa, un estudio piloto con 14 cuidadores de pacientes con deterioro cognitivo y 3 reuniones de consenso. Resultados: El DAD-E mantiene los 40 ítems originales. Se han añadido a la codificación de respuestas y puntuaciones originales 4 opciones de respuesta y 8 puntuaciones con el objetivo de detectar la discapacidad funcional exclusivamente causada por DC. Se han modificado y ampliado las instrucciones de administración para mejorar la fiabilidad del contenido. Conclusiones: La versión DAD-E supone una adaptación lingüística y cultural equivalente de la escala original, lo que permite su uso en nuestro contexto español. Puede ser un instrumento de gran utilidad clínica, ya que proporciona una evaluación más precisa de la discapacidad funcional causada por DC (AU)

Background and objective: Functional assessment is especially relevant in patients with cognitive impairment (CI). The Disability Assessment for Dementia (DAD) scale assesses functional ability and its use is becoming increasingly popular. This study aims to perform the translation and cultural adaptation of the DAD scale in order to create a Spanish version: DAD-E. Patients and method: A double translation/back-translation process was developed, as well as a pilot study with 14 caregivers of patients with CI, and 3 review meetings to achieve general agreement. Results: The DAD-E includes the 40 original items. Four response options and 8 scores were added in order to detect functional disability induced by CI independently of other possible causes. More detailed instructions for administration and scoring of the scale have been provided in order to improve the reliability of the content. Conclusions: The DAD-E was shown to be a cultural and linguistic adaptation equivalent of the original scale, which allows it to be applied to the Spanish population. It may be a useful instrument in clinical practice since it provides a more accurate assessment of functional disability due to cognitive impairment (AU)

IRT Analysis of the Frontal Systems Behavior Scale: Identifying the Best Items for Use with Geriatric Patients in Primary Care.

OBJECTIVE: The Frontal Systems Behavior Scale (FrSBe) (Grace & Malloy, 2001) assesses behavioral dysfunction associated with frontal-subcortical damage; it is often used to measure these indicators of executive dysfunction in older adults with possible dementia. Although prior research supports the FrSBe's clinical utility and factorial validity, little attempt has been made to examine which items are most useful for geriatric cases. The goal of the present study is to identify these items. METHOD: Data from 304 older patients referred for neuropsychological assessment were used to examine the FrSBe's three subscales: Apathy (A; 14 items), Executive Dysfunction (E; 17 items), and Disinhibition (D; 15 items). Item properties were investigated using the Graded Response Model, a two-parameter polytomous item response theory model. RESULTS: Difficulty parameters, discrimination parameters, and information curves identified 18 items that effectively discriminate (a ≥ 1.70) between levels of behavioral dysfunction and measure a range of dysfunction (bA: -1.23 - 2.22; bD: -.29 - 2.14; bE: -1.81 - 1.77). CONCLUSIONS: Most FrSBe items were effective at discriminating various levels of behavioral dysfunction, though weaker items were identified. CLINICAL IMPLICATIONS: The findings suggest the FrSBe is a useful clinical tool when working with a geriatric population, though some items provide more information than others.

Test modificado de clasificación de tarjetas de Wisconsin: normalización y estandarización de la prueba en población española / Modified Wisconsin Card Sorting Test: standardization and norms of the test for a population sample in Spain

Introducción. El test modificado de clasificación de tarjetas de Wisconsin (M-WCST) es una versión breve y modificada del WCST que evalúa las funciones ejecutivas y la flexibilidad mental. Presenta algunas diferencias y ventajas respecto a otras versiones del WCST que se han descrito en la bibliografía. Objetivo. Estandarizar y desarrollar datos normativos calibrados demográficamente para el M-WCST en una muestra representativa de la población española. Sujetos y métodos. Como parte del proyecto multicéntrico Normacog, se administró el M-WCST a 700 participantes (rango: 18-90 años). Se analizaron el efecto de la edad, el nivel educativo y el sexo sobre el M-WCST, y se crearon percentiles y puntuaciones escalares calibradas demográficamente para cada puntuación directa. Resultados. Se observó un efecto significativo de la edad y del nivel educativo sobre las variables analizadas del M-WCST (categorías correctas, errores perseverativos y errores totales), pero no un efecto significativo del sexo en ninguna de las variables. La edad y la educación explicaban un 5,0-21,2% de la varianza en el M-WCST y mostraron que, a mayor edad y menor nivel de educación formal, el número de categorías correctas disminuía y se cometían mayor cantidad de errores. Conclusión. El presente estudio aporta por primera vez los baremos normativos del M-WCST para la población española teniendo en cuenta las características sociodemográficas de nuestra sociedad. Se confirma la influencia de la edad y el nivel educativo sobre el rendimiento del M-WCST (AU)

Introduction. The Modified Wisconsin Card Sorting Test (M-WCST) is a shorter, modified version of the WCST that assesses executive functioning and mental flexibility. The M-WCST presents some differences and advantages compared to other versions of the WCST, as previously described in the scientific literature. Aim. To standardize and develop demographically-calibrated norms for the M-WCST in a sample representing of the population of Spain. Subjects and methods. This study is part of the multisite Normacog project. Seven hundred participants from 18 to 90 years old were assessed using the M-WCST. The effects of age, sex, and educational level on M-WCST performance were analyzed, and demographically-calibrated percentiles and scaled scores corresponding to each raw score were created. Results. The effect of age and level of education on the M-WCST variables analyzed (correct categories, perseverative errors and total errors) was statistically significant, whereas sex was not significant. Age and education explained 5.0-21.2% of the variance in M-WCST performance. Older participants with lower level of formal education completed fewer category sorts and made more errors than younger and more educated participants. Conclusion. This study reports the first normative data for the M-WCST in a contemporary Spanish sample, taking sociodemographic characteristics of the population into account. The influence of age and level of education on the M-WCST performance was confirmed (AU)

Atención, memoria y funciones ejecutivas en los trastornos del espectro autista: ¿cuánto hemos avanzado desde Leo Kanner? / Attention, memory and executive functions in Autism Spectrum Disorders. How much do we go forward since Leo Kanner?

Los trastornos del espectro autista se caracterizan por dificultades en la comunicación social y patrones de conducta e intereses restringidos y repetitivos. Desde la descripción pionera de Leo Kanner a mediados del S. XX y que aludía de forma indirecta a posible afectación en algunas funciones cognitivas como lenguaje o funciones ejecutivas, se han publicado numerosos trabajos relativos a la fenomenología, la etiología y el tratamiento; y desde disciplinas variadas como la Psicología Cognitiva y la Neuropsicología, entre otras. La revisión de los trabajos publicados en los últimos 14 años relativos a la evaluación de la memoria, la atención y las funciones ejecutivas en niños y adolescentes con trastornos del espectro autista permite concluir un perfil de afectación particular, que sostiene y precisa en mayor medida las hipótesis que Kanner había propuesto en el siglo pasado (AU)

Autism spectrum disorders are characterized by difficulties in social communication as well as restricted and repetitive behavior patterns and interests. Since Leo Kanner´s first description in the mid-20th century, which indirectly mentioned impairments in some cognitive functions as language or executive funciones, many papers concerning phenomenology, etiology and treatment have been publicated; from different disciplines as Cognitive Psychology and Neuropsychology, among others. The review of the articles published in the last 14 years related to the evaluation of memory, attention and executive functions in autism spectrum disorders allow us to conclude an impaired cognitive profile that supports and specifies Kanners´s hypothesis in the last century (AU)

Executive functions profiles in traumatic brain injury adults: Implications for rehabilitation studies.

PRIMARY OBJECTIVE: This study aimed to identify and characterize profiles of executive functions (EF) following traumatic brain injury (TBI). RESEARCH DESIGN: The sample was comprised of 84 adult outpatients with mild and moderate/severe TBI who were assessed by means of a battery of EF tasks. A Hierarchical Cluster analysis was performed with tasks Z-scores. Clusters were compared by means of ANOVA and Chi-square analyses. MAIN OUTCOMES AND RESULTS: Three clusters were characterized by deficits in: (1) inhibition, flexibility and focused attention; (2) inhibition, flexibility, working memory and focused attention; and (3) no expressive executive deficits. Clusters did not differ in clinical or demographical variables. CONCLUSIONS: The first cluster replicated findings of previous studies on TBI EF profiles. IT is suggested that TBI rehabilitation studies of EF must select participants by their EF profile rather than for clinical or demographical variables.

Does the model of hierarchical complexity produce significant gaps between orders and are the orders equally spaced?

The model of hierarchical complexity (MHC) provides an analytic a priori measurement of the difficulty of tasks. As part of the theory of measurement in mathematical psychology, the model of hierarchical complexity (Commons and Pekker, 2008) defines a new kind of scale. It is important to note that the orders of hierarchical complexity of tasks are postulated to form an ordinal scale. A formal definition of the model of hierarchical complexity is presented along with the descriptions of its five axioms that help determine how the model of hierarchical complexity orders actions to form a hierarchy. The fourth and the fifth axioms are of particular importance in establishing that the orders of hierarchical complexity form an equally spaced ordinal scale. Previously, it was shown that Rasch-scaled items followed the same sequence as their orders of hierarchical complexity. Here, it is shown that the gaps between the highest Rasch scaled item scores at a lower order and the lowest scores at the next higher order exist. We found there was no overlap between the Rasch-scaled item scores at one order of complexity, and those of the adjoining orders. There are 'gaps' between the stages of performance on those items. Second, we tested for equal spacing between the orders of hierarchical complexity. We found that the orders of hierarchical complexity were equally spaced. To deviate significantly from the data, the orders had to deviate from linearity by over .25 of an order. This would appear to be an empirical and mathematical confirmation for the equally spaced stages of development.

Conflicted goal engagement: undermining physical activity and health in late life.

OBJECTIVES: Pursuing health goals in very old age is a challenging task that may be undermined by conflicted goal engagement involving mismatched primary (behavior-focused) and secondary (motivation-focused) control striving. Our study explored whether one potentially detrimental combination of control strategies (low primary control/high secondary control) compromised 3-year indicators of everyday physical activity and blood oxygen saturation. METHOD: We analyzed data from a representative sample of very old adults (n = 107) using simple slope regression analyses that tested the conditional effects of control striving on everyday physical activity and blood oxygen saturation. RESULTS: We found a conflicted engagement effect wherein primary control predicted our outcomes only when secondary control was high. The lowest levels of everyday physical activity and blood oxygen saturation were found for older adults high in secondary control but low in primary control. A supplemental mediation analysis suggested everyday physical activity was the mechanism through which conflicted engagement undermined blood oxygen saturation. DISCUSSION: Employing health maintenance strategies that promote motivation-focused thinking but discourage goal-directed behaviors (conflicted engagement) may compromise physical activity and health among very old adults. Further research is needed to determine whether control-enhancing interventions promote harmonious goal engagement and better health among these high-risk individuals.

Executive functioning: a scoping review of the occupational therapy literature.

BACKGROUND: Increasingly recognized as an important factor in the performance of complex, goal-directed tasks, executive functioning is understood in different ways across disciplines. PURPOSE: The aim was to explore the ways in which executive functioning is conceptualized, discussed, described, and implied in the occupational therapy literature. METHOD: A scoping review of the occupational therapy literature was conducted following Levac, Colquhoun, and O'Brien's (2010) recommended methodology. RESULTS: Executive functioning is described both as a set of performance component skills or processes and as the executive occupational performance inherent in complex occupations. Executive functioning is implicit in occupational performance and engagement, and some health conditions seem to be commonly associated with impaired executive functioning. Assessing executive functioning requires dynamic occupation- and performance-based assessment. Interventions targeting executive functioning are grounded in metacognitive approaches. CONCLUSION: Executive functioning is a complex construct that is conceptualized with considerable variance within the occupational therapy literature, creating barriers to effective service delivery.

Determinantes de la capacidad funcional en personas mayores según el género / Determinants of the functional capacity in older people by gender

El propósito de este trabajo es identificar factores determinantes de carácter socio-demográficos, de salud y de actividad física que influyan en la aparición de la discapacidad para las actividades básicas e instrumentales de la vida diaria en 380 individuos mayores de 64 años que asisten a centros sociales de Zaragoza. Un modelo multivariante de regresión logística analizó la capacidad funcional por sexo. Variables sociodemográficas, enfermedades crónicas y actividad física fueron variables explicativas Conclusiones: las condiciones médicas son el principal marcador de la discapacidad, y la actividad física es una medida que se puede promover en la Atención Primaria para reducir el riesgo de discapacidad (AU)

The purpose is to identify the sociodemographic, health and physical activity determinants that influence the appearance of disability for basic and instrumental activities of daily life in 380 individuals older than 64 who attend social centres of Zaragoza. A multivariate logistic regression model was used to analyse the functional capacities by gender. Sociodemographic variables, chronic diseases and physical activity were explanatory variables. Conclusions: medical conditions are the main marker of disability, and physical activity is a instrument that can be promoted in Primary Care to reduce the risk of disability (AU)