Normative Data for Verbal Fluency, Trail Making, and Rey-Osterrieth Complex Figure Tests on Monolingual Spanish-Speaking Older Adults.

OBJECTIVE: This study aimed to generate updated normative data for commonly used tests in neuropsychological assessment applied to older monolingual Spanish-speaking adults: Verbal fluency tests, the Trail Making Test (TMT), and the Rey-Osterrieth complex figure test (ROCF). METHOD: To obtain normative data, 382 cognitively healthy 60- to 90-year-old Spanish monolingual participants from the Autonomous Community of Madrid (Spain) with 0-22 years education were assessed using an overlapping interval strategy that involved cell and midpoint techniques, and that assessed the influence of age, education, and sex. RESULTS: Age and education were associated with the scores in the verbal fluency tests, TMT, and ROCF, whereas sex only significantly affected the TMT results. Age-adjusted scaled scores (SSA) based on percentile ranks were also converted into age-education scaled scores (SSAE) using a linear regression model. In addition, tables with the relevant adjustments for sex are provided for TMT-A and TMT-B. CONCLUSIONS: Thus, this study provides updated, uniform normative data for widely used neuropsychological tests on older Spanish adults. The normative procedure followed helps to make consistent comparisons when using these neuropsychological tests, which will improve the interpretation of the data obtained when these tools are employed, reducing the risk of misdiagnosing cognitive impairment in older adults.

Normative data for the Spanish version of the California Verbal Learning Test (TAVEC) from older adults.

The aim of this study was to establish normative data for the Spanish version of the California Verbal Learning Test, the Test de Aprendizaje Verbal España-Complutense (TAVEC). Through different subtests, the TAVEC allows verbal learning and episodic memory to be evaluated, an assessment that was carried out on a sample of 382 cognitive healthy Spanish individuals aged 60-90 years old. Unlike the participant's educational level, their age and sex significantly influenced performance in the TAVEC. We provide tables that allow the scaled scores obtained with this test to be adjusted for age and other tables with the relevant adjustments for sex. The normative data obtained in this study will help more precisely interpret the performance of older Spanish adults in the TAVEC, enhancing the utility of this neuropsychological test to evaluate verbal learning and episodic memory in clinical settings and in relation to healthy aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Problems in Classifying Mild Cognitive Impairment (MCI): One or Multiple Syndromes?

As the conceptual, methodological, and technological advances applied to dementias have evolved the construct of mild cognitive impairment (MCI), one problem encountered has been its classification into subtypes. Here, we aim to revise the concept of MCI and its subtypes, addressing the problems of classification not only from the psychometric point of view or by using alternative methods, such as latent class analysis, but also considering the absence of normative data. In addition to the well-known influence of certain factors on cognitive function, such as educational level and cultural traits, recent studies highlight the relevance of other factors that may significantly affect the genesis and evolution of MCI: subjective memory complaints, loneliness, social isolation, etc. The present work will contemplate the most relevant attempts to clarify the issue of MCI categorization and classification, combining our own data with that from recent studies which suggest the role of relevant psychosocial factors in MCI.

Neuropsychological predictors of conversion to probable Alzheimer disease in elderly with mild cognitive impairment.

In the field of neuropsychology, it is essential to determine which neuropsychological tests predict Alzheimer's disease (AD) in people with mild cognitive impairment (MCI) and which cut-off points should be used to identify people at greater risk for converting to dementia. The aim of the present study was to analyse the predictive value of the cognitive tests included in a neuropsychological battery for conversion to AD among MCI participants and to analyse the influence of some sociodemographic variables - sex, age, schooling - and others, such as follow-up time and emotional state. A total of 105 participants were assessed with a neuropsychological battery at baseline and during a 3-year follow-up period. For the present study, the data were analysed at baseline. During the follow-up period, 24 participants (22.85%) converted to dementia (2.79 ± 1.14 years) and 81 (77.14%) remained as MCI. The logistic regression analysis determined that the long delay cued recall and the performance time of the Rey figure test were the best predictive tests of conversion to dementia after an MCI diagnosis. Concerning the sociodemographic factors, sex had the highest predictive power. The results reveal the relevance of the neuropsychological data obtained in the first assessment. Specifically, the data obtained in the episodic verbal memory tests and tests that assess visuospatial and executive components may help to identify people with MCI who may develop AD in an interval not longer than 4 years, with the masculine gender being an added risk factor.

Profiles of Mild Cognitive Impairment (MCI) in the Elderly.

We applied latent class analysis (LCA) to a set of neuropsychological data with the aim of corroborating the three cognitive profiles of mild cognitive impairment (MCI) described in the literature, namely: healthy, amnestic, non-amnestic, and multidomain. The ultimate purpose of the LCA was to try to find the underlying classification of MCI and related pathologies by means of the participants' response patterns, rather than on more classical psychometric criteria, such as the standard deviation of the mean. We computed 547 neuropsychological assessments derived from 223 participants who were assessed annually for three consecutive years. The battery included tests of memory, language, executive function, and praxis. The results obtained by means of LCA, with a four-group solution and using the 40th percentile as the criterion, confirm prior classifications obtained with more questionable psychometric criteria, while providing longitudinal data on the course of MCI and the stability of group assignment over time.

Profiles of mild cognitive impairment (MCI) in the elderly

We applied latent class analysis (LCA) to a set of neuropsychological data with the aim of corroborating the three cognitive profiles of mild cognitive impairment (MCI) described in the literature, namely: healthy, amnestic, nonamnestic, and multidomain. The ultimate purpose of the LCA was to try to find the underlying classification of MCI and related pathologies by means of the participants’ response patterns, rather than on more classical psychometric criteria, such as the standard deviation of the mean. We computed 547 neuropsychological assessments derived from 223 participants who were assessed annually for three consecutive years. The battery included tests of memory, language, executive function, and praxis. The results obtained by means of LCA, with a four-group solution and using the 40th percentile as the criterion, confirm prior classifications obtained with more questionable psychometric criteria, while providing longitudinal data on the course of MCI and the stability of group assignment over time (AU)

No disponible

The characterization of biological rhythms in mild cognitive impairment.

INTRODUCTION: Patients with dementia, especially Alzheimer's disease, present several circadian impairments related to an accelerated perturbation of their biological clock that is caused by the illness itself and not merely age-related. Thus, the objective of this work was to elucidate whether these circadian system alterations were already present in patients with mild cognitive impairment (MCI), as compared to healthy age-matched subjects. METHODS: 40 subjects (21 patients diagnosed with MCI, 74.1 ± 1.5 y.o., and 19 healthy subjects, 71.7 ± 1.4 y.o.) were subjected to ambulatory monitoring, recording wrist skin temperature, motor activity, body position, and the integrated variable TAP (including temperature, activity, and position) for one week. Nonparametrical analyses were then applied. RESULTS: MCI patients exhibited a significant phase advance with respect to the healthy group for the following phase markers: temperature M5 (mean ± SEM: 04:20 ± 00:21 versus 02:52 ± 00:21) and L10 (14:35 ± 00:27 versus 13:24 ± 00:16) and TAP L5 (04:18 ± 00:14 versus 02:55 ± 00:30) and M10 (14:30 ± 00:18 versus 13:28 ± 00:23). CONCLUSIONS: These results suggest that significant advances in the biological clock begin to occur in MCI patients, evidenced by an accelerated aging of the circadian clock, as compared to a healthy population of the same age.

Evaluación y seguimiento del envejecimiento sano y con deterioro cognitivo leve (DCL) a través del TAVEC / Evaluation and follow-up of healthy aging and aging with mild cognitive impairment (MCI) through TAVEC

El deterioro cognitivo leve (DCL) se define como un estado intermedio entre el envejecimiento normal y el patológico, que en ocasiones, puede evolucionar a algún tipo de demencia, principalmente de tipo Alzheimer. La necesidad de encontrar marcadores que detecten tempranamente el DCL hace que determinados tests neuropsicológicos, básicamente de memoria, puedan ser considerados marcadores tempranos de este síndrome. La presente investigación pretende comprobar si el Test de Aprendizaje Verbal España-Complutense (TAVEC) es útil en la evaluación y seguimiento del envejecimiento sano y con DCL en función de su estabilidad e inestabilidad temporal. La muestra de estudio se compuso de 179 participantes (95 sanos y 84 DCL) entre 58-90 años evaluados en dos ocasiones a través del TAVEC junto con otros tests neuropsicológicos. Los resultados en el TA-VEC mostraron diferencias significativas entre la primera y la segunda evaluación llevada a cabo un año después, tomando la muestra total y subdividida en sanos y DCL estables e inestables. Hubo diferencias en la ejecución entre los diferentes subgrupos clasificados en función de la estabilidad/ inestabilidad. Se concluye que el TAVEC es una herramienta útil, tanto en la evaluación de la memoria episódica verbal, como en el seguimiento del envejecimiento sano y con DCL

Mild cognitive impairment (MCI) is defined as an intermediate state between normal aging and disease that can sometimes evolve to Alzheimer's type dementia (DAT). The need to find markers for the early detection of MCI requires specific neuropsychological tests; basically, memory tests can be considered early markers of this syndrome. This proposed research intends to verify whether the Learning Verbal Test from Spain - Complutense (TAVEC) is useful to assess and follow up subjects to determine whether they are aging healthily or they have MCI, depending on whether their stability or instability is temporary. The sample comprises 179 persons (95 healthy subjects and 84 MCIs) aged between 58-90 years old. The subjects are currently tested twice a week with a TAVEC test along with other neuropsychological tests The results showed significant differences between the first and the second evaluation, which is conducted one year later, re-evaluating the total sample and dividing it into healthy subjects or MCI subjects (stable and unstable). There were differences between different subgroups, classified according to the temporary stability or instability. The TAVEC is a useful tool to evaluate verbal episodic memory in its early stages and to follow up healthy aging and/or MCI

Increased morning salivary cortisol levels in older adults with nonamnestic and multidomain mild cognitive impairment.

Exposure to elevated glucocorticoid levels has a detrimental impact on cognitive function. In the present study, elderly individuals were classified according to their cognitive status to (i) cognitively healthy; (ii) amnestic; (iii) nonamnestic; or (iv) multidomain, with an extensive cognitive profiling. Salivary cortisol samples were taken at awakening, evening and night. We report that, compared to cognitively normal control individuals, subjects with nonamnestic or multidomain mild cognitive impairment profiles show increased salivary cortisol levels, immediately after awakening, but not in the evening or at night. Importantly, individuals with amnestic mild cognitive impairment did not show this increase in salivary cortisol levels. We also found that higher morning cortisol levels were associated with a lower global cognitive state, as well as poorer score in executive function and visuoconstructive praxes, verbal fluency, and a worse free immediate recall of items from a word list. These findings open new avenues to the use of salivary cortisol levels as a possible biomarker for nonamnestic and multidomain mild cognitive impairment in elderly subjects.

Adaptación de la batería de Evaluación de la Memoria Semántica en la Demencia de tipo Alzheimer (EMSDA) a la población de la ciudad de Buenos Aires / Evaluation battery for Semantic Memory Deterioration in Dementia of the Alzheimer type (EMSDA): Item's adjustment to the population of Buenos Aires city

Se llevó a cabo la adaptación de la Batería para la Evaluación de la Memoria Semántica en Demencia de tipo Alzheimer (Peraita, González Labra, Sánchez Bernardos & Galeote Moreno, 2000)¹ para su aplicación en la Ciudad de Buenos Aires (República Argentina). Esta batería permite evaluar mediante pruebas de modalidad visual, verbal y auditiva, el deterioro del conocimiento de seis categorías semánticas de seres vivientes y no vivientes. Ha sido desarrollada para población de habla hispana con la finalidad de evaluar el deterioro semántico en la Demencia de tipo Alzheimer. Su valor radica en que complementa la evaluación neuropsicológica, donde los aspectos de la memoria semántica por lo general están poco representados, otorgándole valor predictivo al posibilitar la detección temprana de determinadas patologías en las que se encuentra afectado ese sistema de la memoria. Se administró la batería a 30 sujetos sin deterioro cognitivo que tenían entre 61 y 88 años de edad y un promedio de 12 años de escolaridad. Los participantes fueron cuidadosamente seleccionados y se excluyeron a quienes pudieran presentar indicadores de deterioro cognitivo. La evaluación de los ítemes se realizó en base a la frecuencia de las respuestas correctas. Se tomó este criterio considerando que se trata de variables categóricas y el tamaño de la muestra. Se estimó la proporción de respuestas correctas en las seis categorías y dominios de seres vivientes y seres no vivientes. Los nuevos ítemes fueron seleccionados respetando la estructura de la batería y considerando su correlación entre las distintas pruebas.

In this work some items of the Evaluation Battery for Semantic Memory Deterioration in Alzheimer's Disease, were adapted to be used in the population of Buenos Aires city - República Argentina (EMSDA -in Spanish-, Peraita, González Labra, Sánchez Bernardos, & Galeote Moreno, 2000). The original battery presents a series of tasks, elaborated with the aim of assessing semantic deterioration and/or conceptual memory in patients with Alzheimer's disease. It allows specifically, assessing some features of the semantic visual and verbal knowledge of six categories concerning to living / animated beings and inanimate objects as well as the attributes that organize them. The evaluation of attributes belonging to the categories assessed by the EMSDA is implemented following a conceptual representation model, according to which attributes can be grouped in at least nine common conceptual components for the living things and inanimate objects categories. This conceptual representation model was constructed on the basis of an empirical approximation to the study of formation and representation of natural categories and objects representation (Peraita, Elosúa, & Linares, 1992). The various conceptual components vary in their frequency, according to the level of generality of the categories (superordinate, basic, or subordinate), category type, age, and education level, verifying this tendency in samples of patients with dementia of the Alzheimer´s type (DAT). The purpose of this paper is to present the items adjustment of some tasks of the EMSDA to the population of Buenos Aires city. The battery was administered to 30 healthy elderly between 61 and 88 years and 12 years average of education. The participants were carefully selected to be included in the sample. To rule out cognitive deterioration we did not include participants whose performance in the Mini Mental State Examination and the Wechsler Memory Scale Revised were one standard deviation bellow the expected scoring for age and educational level. To study the items we evaluated the frequency of answers, considering them more suitable when 75% or more participants gave the expected target. This criterion was chosen considering the variables were categorical, and the sample was formed with healthy elderly participants, i.e. without cognitive deterioration. To this preliminary analysis, it was estimated the proportion of correct answers to the six categories belonging to domains of living beings and in animate objects with the original and new items. We observed that some of them did not reach the 75% of agreement, and consistently, we determined to change the following tasks: Picture Naming, Spoken Word / Picture Matching, Sentence Verification, and Semantic Analogies. We selected new items taking into account the structure of the original version of the battery, and their correlations between the tasks. This new items were administered to 28 participants of the original sample. The means of each task were analyzed by Students distribution obtaining higher scorings with the adapted items (p < .0001). It is important to note that the proportion of expected answers to the living / animate and non living / inanimate objects were similar. The same results were observed to the supra ordinate and basic level of the category. However, to study the reliability of these results it would be necessary to explore the items in a larger sample. These preliminary results indicate that the new items can be considered an appropriate adjustment to our social culture context and to determine semantics impairments. This is considered a useful tool for the neuropsychological assessment to investigate the category specific deficits and other cognitive processes.

Lexical access changes in patients with multiple sclerosis: a two-year follow-up study.

The aim of the study was to analyze lexical access strategies in patients with multiple sclerosis (MS) and their changes over time. We studied lexical access strategies during semantic and phonemic verbal fluency tests and also confrontation naming in a 2-year prospective cohort of 45 MS patients and 20 healthy controls. At baseline, switching lexical access strategy (both in semantic and in phonemic verbal fluency tests) and confrontation naming were significantly impaired in MS patients compared with controls. After 2 years follow-up, switching score decreased, and cluster size increased over time in semantic verbal fluency tasks, suggesting a failure in the retrieval of lexical information rather than an impairment of the lexical pool. In conclusion, these findings underline the significant presence of lexical access problems in patients with MS and could point out their key role in the alterations of high-level communications abilities in MS.

The semantic organization of the animal category: evidence from semantic verbal fluency and network theory.

Semantic memory is the subsystem of human memory that stores knowledge of concepts or meanings, as opposed to life-specific experiences. How humans organize semantic information remains poorly understood. In an effort to better understand this issue, we conducted a verbal fluency experiment on 200 participants with the aim of inferring and representing the conceptual storage structure of the natural category of animals as a network. This was done by formulating a statistical framework for co-occurring concepts that aims to infer significant concept-concept associations and represent them as a graph. The resulting network was analyzed and enriched by means of a missing links recovery criterion based on modularity. Both network models were compared to a thresholded co-occurrence approach. They were evaluated using a random subset of verbal fluency tests and comparing the network outcomes (linked pairs are clustering transitions and disconnected pairs are switching transitions) to the outcomes of two expert human raters. Results show that the network models proposed in this study overcome a thresholded co-occurrence approach, and their outcomes are in high agreement with human evaluations. Finally, the interplay between conceptual structure and retrieval mechanisms is discussed.

[Estimation of the influence of some quality-of-life variables on the results of a battery of neuropsychological tests]. / Estimación de la influencia de algunas variables de calidad de vida en los resultados de un conjunto de pruebas neuropsicológicas.

INTRODUCTION: Given current interest in the field of ageing, the objective of this study was to determine the factors related to quality of life that underlie healthy ageing. Two areas were analyzed: firstly, the influence of specific quality-of-life variables on the scores of the Mini Examen Cognoscitivo (MEC), on the classification of subjects as healthy or with mild cognitive impairment (MCI), and on the results of specific memory tests and, secondly, the predictive character of these variables in these tests. MATERIALS AND METHODS: We performed an inferential study in an incidental sample composed of 140 elderly persons whose memory, praxis, language, and executive function were evaluated using a battery of neuropsychological tests. Data related to lifestyle and clinical history were collected at an interview. RESULTS: Using a series of univariate analyses, we observed that alcohol consumption and a history of cerebrovascular accident affected the results of the MEC and of some of the memory tests, as well as the classification of a subject as healthy versus impaired. A backward regression analysis confirmed the predictive value of these variables in the MEC scores and in some of the memory tests. CONCLUSIONS: Some variables related to quality of life and lifestyle affect the results of certain cognitive tests. Given the current interest this area arouses, future studies that make quality-of-life variables more operative and include factors such as physical exercise are required.

Estimación de la influencia de algunas variables de calidad de vida en los resultados de un conjunto de pruebas neuropsicológicas / Estimation of the influence of some quality-of-life variables on the results of a battery of neuropsychological tests

Introducciónel interés por conocer los factores de calidad y estilo de vida que influyen en un envejecimiento saludable subyace al objetivo de este trabajo. Se analizan dos aspectos: el primero es la influencia de determinadas variables de calidad de vida en las puntuaciones del Mini Examen Cognoscitivo (MEC), así como en la clasificación del sujeto como sano o con deterioro cognitivo leve (DCL), y en los resultados en pruebas de memoria; el segundo es el carácter predictivo de estas mismas variables en esas pruebas.Material y métodosestudio inferencial en una muestra incidental formada por 140 personas mayores evaluadas en memoria, praxias, lenguaje y función ejecutiva con una batería neuropsicológica. Los datos relacionados con el estilo de vida y los antecedentes médicos se recogieron en una entrevista.Resultadosmediante una serie de análisis univariados constatamos que el hábito de consumo de alcohol y los antecedentes de accidentes cerebrovasculares (ACV) tienen influencia en los resultados obtenidos en el MEC, en la clasificación del sujeto como sano frente a deterioro y en algunas de las pruebas de memoria. Mediante un análisis de regresión “backward” (eliminación hacia atrás) confirmamos el valor predictivo de esas mismas variables en las puntuaciones del MEC y en algunas pruebas de memoria.Conclusionesalgunas variables relacionadas con la calidad y el estilo de vida influyen en los resultados de determinadas pruebas. Futuros estudios con un mayor nivel de operativización de las variables, en el que se incluyan factores como el ejercicio físico, serán necesarios por el interés del tema del envejecimiento activo en el mundo actual (AU)

IntroductionGiven current interest in the field of ageing, the objective of this study was to determine the factors related to quality of life that underlie healthy ageing. Two areas were analyzed: firstly, the influence of specific quality-of-life variables on the scores of the Mini Examen Cognoscitivo (MEC), on the classification of subjects as healthy or with mild cognitive impairment (MCI), and on the results of specific memory tests and, secondly, the predictive character of these variables in these tests.Materials and methodsWe performed an inferential study in an incidental sample composed of 140 elderly persons whose memory, praxis, language, and executive function were evaluated using a battery of neuropsychological tests. Data related to lifestyle and clinical history were collected at an interview.ResultsUsing a series of univariate analyses, we observed that alcohol consumption and a history of cerebrovascular accident affected the results of the MEC and of some of the memory tests, as well as the classification of a subject as healthy versus impaired. A backward regression analysis confirmed the predictive value of these variables in the MEC scores and in some of the memory tests.ConclusionsSome variables related to quality of life and lifestyle affect the results of certain cognitive tests. Given the current interest this area arouses, future studies that make quality-of-life variables more operative and include factors such as physical exercise are required (AU)

Análisis de la estructura conceptual de categorías semánticas naturales y artificiales en una muestra de pacientes de Alzheimer / Analysis of the conceptual structure of natural and artifactual categories in Alzheimer’s disease patients

En este estudio se pretende profundizar en el análisis de la estructura conceptual de una serie de categorías naturales y de artefactos, análisis llevado a cabo mediante la técnica de escalamiento multidimensional. Se parte del supuesto de que dicha estructura conceptual está compuesta por conjuntos de rasgos o atributos semánticos de diversa entidad y naturaleza, y se toma la frecuencia de producción de los mismos en una tarea de producción verbal libre, como índice de su relevancia en la representación mental de dichas categorías. Como segundo objetivo se compara la estructura conceptual subyacente en las representaciones categoriales de ancianos controles sanos con la de enfermos de Alzheimer, en los que las representaciones conceptuales y semánticas sufren un deterioro considerable, partiéndose del supuesto de que las representaciones de estos últimos presentan, en ciertas fases de la enfermedad, un deterioro que consiste en la pérdida de rasgos y que ello repercute en la integridad de la estructura conceptual

This work has two goals, the first one is to study in detail the conceptual structure of some natural and artifactual categories, by using multidimensional scaling (MDS). According to our theoretical approximation, conceptual structure is composed of semantic features, and these features have different entities and nature. As an index of relevance in mental representation of semantic categories, we took the frequency of production of semantic features on a free verbal production task. Our second goal was to compare the structure of conceptual representations in two populations, healthy elderly and Alzheimer’s disease (AD) patients, assuming that conceptual representation is impaired in this last population. We assume that the impairment in the conceptual representations of AD patients will show, when the disease reaches a determined level, loosing specific features. This impairment will have serious consequences in the whole conceptual structure

[Analysis of the conceptual structure of natural and artifactual categories in Alzheimer's disease patients]. / Análisis de la estructura conceptual de categorías semánticas naturales y artificiales en una muestra de pacientes de Alzheimer.

This work has two goals, the first one is to study in detail the conceptual structure of some natural and artifactual categories, by using multidimensional scaling (MDS). According to our theoretical approximation, conceptual structure is composed of semantic features, and these features have different entities and nature. As an index of relevance in mental representation of semantic categories, we took the frequency of production of semantic features on a free verbal production task. Our second goal was to compare the structure of conceptual representations in two populations, healthy elderly and Alzheimer's disease (AD) patients, assuming that conceptual representation is impaired in this last population. We assume that the impairment in the conceptual representations of AD patients will show, when the disease reaches a determined level, loosing specific features. This impairment will have serious consequences in the whole conceptual structure.