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1.
Occup Ther Int ; 2021: 8874953, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33824630

RESUMEN

Purpose: This study is aimed at validating the A-ONE scale in an Italian population with Central Nervous System (CNS) dysfunction. Material and Methods. Between May and November 2018, people aged between 60 and 90 with CNS dysfunction were recruited in a hospital in Rome, Italy. Patients were observed and evaluated during the activities of daily living. Internal consistency and reliability were evaluated with Cronbach's coefficient alpha and intraclass correlation coefficient, respectively. As measured with Pearson's correlation coefficient, the validity was examined comparing results of the A-ONE with the Barthel index. Responsiveness was evaluated 30 days after the first administration. Results: A total of 70 people having a diagnosis of neurological disorders were evaluated. The internal consistency showed Cronbach's coefficient alpha ranging from 0.634 to 0.959. The measurement of reliability varied from 0.984 to 0.997 for intrarater and from 0.979 to 0.998 for interrater. Pearson's correlation coefficient between the A-ONE and the Barthel index and the responsiveness showed statistically significant values (p < 0.01). Conclusions: The present study provides preliminary evidence of reliability, validity, and responsiveness of the A-ONE when using elderly people with CNS dysfunction.


Asunto(s)
Actividades Cotidianas , Trastornos Cerebrovasculares/rehabilitación , Pruebas Neuropsicológicas/normas , Psicometría/estadística & datos numéricos , Encuestas y Cuestionarios/normas , Anciano , Anciano de 80 o más Años , Estudios Transversales , Evaluación de la Discapacidad , Femenino , Humanos , Italia , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Análisis y Desempeño de Tareas
2.
Psicothema (Oviedo) ; 33(1): 70-76, feb. 2021. tab
Artículo en Inglés | IBECS | ID: ibc-199555

RESUMEN

BACKGROUND: Detecting cognitive impairment is a priority for health systems. The aim of this study is to create normative data on screening tests (MMSE, GDS and MFE) for middle-aged and older Spanish adults, considering the effects of sociodemographic factors. METHOD: A total of 2,030 cognitively intact subjects who lived in the community, aged from 50 to 88 years old, participated voluntarily in SCAND consortium studies. The statistical procedure included the conversion of percentile ranges into scalar scores. Secondly, the effects of age, educational level and gender were verified. Linear regressions were used to calculate the scalar adjusted scores. Cut-off values for each test were also calculated. RESULTS: Scalar scores and percentiles corresponding to MMSE, GDS-15 and MFE are shown. An additional table is provided which shows the points that must be added or subtracted from MMSE score depending on the subject's educational level. CONCLUSIONS: The current norms should provide clinically useful data for evaluating Spanish people aged 50 to 88 years old and should contribute to improving the detection of initial symptoms of cognitive impairment in people living in the community, taking into account the influence of gender, age and educational level


ANTECEDENTES: detectar el deterioro cognitivo es una prioridad del sistema sanitario. El objetivo de este estudio es la presentación de datos normativos de pruebas de cribado (MMSE, GDS y MFE) para adultos españoles de mediana edad y adultos mayores, considerando los efectos de factores sociodemográficos. MÉTODO: en los estudios realizados por el consorcio SCAND participaron voluntariamente 2.030 personas cognitivamente sanas, de 50 a 88 años, residentes en su comunidad. El procedimiento estadístico supuso la conversión de rangos percentiles en puntuaciones escalares. Posteriormente, se comprobaron los efectos de la edad, el nivel educativo y el género. Se utilizaron regresiones lineales para calcular las puntuaciones escalares ajustadas. También se calcularon los puntos de corte para cada prueba. RESULTADOS: se muestran las puntuaciones escalares y los percentiles correspondientes a MMSE, GDS-15 y MFE. Además, se presenta una tabla que muestra los puntos que deben sumarse o restarse a la puntuación del MMSE dependiendo del nivel educativo del individuo. CONCLUSIONES: los datos normativos presentados tienen una utilidad clínica para evaluar a población española de 50 a 88 años, y contribuyen a mejorar la detección de los síntomas iniciales del deterioro cognitivo teniendo en cuenta la influencia del género, la edad y el nivel educativo


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Disfunción Cognitiva/diagnóstico , Pruebas de Estado Mental y Demencia/normas , Envejecimiento Cognitivo/psicología , Escala del Estado Mental/normas , Pruebas Neuropsicológicas/normas , Disfunción Cognitiva/psicología , Evaluación Geriátrica/estadística & datos numéricos , Modelos Lineales , Escolaridad
4.
Rev. neurol. (Ed. impr.) ; 72(2): 35-42, 16 ene., 2021. graf, tab
Artículo en Español | IBECS | ID: ibc-199582

RESUMEN

INTRODUCCIÓN: El test de aprendizaje verbal de Hopkins revisado (HVLT-R) se creó originalmente con el objetivo de proporcionar un test de aprendizaje y memoria verbal corto y con seis versiones paralelas que permitieran su readministración. OBJETIVO: Obtener datos normativos y estandarizados para el HVLT-R adaptado a las características sociodemográficas de la población española actual. Sujetos y métodos: El estudio se enmarca dentro del proyecto Normacog, para el cual se evaluó a 700 participantes (rango de edad: 18-90 años). Se analizó el efecto de la edad, el nivel educativo y el sexo sobre el rendimiento del HVLT-R, y se crearon los percentiles y las puntuaciones escalares ajustadas por edad y nivel educativo. RESULTADOS: Se observó un efecto significativo de la edad y el nivel educativo sobre las variables analizadas del test, que explicaba entre el 15 y el 29% de la varianza (ensayo 1, recuerdo total, ensayo 4, índice de discriminación). Como era de esperar, a mayor edad y menor nivel educativo, el rendimiento en el HVLT-R fue menor en todas las variables analizadas. Sin embargo, el sexo presentó un efecto significativo únicamente en las variables ensayo 1, recuerdo total e índice de discriminación. CONCLUSIÓN: Este estudio presenta baremos estandarizados y normalizados para el HVLT-R para población española, y ofrece normas actuales para los clínicos e investigadores. Los resultados confirman la influencia de la edad y la educación en todos los indicadores del test, por lo que se aportan datos que permiten corregir el HVLT-R teniendo en cuenta dichas características


INTRODUCTION: The Hopkins Verbal Learning Test-revised (HVLT-R) was originally created with the objective of providing a short verbal memory and learning test with six alternative forms that allow the re-administration. AIM: To obtain normative and standardized data for the HVLT-R taking into account the sociodemographic characteristics of the current Spanish population. SUBJECTS AND METHODS: The study is part of the Normacog Project. Seven hundred participants (18 to 90 years old) were assessed. The effect of age, level of education and gender on the performance of HVLT-R were analyzed, and percentiles and scalar scores adjusted by age and level of education were created. RESULTS: A significant effect of age and educational level on the analyzed variables of the test was observed, explaining from 15% to 29% of the variance (trial 1, total recall, trial 4, discrimination index). As expected, the older and less educated obtained lower performance in all the analyzed variables of the HVLT-R. However, sex only had a significant effect on the variables trial 1, total recall and discrimination index. CONCLUSION. This study provides standardized and normalized data for the HVLT-R for the Spanish population, offering current norms to clinicians and researchers. The results confirm the influence of age and level of education on all the indicators of the test, so normative data are provided to correct the HVLT-R taking into account these characteristics


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Aprendizaje Verbal/fisiología , Evaluación Educacional/normas , Disfunción Cognitiva/terapia , Memoria/fisiología , Pruebas Neuropsicológicas/normas , Escolaridad , España , Estándares de Referencia , Análisis Estadístico , Análisis de Varianza , Recuerdo Mental/fisiología
5.
Br J Clin Psychol ; 60(1): 116-128, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33314162

RESUMEN

OBJECTIVES: Acquired brain damage is associated with a reduced capacity for empathy, and emerging evidence indicates that there may also be elevated levels of schizotypy. However, although a relationship between schizotypy and empathy has been identified in other populations, no study to date has tested whether this relationship is also evident following acquired brain damage, and if so, whether it is specific to certain types of brain damage, or specific types of empathy. METHODS: People with acquired brain damage restricted to either frontal (N = 18) or non-frontal (N = 24) neural structures and demographically matched controls (N = 48) completed an assessment of schizotypy and a measure of empathy that differentiated between cognitive, emotional, and social skills empathy. RESULTS: Relative to the control group, people with frontal and non-frontal brain injuries reported elevated schizotypy, with the frontal group also reporting lower social skills empathy. Only in the frontal group was there support for an association between schizotypy and empathy, and this was specific to the social skills component of empathy. CONCLUSIONS: Schizotypy levels are elevated following brain damage, and frontal brain injury is linked to greater difficulties with the social skills component of empathy. Schizotypy appears to be an important consideration when understanding the link between empathy and frontal brain damage, with higher schizotypy levels associated with reduced social skills empathy in this population. Future research is now needed to establish whether problems with more implicit aspects of social understanding are relevant to understanding the relationship between schizotypy and poor social behavioural outcomes identified in other clinical groups that present with frontal brain damage. PRACTITIONER POINTS: People with an acquired brain injury experience deficits in empathic processing as well as elevated levels of schizotypal traits. Schizotypy levels and social skills empathy were inversely related in people who had experienced a frontal acquired brain injury, suggesting that schizotypy might be important for understanding social skill difficulties in this particular population. These findings highlight the potential benefit of including social cognitive assessments and schizotypy measures in standard neuropsychological assessment batteries.


Asunto(s)
Lesiones Encefálicas/complicaciones , Empatía/fisiología , Pruebas Neuropsicológicas/normas , Trastorno de la Personalidad Esquizotípica/etiología , Adulto , Anciano , Lesiones Encefálicas/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastorno de la Personalidad Esquizotípica/psicología
6.
Medicine (Baltimore) ; 99(45): e23060, 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33157962

RESUMEN

Parkinsonian syndromes include typical cases of idiopathic Parkinson's disease (PD) and atypical parkinsonian syndromes (APS) associated with cognitive and vegetative disorders, which are more challenging to diagnose. The aim of this study was to assess -the value of dual-tracer imaging 6-fluoro-(18F)-L-DOPA (FDOPA) and fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), performed in routine patients demonstrating extrapyramidal signs and cognitive complains, for the diagnosis and management of parkinsonian syndromes.We retrospectively included 143 consecutive patients who underwent both FDOPA PET/CT (for the evaluation of parkinsonism) and FDG PET/CT (for the evaluation of cognitive complaints) in the same institution. The suspected clinical diagnosis before imaging and the final post-imaging diagnosis were collected by a dedicated questionnaire.FDOPA was pathological in 90.2% of cases, including 74.1% of PD, 3.5% of parkinsonian dementia and 7% of APS. FDG was normal or near normal in 58.7% of patients. A pattern of diffuse cortical hypometabolism was observed in the remaining patients, more frequently in APS than in PD patients (P = .001). Importantly, in 7.7% of cases dual-tracer PET/CT allowed to decide between several diagnostic hypotheses and led to a new diagnosis in 14.0%. Therefore, the management of these patients was modified, with clinical re-evaluation in a specialized unit and a control of neuropsychological tests and imaging.Dual-tracer PET/CT imaging may be a precious help in the diagnosis and management of parkinsonian syndromes.


Asunto(s)
Fluorodesoxiglucosa F18/metabolismo , Trastornos Parkinsonianos/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Radiofármacos/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/etiología , Demencia/diagnóstico , Demencia/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas/normas , Trastornos Parkinsonianos/metabolismo , Trastornos Parkinsonianos/patología , Manejo de Atención al Paciente/métodos , Estudios Retrospectivos
7.
Cogn Behav Neurol ; 33(3): 179-191, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32889950

RESUMEN

OBJECTIVE: To determine the contribution of white matter hyperintensities (WMH) to language deficits while accounting for cortical atrophy in individuals with primary progressive aphasia (PPA). METHOD: Forty-three individuals with PPA completed neuropsychological assessments of nonverbal semantics, naming, and sentence repetition plus T2-weighted and fluid-attenuated inversion recovery scans. Using three visual scales, we rated WMH and cerebral ventricle size for both scan types. We used Spearman correlations to evaluate associations between the scales and scans. To test whether visual ratings-particularly of WMH-are associated with language, we compared a base model (including gray matter component scores obtained via principal component analysis, age, and days between assessment and MRI as independent variables) with full models (ie, the base model plus visual ratings) for each language variable. RESULTS: Visual ratings were significantly associated within and between scans and were significantly correlated with age but not with other vascular risk factors. Only the T2 scan ratings were associated with language abilities. Specifically, controlling for other variables, poorer naming was significantly related to larger ventricles (P = 0.033) and greater global (P = 0.033) and periventricular (P = 0.049) WMH. High global WMH (P = 0.034) were also correlated with worse sentence repetition skills. CONCLUSION: Visual ratings of global brain health were associated with language deficits in PPA independent of cortical atrophy and age. While WMH are not unique to PPA, measuring WMH in conjunction with cortical atrophy may elucidate more accurate brain structure-behavior relationships in PPA than cortical atrophy measures alone.


Asunto(s)
Afasia Progresiva Primaria/patología , Encéfalo/patología , Lenguaje , Pruebas Neuropsicológicas/normas , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sustancia Blanca/patología
8.
Cogn Behav Neurol ; 33(3): 201-207, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32889952

RESUMEN

BACKGROUND: Subjective cognitive decline (SCD) has been called the prodromal stage of amnestic mild cognitive impairment (aMCI); however, further investigation is needed to confirm this observation. OBJECTIVE: To define the relationship between SCD and aMCI. METHOD: In this case-control study, we used the feeling-of-knowing in episodic memory (FOK-EM) test to measure the memory-monitoring function of 40 adults with aMCI, 60 with SCD, and 55 healthy controls. RESULTS: The recognition rates of FOK-EM (53.53% ± 7.82%; 55.12% ± 6.08%) and judgment accuracy of the aMCI and SCD groups (γ values 0.21 ± 0.11; 0.30 ± 0.16) were significantly lower than those of the control group (72.32% ± 5.14%; 0.57 ± 0.16) (F = 116.24, P < 0.01; F = 128.57, P < 0.01; F = 73.33, P < 0.01). The scores for correct decision/correct recognition (RR; 27.2 ± 6.43; 29.36 ± 5.16) and correct decision/false recognition (RF; 30.41 ± 5.06; 27.26 ± 4.37) of the aMCI and SCD groups were also significantly lower than those of the control group (49.35 ± 7.13; 11.16 ± 4.35) (FRR = 132.67, P < 0.01; FRF = 131.8, P < 0.01). CONCLUSION: Mild clinical impairments in memory-monitoring function may precede clinically confirmed objective memory impairment in individuals with SCD.


Asunto(s)
Disfunción Cognitiva/complicaciones , Trastornos de la Memoria/etiología , Pruebas Neuropsicológicas/normas , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad
9.
Cogn Behav Neurol ; 33(3): 208-217, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32889953

RESUMEN

BACKGROUND: Traumatic brain injury (TBI) is a known risk factor for neurodegenerative dementias such as Alzheimer disease (AD); however, the potential risk of mild cases of TBI, such as concussions, remains unclear. OBJECTIVE: To explore whether a small sample of retired professional athletes with a diagnosis of mild cognitive impairment (MCI)-the prodromal stage of AD-and a history of multiple mild TBIs exhibit greater neuropsychological impairment than age-matched nonathletes with MCI and no history of TBI. METHOD: Ten retired National Football League players diagnosed with MCI and reporting multiple mild TBIs, and 10 nonathletes, also diagnosed with MCI but with no history of TBI, completed a standard neurologic examination and neuropsychological testing. Independent samples t tests were conducted to examine differences in neuropsychological performance between the two groups. RESULTS: The retired athletes with a history of mild TBI obtained generally similar scores to the nonathlete controls on measures of verbal learning and memory, verbal fluency, and processing speed. However, the retired athletes scored lower than the controls on tests of confrontation naming and speeded visual attention. CONCLUSION: Retired athletes with MCI and a history of mild TBI demonstrated similar neuropsychological profiles as nonathlete controls despite lower scores on measures of confrontation naming and speeded visual attention. These findings suggest that a history of multiple mild TBIs does not significantly alter the overall neuropsychological profile of individuals with MCI; confirmation of this will require longitudinal research with larger sample sizes.


Asunto(s)
Conmoción Encefálica/complicaciones , Lesiones Traumáticas del Encéfalo/complicaciones , Disfunción Cognitiva/etiología , Fútbol Americano/lesiones , Pruebas Neuropsicológicas/normas , Jubilación/psicología , Anciano , Anciano de 80 o más Años , Atletas/psicología , Femenino , Fútbol Americano/psicología , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto
10.
Cogn Behav Neurol ; 33(3): 218-225, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32889954

RESUMEN

BACKGROUND: Individuals with diabetes can develop cognitive impairment due to dysfunction of glucose metabolism; however, it remains unclear whether cognition becomes altered in the prediabetic stage. Substantial evidence links cognitive impairment in diabetes to aberrant serum insulin-degrading enzyme (s[IDE]) levels. This relationship remains to be investigated in individuals with prediabetes. OBJECTIVE: To investigate the relationship between cognitive function and s[IDE] levels in individuals with prediabetes. METHOD: The study group consisted of 47 individuals who had been diagnosed with prediabetes and 41 healthy controls. Cognitive functions were evaluated using the Montreal Cognitive Assessment (MoCA), and s[IDE] levels were measured using enzyme-linked immunosorbent assay. RESULTS: The MoCA total scores and s[IDE] levels of the individuals with prediabetes were significantly lower (P = 0.001, 0.006) than those of the controls, and the MoCA Attention measure of the individuals with prediabetes was also very low (P = 0.001). To determine cognitive impairment, we divided the prediabetics into two subgroups according to the MoCA cutoff value. Scores on all of the MoCA tests were significantly lower in the group with mild cognitive impairment (P < 0.05). There was no correlation between MoCA scores and s[IDE] levels (P > 0.05), but serum-fasting glucose levels showed a negative correlation with MoCA scores (P < 0.05, ρ = -0.287). CONCLUSION: Evidence of mild cognitive impairment was high in the individuals with prediabetes and showed a negative correlation with serum-fasting glucose levels but not with s[IDE] levels.


Asunto(s)
Cognición/fisiología , Insulisina/efectos adversos , Pruebas Neuropsicológicas/normas , Estado Prediabético/complicaciones , Adulto , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
11.
PLoS One ; 15(8): e0237038, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32776953

RESUMEN

BACKGROUND: We conducted three studies to validate the Polish version of the BRS. Our objectives are as follows: first, to explore the dimensional structure of the scale and to determine the internal consistency (study 1: n = 1022); second, to determine the congruent and divergent validity of the BRS (study 2: n = 242); and third, to examine sensitivity of the BRS scale to detect high-risk population (study 3: n = 602). METHODS: To explore the dimensional structure of the scale, we tested a two-factor model with one factor for positively worded items and one factor for negatively worded items. To determine the congruent and divergent validity of the BRS, we analysed correlations among BRS and resilience, positive mental health, and with positive and negative religious coping. We used Student's t-test to examine sensitivity of the BRS scale to detect a high-risk population. RESULTS: Based on the CFA, a bivariate model was confirmed for items positively and negatively formulated with a higher order factor, which indicates the homogeneity of the scale, similar to the analyses carried out for their language versions confirming this type of homogeneity of the scale. The internal compatibility assessment based on Cronbach's Alpha and McDonald's Omega is good (0.88). Our analyses intended to test convergent and divergent validity, and showed that the BRS results are significantly related to a questionnaire measuring similar constructions. Our validation studies also provided important diagnoses regarding BRS "sensitivity", indicating that groups with higher stress levels achieved lower BRS resilience results. CONCLUSION: The results of our research indicate that the Polish version of the BRS should be considered to be a reliable and valid research tool. The Polish version of BRS is a reliable and accurate way of measuring resilience as the ability to bounce back from adversity and overcome various challenges or stressors. This scale may be used for both research and intervention purposes.


Asunto(s)
Pruebas Neuropsicológicas/normas , Psicometría/métodos , Adaptación Psicológica/fisiología , Adulto , Análisis Factorial , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Polonia , Psicometría/normas , Reproducibilidad de los Resultados , Resiliencia Psicológica , Encuestas y Cuestionarios
12.
Clin Neuropsychol ; 34(7-8): 1411-1452, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32519594

RESUMEN

Objective: Due to the recent COVID-19 pandemic, the field of neuropsychology must rapidly evolve to incorporate assessments delivered via telehealth, or teleneuropsychology (TNP). Given the increasing demand to deliver services electronically due to public health concerns, it is important to review available TNP validity studies. This systematic review builds upon the work of Brearly and colleagues' (2017) meta-analysis and provides an updated review of the literature, with special emphasis on test-level validity data.Method: Using similar methodology as Brearly and colleagues (2017) three internet databases (PubMed, EBSCOhost, PsycINFO) were searched for relevant articles published since 2016. Studies with older adults (aged 65+) who underwent face-to-face and TNP assessments in a counterbalanced cross-over design were included. After review, 10 articles were retained. Combined with nine articles from Brearly's analysis, a total of 19 studies were included in the systematic review.Results: Retained studies included samples from 5 different countries, various ethnic/cultural backgrounds, and diverse diagnostic populations. Test-level analysis suggests there are cognitive screeners (MMSE, MoCA), language tests (BNT, Letter Fluency), attention/working memory tasks (Digit Span Total), and memory tests (HVLT-R) with strong support for TNP validity. Other measures are promising but lack sufficient support at this time. Few TNP studies have done in-home assessments and most studies rely on a PC or laptop.Conclusions: Overall, there appears to be good support for TNP assessments in older adults. Challenges to TNP in the current climate are discussed. Finally, a provisional outline of viable TNP procedures used in our clinic is provided.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Pruebas Neuropsicológicas/normas , Neuropsicología/normas , Neumonía Viral/terapia , Telemedicina/normas , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/epidemiología , Bases de Datos Factuales/normas , Femenino , Humanos , Masculino , Neuropsicología/métodos , Pandemias , Neumonía Viral/epidemiología , Reproducibilidad de los Resultados , Telemedicina/métodos
13.
Cogn Behav Neurol ; 33(2): 77-89, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32496293

RESUMEN

Functional neurological (conversion) disorder (FND) is a neuropsychiatric condition characterized by sensorimotor symptoms exhibiting features incompatible with other neurologic diseases. Individuals with motor FND (mFND) typically present with limb weakness, nonepileptic seizures, and/or abnormal movements. However, this population also frequently reports clouded thinking, inattention, and memory difficulties. Cognitive complaints in individuals with mFND are important to evaluate as they may negatively impact quality of life and impede treatment engagement. We provide a narrative review of the neuropsychological testing literature detailing neurocognitive profiles of individuals with mFND. We also present three illustrative clinical cases at the intersection of mFND and cognitive concerns. Several studies and our case examples highlight that generally normal cognitive performance can be observed concurrently with subjective cognitive complaints in some individuals with mFND; this mismatch may be a possible "rule-in" sign of functional cognitive symptoms. Other studies have reported impairments in attention, memory, language, visuospatial, and executive functioning in individuals with mFND. These impairments could be related to medical-psychiatric comorbidities, psychotropic medication side effects, and intrinsic disease mechanisms. When evaluating individuals with mFND and their cognitive complaints, clinicians can use performance validity test and psychopathology findings to help them interpret the neuropsychological test results. Perceptual mismatches between intact objective cognitive performance and subjective cognitive complaints may reflect a negative attentional bias for cognitive abilities that can be targeted with cognitive retraining and cognitive behavioral therapy. Neuropsychological evaluations may provide a useful adjunctive tool clinicians can use to help assess individuals with mFND and cognitive concerns.


Asunto(s)
Trastornos del Conocimiento/diagnóstico , Trastornos de Conversión/diagnóstico , Pruebas Neuropsicológicas/normas , Calidad de Vida/psicología , Adulto , Trastornos de Conversión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad
14.
Cogn Behav Neurol ; 33(2): 103-112, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32496295

RESUMEN

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.


Asunto(s)
Trastorno Bipolar/complicaciones , Trastorno Bipolar/psicología , Disfunción Cognitiva/etiología , Pruebas Neuropsicológicas/normas , Adolescente , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
15.
Cogn Behav Neurol ; 33(2): 122-128, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32496297

RESUMEN

BACKGROUND: Semantic dementia (SD) is characterized by progressive semantic anomia extending to a multimodal loss of semantic knowledge. Although often considered an early-onset dementia, SD also occurs in later life, when it may be misdiagnosed as Alzheimer disease (AD). OBJECTIVE: To evaluate late-onset SD in comparison to early-onset SD and to AD. METHODS: We identified 74 individuals with SD and then compared those with late-onset SD (≥65 years of age) to those with early-onset SD (<65) on demographic and clinical features. We also compared a subgroup of 23 of the late-onset SD individuals with an equal number of individuals with clinically probable AD. RESULTS: Twenty-six (35.1%) of the SD individuals were late onset, and 48 (64.9%) were early onset. There were no differences between the two groups on clinical measures, although greater asymmetry of temporal involvement trended to significance in the late-onset SD group. Compared to the 23 AD individuals, the subgroup of 23 late-onset SD individuals had worse performance on confrontational naming, irregular word reading, and face recognition; however, this subgroup displayed better verbal delayed recall and constructions. The late-onset SD individuals also experienced early personality changes at a time when most individuals with AD had not yet developed behavioral changes. CONCLUSIONS: Approximately one-third of SD individuals may be late onset, and the differentiation of late-onset SD from AD can lead to better disease management, education, and prognosis. SD may be distinguished by screening for disproportionate changes in reading, face recognition, and personality.


Asunto(s)
Demencia Frontotemporal/diagnóstico , Pruebas Neuropsicológicas/normas , Semántica , Anciano , Femenino , Demencia Frontotemporal/patología , Humanos , Masculino , Estudios Retrospectivos
16.
Neurología (Barc., Ed. impr.) ; 35(5): 303-310, jun. 2020. tab
Artículo en Español | IBECS | ID: ibc-197538

RESUMEN

INTRODUCCIÓN: Repeatable Battery for the Asessment of Neuropsychological Status (RBANS) es utilizada habitualmente en la práctica clínica para la evaluación de funciones cognitivas. Se caracteriza por su corta duración, 20-30 minutos de administración, por la ausencia de efecto aprendizaje, dispone de 4 versiones paralelas y por su capacidad discriminativa de diferentes enfermedades. Se presentan datos normativos de la RBANS-E (versión española forma A de la batería) para población española de 20-89 años. MÉTODOS: Seiscientos nueve individuos accedieron a participar. Se les sometió a una valoración previa mediante anamnesis que incluía el Mini Mental State Examination como instrumento de cribado cognitivo y la Blessed Disability Rating Scale como escala funcional. A los 609 sujetos sanos de entre 20 y 89 años de edad se les administró la batería RBANS-E en una sola sesión. RESULTADOS: Los resultados muestran la influencia de la escolaridad en las puntuaciones de todos los subtest. No se observa influencia del género en ninguno de ellos. CONCLUSIONES: Las normas obtenidas aportan datos de gran utilidad clínica para la evaluación cognitiva de población joven y adulta


INTRODUCTION: The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is frequently used in clinical practice to evaluate cognitive function. It is quick to administer (20-30 minutes) and is not influenced by a learning effect. The RBANS includes 4 parallel versions and has a high discriminative ability. Our study provides normative data from the RBANS-E (Spanish-language version of RBANS form A) for a Spanish population aged 20 to 89 years. METHODS: The study included 609 subjects aged 20 to 89 years. Participants were evaluated at baseline with a short interview, a cognitive screening test (Mini-Mental State Examination), and a functional scale (Rapid Disability Rating Scale). The RBANS-E was then administered to all 609 participants. RESULTS: Our results show the influence of education on all subtest scores. Sex was observed to have no impact on any subtest. CONCLUSION: Our study provides highly useful normative data for the cognitive evaluation of young and adult populations


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Cognición , Pruebas Neuropsicológicas/normas , Traducción , Pruebas de Estado Mental y Demencia , Psicometría , España
17.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(3): 137-146, mayo-jun. 2020. tab
Artículo en Español | IBECS | ID: ibc-196161

RESUMEN

INTRODUCCIÓN: La evaluación neuropsicológica es esencial para identificar los cambios cognitivos que ocurren durante el envejecimiento normal y patológico. Sin embargo, es necesario contar con baremos adaptados a las características del funcionamiento cognitivo de la población diana para reducir la posibilidad de falsos diagnósticos de alteración cognitiva. El objetivo de este trabajo es proporcionar baremos normativos basados en una muestra de personas mayores cognitivamente activas que participan en un programa universitario para personas mayores. MATERIALES Y MÉTODOS: Se analizaron datos de 87 participantes (70,9% mujeres) de 66,73 años de edad media, emparejados por edad y nivel educativo, a quienes se aplicó el test de Barcelona revisado-abreviado. Los datos normativos se calcularon mediante regresión lineal controlando la edad, el sexo y los años de escolaridad. Se analizó la utilidad de estos datos normativos en comparación con los baremos disponibles en el manual del test y obtenidos en la población general. RESULTADOS: La variable con mayor peso en la regresión fueron los años de escolaridad, seguida de la edad y el sexo. Los baremos obtenidos en la muestra de personas cognitivamente activas mostraron un número de puntuaciones bajas diferente al de los datos normativos de la población general. El número de puntuaciones bajas difirió en función de los años de escolaridad y del funcionamiento cognitivo general. CONCLUSIONES: Los datos normativos obtenidos con la población mayor cognitivamente activa podrían ayudar a identificar el funcionamiento cognitivo real de personas mayores cognitivamente activas con mayor precisión que utilizando los baremos establecidos con la población general


INTRODUCTION: Neuropsychological assessment is mandatory in order to identify cognitive changes that occur during either normal or pathological aging. However, normative data adapted to the characteristics of the population are needed in order to reduce the probability of false diagnoses of cognitive impairment. The aim of the present work was to compute normative data for cognitively active elderly people attending a University course for the elderly. MATERIALS AND METHODS: An analysis was performed on the data from 87 participants (70.9% women) with a mean age of 66.73 years who undertook the abbreviated- revised Barcelona test (test de Barcelona revisado-abreviado). Normative data were calculated using linear regressions controlling for age, gender, and years of education. Adjusted normative data were compared with normative data available from the test manual and obtained from the general population. RESULTS: Years of education and gender showed the highest weights in the regression model. Normative data for cognitively active older adults showed a different number of low scores compared to normative data from the general population. The number of low scores were related to years of education and general cognitive functioning. CONCLUSIONS: Normative data obtained from cognitively active older people could help identify more accurately the cognitive functioning of cognitively active older people than do normative data obtained from the general population


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Envejecimiento , Pruebas Neuropsicológicas/normas , Cognición/fisiología , Envejecimiento Cognitivo/fisiología , Pruebas Neuropsicológicas/estadística & datos numéricos , Escolaridad
18.
J Med Internet Res ; 22(5): e14617, 2020 05 07.
Artículo en Inglés | MEDLINE | ID: mdl-32379048

RESUMEN

BACKGROUND: Apolipoprotein E (APOE) ε4 allele is a major genetic risk factor for Alzheimer disease and mild cognitive impairment (MCI). Computer-based training programs can improve cognitive performance in elderly populations. However, the effects of computer-based interventions on MCI APOE ε4 carriers have never been studied before. OBJECTIVE: The effects of different web-based interventions and the APOE isoform-specific differences in training outcomes are investigated. METHODS: Using a quasi-experimental study design, 202 participants with MCI aged 60 years and older took part in three different intervention programs (physical and cognitive [Long-Lasting Memories, or LLM], cognitive [Active Control, or AC], or physical intervention [Physical Training Control, or PTC]) via an innovative information and communication technologies exergaming platform. Participants in each interventional group were subdivided into APOE ε4 carriers and non-APOE ε4 carriers. All participants underwent an extensive neuropsychological evaluation before and after the training, blood tests, and brain imaging. RESULTS: All interventions resulted in multiple statistically significant cognitive benefits after the intervention. Verbal learning (California Verbal Learning Test: immediate recall test score-LLM: P=.04; AC: P<.001), working memory (digit span forward and backward test scores-AC: P=.03; PTC: P=.02 and P=.006, respectively), and long-term memory (California Verbal Learning Test: delayed recall test score-LLM: P=.02; AC: P=.002; and PTC: P=.02) were improved. There was no statistically significant difference among the intervention effects. APOE ε4 presence moderates intervention effects as the LLM intervention improved only their task-switching processing speed (Trail Making Test, Part B: P=.03) and the PTC intervention improved only the working memory (digit span backward: P=.03). No significant performance alteration was noted for the APOE ε4+ cognitive AC training group. CONCLUSIONS: None of the applied interventions could be identified as the optimal one; it is suggested, however, that combined cognitive and physical training and physical training via exergaming may be more effective for the high-risk MCI ΑPOE ε4+ subgroup.


Asunto(s)
Apolipoproteínas E/genética , Disfunción Cognitiva/terapia , Intervención basada en la Internet/estadística & datos numéricos , Pruebas Neuropsicológicas/normas , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados no Aleatorios como Asunto , Factores de Riesgo
19.
Dev Neuropsychol ; 45(3): 95-109, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32374196

RESUMEN

Convergent validation of a verbal incidental learning (IL) task from the WAIS-IV using neuroimaging biomarkers is warranted to understand its sensitivity to Alzheimer's disease (AD) pathology. Fifty-five memory clinic patients aged 59 to 87 years received neuropsychological assessment, and measures of IL and quantitative brain imaging. Worse IL-Total Score and IL-Similarities performances were significantly associated with smaller hemispheric hippocampal volumes. IL measures were not significantly correlated with cerebral ß-amyloid burden, though a trend was present and effect sizes were mild. These hippocampal volume results suggest that this IL task may be sensitive to AD pathology along the AD continuum.


Asunto(s)
Enfermedad de Alzheimer/psicología , Biomarcadores/metabolismo , Neuroimagen/métodos , Pruebas Neuropsicológicas/normas , Aprendizaje Verbal/fisiología , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad
20.
Adv Exp Med Biol ; 1194: 285-291, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32468544

RESUMEN

BACKGROUND: Cognitive assessment is an essential element of the screening process of Alzheimer's disease. The prevalence of dementia is increasing and so are the numbers of immigrants and elderly population relocating and in need for health diagnosis and treatment. However, most of the psychometric tools used in psychological assessments are time-consuming and suffer from biases of language and cultural restrictions. OBJECTIVES: Our objective was to create a computerized version of a multicultural cognitive screening test, which would simplify cognitive assessment of elderly multicultural population, as routine part of health check-up procedures. METHODS: The application was implemented in Android Studio and was written in Java code with the use of a home PC and a tablet. Rowland Universal Dementia Assessment Scale (RUDAS) was chosen. RUDAS is a cognitive screening tool with good psychological characteristics, which was created for multicultural and bilingual populations and was free to download. The collaboration with an authorized psychologist was essential for the ethics of the psychometric science. RESULTS: The complete computerized version of RUDAS will include the six-item questionnaire, assessing specific cognitive domains which are in high correlation with Alzheimer's screening process, such as registration, visuospatial orientation, praxis, visuo-constructional drawing, judgment, memory recall and language. CONCLUSION: The utilization of informatics in making cognitive assessment a user-friendly, validated, not time- or cost-consuming procedure would add value to psychometric tools which still are administered with "pen and paper", when this proceeds with respect to the ethics of the science.


Asunto(s)
Cognición , Demencia , Pruebas Neuropsicológicas , Programas Informáticos , Anciano , Enfermedad de Alzheimer/diagnóstico , Cognición/clasificación , Diversidad Cultural , Demencia/diagnóstico , Humanos , Pruebas Neuropsicológicas/normas , Psicometría/normas , Psicometría/tendencias , Programas Informáticos/normas , Encuestas y Cuestionarios
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