BACKGROUND: Cognitive performance is not easily predicted, since different variables play an important role in the manifestation of age-related declines. The objective of this study is to analyze the predictors of cognitive performance in a Spanish sample over 50 years from a multidimensional perspective, including socioeconomic, affective, and physical variables. Some of them are well-known predictors of cognition and others are emergent variables in the study of cognition. METHODS: The total sample, drawn from the "Longitudinal Study Aging in Spain (ELES)" project, consisted of 832 individuals without signs of cognitive impairment. Cognitive function was measured with tests evaluating episodic and working memory, visuomotor speed, fluency, and naming. Thirteen independent variables were selected as predictors belonging to socioeconomic, emotional, and physical execution areas. Multiple linear regressions, following the enter method, were calculated for each age group in order to study the influence of these variables in cognitive performance. RESULTS: Education is the variable which best predicts cognitive performance in the 50-59, 60-69, and 70-79 years old groups. In the 80+ group, the best predictor is objective economic status and education does not enter in the model. CONCLUSIONS: Age-related decline can be modified by the influence of educational and socioeconomic variables. In this context, it is relevant to take into account how easy is to modify certain variables, compared to others which depend on each person's life course.
Aging/psychology , Cognition , Emotions , Memory, Short-Term , Aged , Aged, 80 and over , Cross-Sectional Studies , Educational Status , Female , Humans , Independent Living , Linear Models , Longitudinal Studies , Male , Memory, Episodic , Middle Aged , Psychological Tests , Socioeconomic Factors , Spain
Introducción. La evaluación cognitiva de pacientes con demencias avanzadas es una necesidad no cubierta de forma adecuada, por lo que es necesario desarrollar herramientas que permitan obtener información del estado cognitivo y los recursos con los que aún cuentan estos sujetos. El presente trabajo realiza el estudio de validación al castellano de la escala Severe Mini-Mental State Examination (SMMSE). Material y métodos. Participaron 47 sujetos con demencia avanzada (Mini-Examen Cognoscitivo [MEC] < 11), evaluados con las escalas Global Deterioration Scale de Reisberg, MEC, SMMSE y Severe Cognitive Impairment Profile. Resultados. Todos los ítems que componen la prueba mostraron una buena capacidad de diferenciación. La prueba mostró una alta consistencia interna (α=0,88), y buena fiabilidad test-retest (0,64-1,00; p<0,01) e interjueces (0,69-1,00; p<0,01), tanto para la puntuación total como para cada uno de los ítems. La validez de constructo se analizó mediante la correlación con el MEC (r=0,59; p<0,01). Además, se dividió la muestra entre sujetos con MEC 0-5 y MEC>5, hallando que la correlación entre las puntuaciones en SMMSE y MEC era significativa en el grupo de MEC 0-5 (r=0,55; p<0,05), mientras que no lo era en aquellos con MEC>5. Asimismo se encontraron diferencias de puntuación en SMMSE, pero no en MEC, entre los tres grupos de GDS (5, 6 y 7) (H=11,1; p<0,05). Conclusiones. El SMMSE es un instrumento de evaluación del deterioro cognitivo avanzado que amplía el rango inferior de medida del MEC evitando el «efecto suelo». A partir de nuestros resultados el instrumento puede ser considerado válido y fiable, así como rápido y fácil de administrar(AU)
Introduction. The cognitive assessment of patients with advanced dementia needs proper screening instruments that allow obtain information about the cognitive state and resources that these individuals still have. The present work conducts a Spanish validation study of the Severe Mini Mental State Examination (SMMSE). Material and methods. Forty-seven patients with advanced dementia (Mini-Cognitive Examination [MEC]<11) were evaluated with the Reisberg's Global Deterioration Scale, MEC, SMMSE and Severe Cognitive Impairment Profile scales. Results. All test items were discriminative. The test showed high internal (α=0.88), test-retest (0.64 to 1.00, P<.01) and between observers reliabilities (0.69-1.00, p<0.01), both for scores total and for each item separately. Construct validity was tested through correlations between the instrument and MEC scores (r=0.59, P< 0 .01). Further information on the construct validity was obtained by dividing the sample into groups that scored above or below 5 points in the MEC and recalculating their correlations with SMMSE. The correlation between the scores in the SMMSE and MEC was significant in the MEC 0-5 group (r=0.55, P<.05), but not in the MEC>5 group. Additionally, differences in scores were found in the SMMSE, but not in the MEC, between the three GDS groups (5, 6 and 7) (H=11.1, P<.05). Conclusions. The SMMSE is an instrument for the assessment of advanced cognitive impairment which prevents the floor effect through an extension of lower measurement range relative to that of the MEC. From our results, this rapid screening tool and easy to administer, can be considered valid and reliable(AU)
Humans , Male , Female , Aged , Aged, 80 and over , Brief Psychiatric Rating Scale/statistics & numerical data , Brief Psychiatric Rating Scale/standards , Alzheimer Disease/diagnosis , Alzheimer Disease/therapy , Dementia/diagnosis , Dementia/therapy , Neurobehavioral Manifestations/physiology , Neurocognitive Disorders/diagnosis
INTRODUCTION: The cognitive assessment of patients with advanced dementia needs proper screening instruments that allow obtain information about the cognitive state and resources that these individuals still have. The present work conducts a Spanish validation study of the Severe Mini Mental State Examination (SMMSE). MATERIAL AND METHODS: Forty-seven patients with advanced dementia (Mini-Cognitive Examination [MEC]<11) were evaluated with the Reisberg's Global Deterioration Scale, MEC, SMMSE and Severe Cognitive Impairment Profile scales. RESULTS: All test items were discriminative. The test showed high internal (α=0.88), test-retest (0.64 to 1.00, P<.01) and between observers reliabilities (0.69-1.00, p<0.01), both for scores total and for each item separately. Construct validity was tested through correlations between the instrument and MEC scores (r=0.59, P<0.01). Further information on the construct validity was obtained by dividing the sample into groups that scored above or below 5 points in the MEC and recalculating their correlations with SMMSE. The correlation between the scores in the SMMSE and MEC was significant in the MEC 0-5 group (r=0.55, P<.05), but not in the MEC>5 group. Additionally, differences in scores were found in the SMMSE, but not in the MEC, between the three GDS groups (5, 6 and 7) (H=11.1, P<.05). CONCLUSIONS: The SMMSE is an instrument for the assessment of advanced cognitive impairment which prevents the floor effect through an extension of lower measurement range relative to that of the MEC. From our results, this rapid screening tool and easy to administer, can be considered valid and reliable.
Cognition , Dementia/psychology , Mental Status Schedule , Aged , Aged, 80 and over , Disease Progression , Female , Humans , Language , Male , Severity of Illness Index
