Bertola Laiss, Benseñor Isabela M, Goulart Alessandra C, Brunoni Andre R, Caramelli Paulo, Barreto Sandhi Maria, Giatti Luana, Salvador Larissa, Griep Rosane Harter, Moreno Arlinda B, Lotufo Paulo A, Suemoto Claudia K
University of São Paulo Medical School, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP01246-903, Brazil.
Epidemiological and Clinical Research Center, University Hospital, University of São Paulo, São Paulo, SP01246-903, Brazil.
J Int Neuropsychol Soc. 2021 Mar;27(3):293-303. doi: 10.1017/S1355617720000880. Epub 2020 Oct 14.
Normative data should consider sociodemographic diversity for the accurate diagnosis of cognitive impairment. This study aims to provide normative data for a brief neuropsychological battery and present diagnostic criteria for cognitive impairment that could be used in primary care settings.
We selected 9618 Brazilian middle-aged and older adults after detailed exclusion criteria to avoid subtle cognitive impairment. We analyzed age, sex, and education influence on cognitive performance. To verify the evidence of criterion validity, we compared the cognitive performance of subjects with and without a depressive episode. Additionally, we verified the percentage of spurious scores under three different cutoffs.
Age and education had the greatest impact on cognition. Normative scores were provided according to age and education groups. Participants with a depressive episode performed poorer than control subjects. The clinical cutoff of at least two scores below the 7th percentile revealed the adequate percentage of spurious and possible clinical performance.
The Longitudinal Study on Adult Health (ELSA-Brasil) provided normative data based on a unique selected set of cognitively normal subjects. Normative groups were selected based on age and education, and the battery was sensitive to the presence of a depressive episode. We suggested clinical cutoffs for the tests in this battery that could be used in primary care settings to improve the accurate diagnosis of cognitive impairment.
为准确诊断认知障碍,规范数据应考虑社会人口学多样性。本研究旨在提供一套简短神经心理测验的规范数据,并提出可用于初级保健机构的认知障碍诊断标准。
我们在详细的排除标准后选取了9618名巴西中老年人,以避免轻微认知障碍。我们分析了年龄、性别和教育程度对认知表现的影响。为验证效标效度的证据,我们比较了有和没有抑郁发作的受试者的认知表现。此外,我们在三种不同的临界值下验证了虚假分数的百分比。
年龄和教育程度对认知的影响最大。根据年龄和教育程度组提供了规范分数。有抑郁发作的参与者表现比对照组差。至少两个分数低于第7百分位数的临床临界值显示了虚假分数和可能的临床表现的适当百分比。
成人健康纵向研究(ELSA-Brasil)基于一组独特的认知正常受试者提供了规范数据。根据年龄和教育程度选择了规范组,并且该测验对抑郁发作的存在敏感。我们建议了该测验在初级保健机构中可用于改善认知障碍准确诊断的临床临界值。