Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.

<h4>Background and objectives</h4>The neuropsychological exam plays a central role in the assessment of elderly patients with cognitive complaints. It is particularly relevant to differentiate patients with mild dementia from those subjects with mild cognitive impairment. Formal educatio...

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Autores principales:	Jonas Jardim de Paula, Laiss Bertola, Rafaela Teixeira Ávila, Lafaiete Moreira, Gabriel Coutinho, Edgar Nunes de Moraes, Maria Aparecida Camargos Bicalho, Rodrigo Nicolato, Breno Satler Diniz, Leandro Fernandes Malloy-Diniz
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f689b04b116245d5bfdfd23bdf6acbcd
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spelling	oai:doaj.org-article:f689b04b116245d5bfdfd23bdf6acbcd2021-11-18T08:55:14ZClinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.1932-620310.1371/journal.pone.0073167https://doaj.org/article/f689b04b116245d5bfdfd23bdf6acbcd2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24066031/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and objectives</h4>The neuropsychological exam plays a central role in the assessment of elderly patients with cognitive complaints. It is particularly relevant to differentiate patients with mild dementia from those subjects with mild cognitive impairment. Formal education is a critical factor in neuropsychological performance; however, there are few studies that evaluated the psychometric properties, especially criterion related validity, neuropsychological tests for patients with low formal education. The present study aims to investigate the validity of an unstructured neuropsychological assessment protocol for this population and develop cutoff values for clinical use.<h4>Methods and results</h4>A protocol composed by the Rey-Auditory Verbal Learning Test, Frontal Assessment Battery, Category and Letter Fluency, Stick Design Test, Clock Drawing Test, Digit Span, Token Test and TN-LIN was administered to 274 older adults (96 normal aging, 85 mild cognitive impairment and 93 mild Alzheimer`s disease) with predominantly low formal education. Factor analysis showed a four factor structure related to Executive Functions, Language/Semantic Memory, Episodic Memory and Visuospatial Abilities, accounting for 65% of explained variance. Most of the tests showed a good sensitivity and specificity to differentiate the diagnostic groups. The neuropsychological protocol showed a significant ecological validity as 3 of the cognitive factors explained 31% of the variance on Instrumental Activities of Daily Living.<h4>Conclusion</h4>The study presents evidence of the construct, criteria and ecological validity for this protocol. The neuropsychological tests and the proposed cutoff values might be used for the clinical assessment of older adults with low formal education.Jonas Jardim de PaulaLaiss BertolaRafaela Teixeira ÁvilaLafaiete MoreiraGabriel CoutinhoEdgar Nunes de MoraesMaria Aparecida Camargos BicalhoRodrigo NicolatoBreno Satler DinizLeandro Fernandes Malloy-DinizPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 9, p e73167 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jonas Jardim de Paula Laiss Bertola Rafaela Teixeira Ávila Lafaiete Moreira Gabriel Coutinho Edgar Nunes de Moraes Maria Aparecida Camargos Bicalho Rodrigo Nicolato Breno Satler Diniz Leandro Fernandes Malloy-Diniz Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.
description	<h4>Background and objectives</h4>The neuropsychological exam plays a central role in the assessment of elderly patients with cognitive complaints. It is particularly relevant to differentiate patients with mild dementia from those subjects with mild cognitive impairment. Formal education is a critical factor in neuropsychological performance; however, there are few studies that evaluated the psychometric properties, especially criterion related validity, neuropsychological tests for patients with low formal education. The present study aims to investigate the validity of an unstructured neuropsychological assessment protocol for this population and develop cutoff values for clinical use.<h4>Methods and results</h4>A protocol composed by the Rey-Auditory Verbal Learning Test, Frontal Assessment Battery, Category and Letter Fluency, Stick Design Test, Clock Drawing Test, Digit Span, Token Test and TN-LIN was administered to 274 older adults (96 normal aging, 85 mild cognitive impairment and 93 mild Alzheimer`s disease) with predominantly low formal education. Factor analysis showed a four factor structure related to Executive Functions, Language/Semantic Memory, Episodic Memory and Visuospatial Abilities, accounting for 65% of explained variance. Most of the tests showed a good sensitivity and specificity to differentiate the diagnostic groups. The neuropsychological protocol showed a significant ecological validity as 3 of the cognitive factors explained 31% of the variance on Instrumental Activities of Daily Living.<h4>Conclusion</h4>The study presents evidence of the construct, criteria and ecological validity for this protocol. The neuropsychological tests and the proposed cutoff values might be used for the clinical assessment of older adults with low formal education.
format	article
author	Jonas Jardim de Paula Laiss Bertola Rafaela Teixeira Ávila Lafaiete Moreira Gabriel Coutinho Edgar Nunes de Moraes Maria Aparecida Camargos Bicalho Rodrigo Nicolato Breno Satler Diniz Leandro Fernandes Malloy-Diniz
author_facet	Jonas Jardim de Paula Laiss Bertola Rafaela Teixeira Ávila Lafaiete Moreira Gabriel Coutinho Edgar Nunes de Moraes Maria Aparecida Camargos Bicalho Rodrigo Nicolato Breno Satler Diniz Leandro Fernandes Malloy-Diniz
author_sort	Jonas Jardim de Paula
title	Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.
title_short	Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.
title_full	Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.
title_fullStr	Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.
title_full_unstemmed	Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.
title_sort	clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/f689b04b116245d5bfdfd23bdf6acbcd
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Clinical applicability and cutoff values for an unstructured neuropsychological assessment protocol for older adults with low formal education.

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