Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_RS |
Texto Completo: | http://tede2.pucrs.br/tede2/handle/tede/7226 |
Resumo: | Neurodegenerative disorders, such as Alzheimer's disease (AD), have a prevalence increasing considerably. It is the only clinical cases that include among the diagnostic procedures the neuropsychological evaluation as mandatory to confirm cognitive and / or functional decline in these individuals. The evaluation of the functionality can be performed directly (eg, Direct Assessment of Functional Status - Revised (DAFS-R)) or indirect (eg, Activities of Daily Living Questionnaire (ADL-Q)). The present master's thesis consists of two studies: (1) aiming at comparing functional performance through direct versus indirect evaluation, and comparing the accuracy of functional performance between groups; And (2) in order to investigate the relationship between the cognitive domains (mnemonic, linguistic, attentional and executive) and direct functionality, as well as whether and how different cognitive domains predict functional performance. The initial sample consisted of 123 individuals, after examining the exclusion criteria. The sample of both studies was divided into 90 elderly adults, divided into three groups: n = 27 controls, n = 35 patients with mild cognitive impairment (MCI) = 28 With mild AD. In the study (1) the direct (DAFS-R) and indirect (ADL-Q) evaluations were used and in (2) the instruments used were: Rey Auditory-Verbal Learning Test; Brief Neuropsychological Assessment Instrument (prospective memory, semantic memory, sentence span of words in sentences, inverse count); Wechsler intelligence scale for adults (digits, sequence of numbers and letters, codes and look for symbols); Hayling test; Track test; Montreal-Toulouse Battery for Language Assessment (listening and speaking); Montreal Assessment of Communication Battery (free verbal, semantic and phonological fluency) and DAFS-R. The Statistical Package for Social Sciences version 20.0 was used for the analyzes. In the study (1), MANCOVA was used to verify the performance of each direct functional domain of the participants in the groups and for those who differed, ROC curves were performed to verify the diagnostic accuracy of the functional scales between the groups. In the direct evaluation, it was observed a better accuracy to differentiate MCI from AD, as well as good accuracy to differentiate MCI controls; The indirect evaluation did not differentiate MCI controls, but showed good accuracy to differentiate MCI from AD. With this, the direct evaluation instrument proves to be extremely important in the elderly who do not have an informant. In the study (2) Spearman correlation was performed between DAFS-R and cognitive components and Stepwise linear regression for all strong correlations found. The domains that most predicted functionality were working memory and late episodic memory. Thus, it can be observed that both performance of executive functions (working memory) and mnemonic is relevant for the functional performance of elderly individuals. In this way, it can be concluded that the evaluation of the direct functional performance presented discriminative power between all the groups investigated. In addition, functional performance was better explained by executive functioning performance than mnemonic performance. Preventive actions, better diagnostic accuracy and guidelines for improving quality of life may consider executive functions and direct examination of functionality among their assumptions. |
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Kochhann, Renata000.448.510-65http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4264350P6015828.890-40http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4364421Z6Fransen, Natália Lemos2017-04-07T18:15:07Z2017-01-04http://tede2.pucrs.br/tede2/handle/tede/7226Neurodegenerative disorders, such as Alzheimer's disease (AD), have a prevalence increasing considerably. It is the only clinical cases that include among the diagnostic procedures the neuropsychological evaluation as mandatory to confirm cognitive and / or functional decline in these individuals. The evaluation of the functionality can be performed directly (eg, Direct Assessment of Functional Status - Revised (DAFS-R)) or indirect (eg, Activities of Daily Living Questionnaire (ADL-Q)). The present master's thesis consists of two studies: (1) aiming at comparing functional performance through direct versus indirect evaluation, and comparing the accuracy of functional performance between groups; And (2) in order to investigate the relationship between the cognitive domains (mnemonic, linguistic, attentional and executive) and direct functionality, as well as whether and how different cognitive domains predict functional performance. The initial sample consisted of 123 individuals, after examining the exclusion criteria. The sample of both studies was divided into 90 elderly adults, divided into three groups: n = 27 controls, n = 35 patients with mild cognitive impairment (MCI) = 28 With mild AD. In the study (1) the direct (DAFS-R) and indirect (ADL-Q) evaluations were used and in (2) the instruments used were: Rey Auditory-Verbal Learning Test; Brief Neuropsychological Assessment Instrument (prospective memory, semantic memory, sentence span of words in sentences, inverse count); Wechsler intelligence scale for adults (digits, sequence of numbers and letters, codes and look for symbols); Hayling test; Track test; Montreal-Toulouse Battery for Language Assessment (listening and speaking); Montreal Assessment of Communication Battery (free verbal, semantic and phonological fluency) and DAFS-R. The Statistical Package for Social Sciences version 20.0 was used for the analyzes. In the study (1), MANCOVA was used to verify the performance of each direct functional domain of the participants in the groups and for those who differed, ROC curves were performed to verify the diagnostic accuracy of the functional scales between the groups. In the direct evaluation, it was observed a better accuracy to differentiate MCI from AD, as well as good accuracy to differentiate MCI controls; The indirect evaluation did not differentiate MCI controls, but showed good accuracy to differentiate MCI from AD. With this, the direct evaluation instrument proves to be extremely important in the elderly who do not have an informant. In the study (2) Spearman correlation was performed between DAFS-R and cognitive components and Stepwise linear regression for all strong correlations found. The domains that most predicted functionality were working memory and late episodic memory. Thus, it can be observed that both performance of executive functions (working memory) and mnemonic is relevant for the functional performance of elderly individuals. In this way, it can be concluded that the evaluation of the direct functional performance presented discriminative power between all the groups investigated. In addition, functional performance was better explained by executive functioning performance than mnemonic performance. Preventive actions, better diagnostic accuracy and guidelines for improving quality of life may consider executive functions and direct examination of functionality among their assumptions.Quadros neurodegenerativos, como a doença de Alzheimer (DA), tem prevalência aumentando consideravelmente. São os únicos quadros clínicos que inclui dentre os procedimentos diagnósticos a avaliação neuropsicológica como obrigatória para se confirmar declínio cognitivo e/ou funcional nestes indivíduos. A avaliação da funcionalidade pode ser realizada de maneira direta (Ex.: Direct Assessment of Functional Status - Revised (DAFS-R)) ou indireta (Ex.: Activities of Daily Living Questionnaire (ADL-Q) (ADL-Q)). A presente dissertação de mestrado é composta por dois estudos: (1) visando a comparar o desempenho funcional através da avaliação direta versus indireta, e comparar a acurácia do desempenho funcional entre os grupos; e (2) com o objetivo de investigar a relação entre os domínios cognitivos (mnemônicos, linguísticos, atencionais e executivos) e a funcionalidade direta, averiguando-se, ainda, se e quanto diferentes domínios cognitivos predizem o desempenho funcional. A amostra inicial foi de 123 indivíduos, após averiguar os critérios de exclusão, a amostra de ambos estudos ficou em 90 adultos idosos, divididos em três grupos: n=27 controles, n=35 pacientes com Comprometimento Cognitivo Leve (CCL) e n=28 com DA leve. No estudo (1) foram utilizadas as avaliações direta (DAFS-R) e indireta (ADL-Q) e no (2) os instrumentos usados foram: Teste de Aprendizagem Auditivo-verbal de Rey; Instrumento de Avaliação Neuropsicológica Breve (memória prospectiva, memória semântica, span auditivo de palavras em sentenças, contagem inversa); Escala de inteligência Wechsler para adultos (dígitos, sequência de números e letras, códigos e procurar símbolos); Teste Hayling; teste de trilhas; Bateria Montreal-Toulouse de Avaliação da Linguagem (compreensão e nomeação oral); Bateria Montreal de Avaliação da Comunicação (fluência verbal livre, semântica e fonológica) e a DAFS-R. O Statistical Package for the Social Sciences versão 20.0 foi utilizado para as análises. No estudo (1) foi utilizado MANCOVA para verificar o desempenho de cada domínio funcional direto dos participantes nos grupos e para os que se diferenciaram foram realizadas curvas ROC para verificar a acurácia diagnóstica das escalas funcionais entre os grupos. Observou-se na avaliação direta uma melhor acurácia para diferenciar CCL de DA, como também, boa acurácia para diferenciar controles de CCL; a avaliação indireta não diferenciou controles de CCL, mas mostrou boa acurácia para diferenciar CCL de DA. Com isso, o instrumento de avaliação direta demonstra ser de extrema importância nos idosos que não possuem um informante. No estudo (2) foram realizadas correlação de Spearman entre a DAFS-R e os componentes cognitivos e regressão linear Stepwise para todas as correlações fortes encontradas. Os domínios que mais predisseram a funcionalidade foi a memória de trabalho e memória episódica tardia. Assim, pode-se observar que tanto desempenho de funções executivas (memória de trabalho) quanto mnemônico é relevante para o desempenho funcional de indivíduos adultos idosos. Desta maneira, pode-se concluir que a avaliação do desempenho funcional direta apresentou poder discriminativo entre todos os grupos investigados. Adicionalmente, o desempenho funcional foi melhor explicado pela performance de funcionamento executivo do que mnemônico. Ações preventivas, de melhor acurácia diagnóstica e de orientações para melhorar qualidade de vida podem considerar as funções executivas e o exame direto da funcionalidade dentre seus pressupostos.Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-04-07T18:15:07Z No. of bitstreams: 1 DIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf: 535158 bytes, checksum: 78c42f6272dea88c23ca1dedd0c76c9e (MD5)Made available in DSpace on 2017-04-07T18:15:07Z (GMT). No. of bitstreams: 1 DIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf: 535158 bytes, checksum: 78c42f6272dea88c23ca1dedd0c76c9e (MD5) Previous issue date: 2017-01-04Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/167818/DIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf.jpgporPontifícia Universidade Católica do Rio Grande do SulPrograma de Pós-Graduação em PsicologiaPUCRSBrasilEscola de HumanidadesDesempenho FuncionalDesempenho CognitivoEnvelhecimentoComprometimento Cognitivo LeveDoença de AlzheimerCIENCIAS HUMANAS::PSICOLOGIAAcurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimentoinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis2588426296948062698600600600600-655753147121811019234118672558173774232075167498588264571info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILDIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf.jpgDIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf.jpgimage/jpeg3724http://tede2.pucrs.br/tede2/bitstream/tede/7226/5/DIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf.jpg20b1a8a8fa703008f6fba6da5be067edMD55TEXTDIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf.txtDIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf.txttext/plain50705http://tede2.pucrs.br/tede2/bitstream/tede/7226/4/DIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf.txte67dc4966e7444f141fbb75e597e1b53MD54LICENSElicense.txtlicense.txttext/plain; charset=utf-8610http://tede2.pucrs.br/tede2/bitstream/tede/7226/3/license.txt5a9d6006225b368ef605ba16b4f6d1beMD53ORIGINALDIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdfDIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdfapplication/pdf535158http://tede2.pucrs.br/tede2/bitstream/tede/7226/2/DIS_NATALIA_LEMOS_FRANSEN_PARCIAL.pdf78c42f6272dea88c23ca1dedd0c76c9eMD52tede/72262017-04-07 20:01:16.381oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2017-04-07T23:01:16Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento |
title |
Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento |
spellingShingle |
Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento Fransen, Natália Lemos Desempenho Funcional Desempenho Cognitivo Envelhecimento Comprometimento Cognitivo Leve Doença de Alzheimer CIENCIAS HUMANAS::PSICOLOGIA |
title_short |
Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento |
title_full |
Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento |
title_fullStr |
Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento |
title_full_unstemmed |
Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento |
title_sort |
Acurácia diagnóstica de funcionalidade e desempenho cognitivo no contínuo de comprometimento cognitivo no envelhecimento |
author |
Fransen, Natália Lemos |
author_facet |
Fransen, Natália Lemos |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Kochhann, Renata |
dc.contributor.advisor1ID.fl_str_mv |
000.448.510-65 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4264350P6 |
dc.contributor.authorID.fl_str_mv |
015828.890-40 |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4364421Z6 |
dc.contributor.author.fl_str_mv |
Fransen, Natália Lemos |
contributor_str_mv |
Kochhann, Renata |
dc.subject.por.fl_str_mv |
Desempenho Funcional Desempenho Cognitivo Envelhecimento Comprometimento Cognitivo Leve Doença de Alzheimer |
topic |
Desempenho Funcional Desempenho Cognitivo Envelhecimento Comprometimento Cognitivo Leve Doença de Alzheimer CIENCIAS HUMANAS::PSICOLOGIA |
dc.subject.cnpq.fl_str_mv |
CIENCIAS HUMANAS::PSICOLOGIA |
description |
Neurodegenerative disorders, such as Alzheimer's disease (AD), have a prevalence increasing considerably. It is the only clinical cases that include among the diagnostic procedures the neuropsychological evaluation as mandatory to confirm cognitive and / or functional decline in these individuals. The evaluation of the functionality can be performed directly (eg, Direct Assessment of Functional Status - Revised (DAFS-R)) or indirect (eg, Activities of Daily Living Questionnaire (ADL-Q)). The present master's thesis consists of two studies: (1) aiming at comparing functional performance through direct versus indirect evaluation, and comparing the accuracy of functional performance between groups; And (2) in order to investigate the relationship between the cognitive domains (mnemonic, linguistic, attentional and executive) and direct functionality, as well as whether and how different cognitive domains predict functional performance. The initial sample consisted of 123 individuals, after examining the exclusion criteria. The sample of both studies was divided into 90 elderly adults, divided into three groups: n = 27 controls, n = 35 patients with mild cognitive impairment (MCI) = 28 With mild AD. In the study (1) the direct (DAFS-R) and indirect (ADL-Q) evaluations were used and in (2) the instruments used were: Rey Auditory-Verbal Learning Test; Brief Neuropsychological Assessment Instrument (prospective memory, semantic memory, sentence span of words in sentences, inverse count); Wechsler intelligence scale for adults (digits, sequence of numbers and letters, codes and look for symbols); Hayling test; Track test; Montreal-Toulouse Battery for Language Assessment (listening and speaking); Montreal Assessment of Communication Battery (free verbal, semantic and phonological fluency) and DAFS-R. The Statistical Package for Social Sciences version 20.0 was used for the analyzes. In the study (1), MANCOVA was used to verify the performance of each direct functional domain of the participants in the groups and for those who differed, ROC curves were performed to verify the diagnostic accuracy of the functional scales between the groups. In the direct evaluation, it was observed a better accuracy to differentiate MCI from AD, as well as good accuracy to differentiate MCI controls; The indirect evaluation did not differentiate MCI controls, but showed good accuracy to differentiate MCI from AD. With this, the direct evaluation instrument proves to be extremely important in the elderly who do not have an informant. In the study (2) Spearman correlation was performed between DAFS-R and cognitive components and Stepwise linear regression for all strong correlations found. The domains that most predicted functionality were working memory and late episodic memory. Thus, it can be observed that both performance of executive functions (working memory) and mnemonic is relevant for the functional performance of elderly individuals. In this way, it can be concluded that the evaluation of the direct functional performance presented discriminative power between all the groups investigated. In addition, functional performance was better explained by executive functioning performance than mnemonic performance. Preventive actions, better diagnostic accuracy and guidelines for improving quality of life may consider executive functions and direct examination of functionality among their assumptions. |
publishDate |
2017 |
dc.date.accessioned.fl_str_mv |
2017-04-07T18:15:07Z |
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2017-01-04 |
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