Acurácia dos testes de fluência verbal com critério semântico e ortográfico na identificação de idosos com síndrome demencial: estudo FIBRA RJ

• Autor(a) principal: Teldeschi, Alina Lebreiro Guimarães
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/8832
• topic: Verbal Fluency Test; Accuracy; Elderly; Diagnosis; Dementia; Teste de fluência verbal; Acurácia; Idosos; Diagnóstico; Demência; Demência; Idosos; Cognição na velhice; Teste de Estado Mental e Demência; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA

Assessment instruments capable of contributing effectively to the identification of potential cases of dementia are fundamental in clinical practice and research. The verbal fluency test is a brief cognitive assessment tool that has been showing high potential in this sense. Numerous studies have proven the sensitivity of this type of test for the detection of cognitive impairment associated to neurodegenerative processes. However, the accuracy of this test has not been consistently studied in Brazil. There is a paucity of national studies with representative samples of the elderly population that seeks care in different clinical contexts. The objectives of this study were to determine the criterion validity of the verbal fluency test with the letters F-A-S and the categories "fruits" and "animals" and to analyze the sociodemographic characteristics of the sample. A cross - sectional study was carried out with a sub - sample of the Frailty in the Brazilian Older People Study - section RJ. The descriptive frequencies of the sociodemographic characteristics of the sample and the area under the ROC Curve were analyzed to evaluate the accuracy of the verbal fluency tests with the letters F-A-S and the categories "fruits" and "animals" in discriminating elderly with dementia from those without dementia. The cutoff points were listed according to the most balanced sensitivity and specificity measures, and their respective positive and negative predictive values were described. Data from 212 individuals with mean age of 80.0 (± 7.5) and mean educational level of 9.1 (± 5.2) were analyzed. Of those, 71.7% were women, 53.8% were 80 years or older, and 42.5% had 12 or more years of schooling. For the verbal fluency test with the letters F-A-S, the best cutoff point was 25/26, with sensitivity of 81% and specificity of 59%. The area under the ROC curve was 0.762 (95% CI 0.696-0.827). For the verbal fluency test with the category "fruits" the best cutoff point was 11/12, with sensitivity of 86% and specificity of 53%. The area under the ROC curve was 0.797 (95% CI 0.733-0.860). For the verbal fluency test with the category "animals" the best cutoff point was 12/13, with sensitivity of 79% and specificity of 62%. The area under the ROC curve was 0.782 (95% CI 0.713-0.850). The present study contributed to clinical practice of health care professionals serving the elderly by presenting good accuracy measures of verbal fluency tests in discriminating elderly with dementia from those without, in a sample more representative of the population that seeks care in geriatric outpatient clinics and in primary care services.