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Executive functions are involved in a series of human neurological and psychiatric disorders. For this reason, appropriate assessment tools with age and education adjusted norms for symptom diagnosis are necessary. OBJECTIVE: To present normative data for adults (19-75 year-olds; with five years of education or more) on the Modified Wisconsin Card Sorting Test (MWCST), Stroop color and word test and Digit Span test. Age and education effects were investigated. METHODS: Three samples were formed after inclusion criteria and data analysis: MWCST (n=124); Digit Span (n=123), and Stroop test (n=158). Groups were divided into young (19-39), middle-aged (40-59) and older (60-75) participants with five to eight years of education and nine years of education or more. Two-way ANOVA and ANCOVA analyses were used. RESULTS: Education effects were found in most variables of the three tasks. An age effect was only found on color naming and color-word naming speed from the Stroop test. No interactions were detected. CONCLUSION: In countries with heterogeneous educational backgrounds, the use of stratified norms by education to assess at least some components of executive functions is essential for an ethical and accurate cognitive diagnosis.

Abstract This systematic review aimed to identify the designs, procedures, and results of empirical studies that performed neuropsychological interventions on WM in adults. Methods: A PubMed and LILACS literature search was conducted using the keywords working memory AND (training OR rehabilitation OR intervention) AND adult. Results: Of the seven studies found, three were randomized controlled trials, two were case reports, one was a clinical trial, and one was an evaluation study. With regard to the type of programs and samples, three studies employed global programs with healthy elderly adults and four employed specific programs for samples with neurologically-impaired adults. Conclusions: The effectiveness of the WM intervention programs was more evident in studies that employed specific methods of rehabilitation for samples with neurological disorders than in those based on global programs with healthy adults. There is a need for more empirical studies to verify the effectiveness of WM intervention programs in order to provide adequate guidance for clinical neuropsychologists and future research.

ABSTRACT Verbal fluency (VF) is a widely used tool in neuropsychological assessment. Objective: We aimed to investigate the influence of age and educational level on clustering and switching in three VF modalities: phonemic (PVF), semantic (SVF) and unconstrained (UVF). We evaluated type of cluster, mean cluster size, and quantity of clusters, intersections, and returns. A total of 260 healthy subjects were assessed. Methods: Participants were divided into three age groups: young adults (18 to 39 years), middle-aged adults (40 to 59 years) and older adults (60 to 80 years) and into two groups of educational level: 1-8 years (low), 9 years or more (high). A two-way ANOVA analysis was conducted to analyze the effect of age and educational level and its interactions. A repeated measures ANOVA was performed to verify the performance during the task. Results: A main effect of age was detected on the UVF and SVF scores for total switches, taxonomic clusters, and for the total semantic clusters on the SVF. There was a greater effect of educational level on total switches (UVF, PFV and SVF), taxonomic clusters (UVF and SVF), thematic clusters and total semantic cluster (UVF), phonemic and mixed clusters (PVF), mean cluster size (UVF and SVF) and intersections (SVF). Educational level had a greater effect on all three VF tasks.

Abstract Objective: To describe the frequency of pragmatic and executive deficits in right brain damaged (RBD) and in traumatic brain injury (TBI) patients, and to verify possible dissociations between pragmatic and executive functions in these two groups. Methods: The sample comprised 7 cases of TBI and 7 cases of RBD. All participants were assessed by means of tasks from the Montreal Communication Evaluation Battery and executive functions tests including the Trail Making Test, Hayling Test, Wisconsin Card Sorting Test, semantic and phonemic verbal fluency tasks, and working memory tasks from the Brazilian Brief Neuropsychological Assessment Battery NEUPSILIN. Z-score was calculated and a descriptive analysis of frequency of deficits (Z< -1.5) was carried out. Results: RBD patients presented with deficits predominantly on conversational and narrative discursive tasks, while TBI patients showed a wider spread pattern of pragmatic deficits. Regarding EF, RBD deficits included predominantly working memory and verbal initiation impairment. On the other hand, TBI individuals again exhibited a general profile of executive dysfunction, affecting mainly working memory, initiation, inhibition, planning and switching. Pragmatic and executive deficits were generally associated upon comparisons of RBD patients and TBI cases, except for two simple dissociations: two post-TBI cases showed executive deficits in the absence of pragmatic deficits. Discussion: Pragmatic and executive deficits can be very frequent following TBI or vascular RBD. There seems to be an association between these abilities, indicating that although they can co-occur, a cause-consequence relationship cannot be the only hypothesis.

Over recent years, neuropsychological research has been increasingly concerned with the need to develop more ecologically valid instruments for the assessment of executive functions. The Hotel Task is one of the most widely used ecological measures of executive functioning, and provides an assessment of planning, organization, self-monitoring and cognitive flexibility. OBJECTIVE: The goal of this study was to adapt the Hotel Task for use in the Brazilian population. METHODS: The sample comprised 27 participants (three translators, six expert judges, seven healthy adults, ten patients with traumatic brain injuries and one hotel manager). The adaptation process consisted of five steps, which were repeated until a satisfactory version of the task was produced. The steps were as follows: (1) Translation; (2) Development of new stimuli and brainstorming among the authors; (3) Analysis by expert judges; (4) Pilot studies; (5) Assessment by an expert in business administration and hotel management. RESULTS: The adapted version proved adequate and valid for the assessment of executive functions. However, further research must be conducted to obtain evidence of the reliability, as well as the construct and criterion validity, sensitivity and specificity, of the Hotel Task. CONCLUSION: Many neurological and/or psychiatric populations may benefit from the adapted task, since it may make significant contributions to the assessment of dysexecutive syndromes and their impact on patient functioning.

Abstract Neuropsychological studies on the processing of some specific cognitive functions throughout aging are essential for the understanding of human cognitive development from ages 19 to 89. Objectives: This study aimed to verify the occurrence of differences in the processing of episodic memory, concentrated attention and speed of attentional processing among four age groups of adults. Methods: A total of 136 neurologically healthy adults, aged 19-89, with 9 or more years of schooling, took part in the study. Participants were divided according to four age groups: young, middle-aged, elderly and oldest old adults. Subtests of the Brief Neuropsychological Evaluation Instrument (NEUPSILIN) were applied for the cognitive assessment. Mean score of corrected answers and of response times were compared between groups by means of a one-way ANOVA test with post-hoc Scheffe procedures and ANCOVA including the co-variables of years of schooling and socio-economical scores. Results: In general, differences in performance were observed from 60 years old on. Only the episodic memory task of delayed recall reflected differences from the age of around 40 onwards and processing speed from around the age of 70 onwards. Thus, differences were found between the age groups regarding their cognitive performance, particularly between young adults and elderly adults, and young adults and oldest old adults. Conclusions: Our research indicates that the middle-aged group should be better analyzed and that comparative cross-sectional studies including only extreme groups such as young and elderly adults are not sufficient.