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The literature lacks information on the performance of patients with brain tumors on the Wechsler Intelligence Scales. This study aimed to explore the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) performance profile of 23 consecutive patients with brain tumors and 23 matched controls selected from the Portuguese WAIS-III standardization sample, using the technical manual steps recommended for score interpretation. The control group was demographically matched to the tumor group regarding gender, age, education, profession, and geographic region. The technical manual steps recommended for score interpretation were applied. Patients with brain tumors had significantly lower performances on the Performance IQ, Full-Scale IQ, Perceptual Organization Index, Working Memory Index, Processing Speed Index, Arithmetic, Object Assembly, and Picture Arrangement, though all scaled scores were within the normal range according to the manual tables. Only Vocabulary and Comprehension scatter scores were statistically different between groups. No strengths or weaknesses were found for either group. The mean discrepancy scores do not appear to have clinical value for this population. In conclusion, the study results did not reveal a specific profile for patients with brain tumors on the WAIS-III. [ABSTRACT FROM AUTHOR]

The Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of cognitive impairment, having surpassed the well-known limitations of the MMSE. The aim of the present study was to validate the MoCA as well as its short version, which was proposed by the NINDS-CSN VCI Harmonization Standards for screening Vascular Dementia (VaD) patients. The results, based on a homogeneous sample of 34 VaD patients, indicate that the MoCA is a psychometrically valid and reliable instrument for cognitive screening in VaD patients, showing excellent discriminant validity. Both the full and short versions of the MoCA had excellent diagnostic accuracy in discriminating VaD patients, exhibiting an area under curve (AUC) higher than the MMSE [AUC(MoCA full version) = .950; 95% IC = .868-.988; AUC(MoCA short version) = .936; 95% IC = .849-.981; AUC(MMSE) = .860; 95% IC = .754-.932]. With a cutoff below 17 on the MoCA full version and 8 on the short version, the results for sensitivity, specificity, positive and negative predictive values, and classification accuracy were superior compared to the MMSE. In conclusion, both versions of the MoCA are valid, reliable, sensitive and accurate screening instruments for VaD patients. [ABSTRACT FROM AUTHOR]

Abstract: Considerable research has shown that neuropsychological tests are predictive of real-world driving ability. The Mini-Mental State Examination (MMSE) is a brief cognitive test that has been commonly used in the assessment of older drivers. However, this test has inherent problems that limit its validity to evaluate cognitive abilities related to driving and to screen for driving impairments in non-demented people. Therefore, it is useful to test new screening instruments that may predict potential unsafe drivers who require an in-depth neuropsychological assessment in a specialised centre. To date, the utility of the Addenbrooke''s Cognitive Examination Revised (ACE-R) as an indicator of driving ability has not been established. In the current study, fifty older drivers (mean age=73.1years) who were referred for a psychological assessment, the protocol of which included the ACE-R, underwent an on-road driving test. Using linear discriminant analyses, the results highlighted the higher classification accuracy of the ACE-R compared to the MMSE score, particularly for detecting unsafe drivers. Measures of visuospatial and executive functions, which are not incorporated in the MMSE score, had an incremental value in the prediction of driving ability. This emerging brief cognitive test may warrant additional study for use in the fitness to drive assessment of older adults. [Copyright &y& Elsevier]

The Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of cognitive impairment. The present study aims to assess the construct related validity of the MoCA through the establishment of the factorial, convergent, and discriminant related validities, and the reliability of data. In a Portuguese sample of 830 participants, several models were tested using Confirmatory Factor Analysis. Although all tested models showed a good fit, the six-factor model based on the conceptual model proposed by the MoCA's authors showed a significantly better fit. The results allowed us to establish the factorial, convergent, and discriminant validity of this six-dimensional structure. An overall psychometric adequacy of the items, and a good reliability were also found. This study contributes to overcome an important gap in the construct related validity of this instrument. The present findings corroborate the six-dimensional structure of the MoCA and provide good evidence of the construct related validity. The MoCA has proved to be an appropriate measure for cognitive screening taking into account different cognitive domains, which will enable clinicians and researchers to use this test and its six latent dimensions to achieve a better understanding of the individuals’ cognitive profile. (JINS, 2012, 18, 242–250) [ABSTRACT FROM PUBLISHER]

Coimbra's Neuropsychological Assessment Battery contains, amongst several other assessment instruments, a Colours Rapid Naming test for children aged 5-6, a Digits Rapid Naming test and a Shapes and Colours Rapid Naming test, both for children aged 7-15. This work presents data concerning these tests psychometric properties, namely temporal stability, tests' intercorrelations, degree of relationship with academic grades and differentiation of groups of children with and without learning problems. The results obtained show, on the one hand, the tests psychometric adequacy and, on the other hand, indicate that the Digits and Shapes and Colours Rapid Naming tests should not be regarded as equivalents. [ABSTRACT FROM AUTHOR]

• In nursing homes, neuropsychiatric symptoms (NPS) are particularly frequent. • Cognition, functional status, needs and psychotropic drugs all correlate with NPS. • Unmet needs and hypnotic/sedatives shown to increase the risk of presenting NPS. • Identifying and modifying these factors would benefit residents' symptomatology. • Findings conform with the unmet needs model, placing emphasis on needs assessment. This study aimed to explore neuropsychiatric symptoms' (NPS) risk factors in a sample of nursing home residents. A cross-sectional study was conducted. Residents over 65 years were included, unless they had a known major psychiatric diagnosis. The Neuropsychiatric Inventory (NPI) was completed, and other measures included residents' sociodemographic characteristics, cognition, functional impairment, regular drugs and number of needs. To explore potential risk factors, a logistic regression was conducted with the presence of NPS (NPI-10 ≥ 1) as dependent variable. Additional exploratory analyses were conducted based on a sub-syndrome approach, and three multivariate models were repeated considering the psychotic, affective and behaviour syndromes as dependent variables. A total of 140 residents were included (age: 83.71 ± 7.29 years). More than half (50.4%) presented at least one NPS. NPI-10 showed significant correlations with cognition (r s =-0.177, p = 0.042), functional impairment (r s = 0.174, p = 0.043), unmet needs (r s = 0.245, p = 0.004) and nervous system-acting drugs (r s = 0.271, p = 0.002), particularly anxiolytics (r s = 0.175, p = 0.047), antidepressants (r s = 0.204, p = 0.019) and hypnotics/sedatives (U = 2434.5, p = 0.028). However, in the multivariate analysis only unmet needs (OR = 1.30; 95% CI: 1.008–1.670) and hypnotic/sedatives (OR = 4.66; 95% CI: 1.132–19.144) showed an independent association with the presence of NPS. Regarding the additional models, unmet needs and literacy, antidepressants and hypnotic/sedatives, and cognitive status, showed to contribute to explain the variability of psychotic, affective and behaviour syndromes, respectively. Identifiable and modifiable factors, including unmet needs and prescribed psychotropic drugs, could have contributed to NPS in this sample, suggesting a role for targeted non-pharmacological and person-centred approaches directed to residents' unmet needs. [ABSTRACT FROM AUTHOR]

Objective: The present study aims to analyze the psychometric characteristics of the TeLPI (Irregular Words Reading Test), a Portuguese premorbid intelligence test, using the Rasch model for dichotomous items. Results: The results reveal an overall adequacy and a good fit of values regarding both items and persons. A high variability of cognitive performance level and a good quality of the measurements were also found. The TeLPI has proved to be a unidimensional measure with reduced DIF effects. Conclusions: The present findings contribute to overcome an important gap in the psychometric validity of this instrument and provide good evidence of the overall psychometric validity of TeLPI results. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to analyze the effects of age, education, gender, computer experience, institutionalization time, and psychotropic drug use on performance on four tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) which are recommended for the assessment of dementia (Rapid Visual Information Processing [RVP], Paired Associates Learning [PAL], Spatial Working Memory [SWM], and Reaction Time [RTI]), and to provide norms for Portuguese older persons without neuropsychiatric diagnoses who are living in retirement homes. Method: The normative sample included 128 adults aged 69-96 years who had no neuropsychiatric diagnosis and who had lived in retirement homes for 3-232 months. The CANTAB was administered, at the latest, one week after a screening session that comprised an interview and the administration of pencil-and-paper tests. Results: The simultaneous multiple linear regression models were significant (p < .05) for all tests except the RTI five-choice movement time measure. The total variance explained by the socio-demographic variables was smaller for the CANTAB measures (4-14%) than for the pencil-and-paper tests (10-33%). Significant effects involving age or gender were observed for RVP, PAL, and SWM. A marginally significant computer experience effect was found for the RTI simple movement time measure. We additionally observed significant effects of education, age, gender, and computer experience on several pencil-and-paper tests. Conclusions: Our findings suggest that different socio-demographic variables influence distinct tests and measures of the same test, and that the associations between computer experience and several pencil-andpaper tests may be mediated by possible cognitive skills developed through computer use. [ABSTRACT FROM AUTHOR]

Introduction: The Free and Cued Selective Reminding Test (FCSRT) is a memory test that controls attention and acquisition, by providing category cues in the learning process. Because it enables an assessment of memory not confounded by normal age-related changes in cognition and a high accuracy on Alzheimer’s disease (AD) evaluation, it has been suggested by the International Working Group on AD. Our aim was to assess the construct related validity of the FCSRT in the AD spectrum disorders.Method: Patients were classified in two groups according to standard criteria: amnestic mild cognitive impairment (n= 100) and AD (n= 70). A matched control group (n= 101) of cognitively healthy subjects was included. The factorial structure of two models and respective construct and diagnostic validities were analyzed.Results: Both models revealed adequate fit values. The appropriated convergent validity and the lack of discriminant validity support the two factors as measuring the same construct (memory ability). The recalls of the FCSRT enabled high classification accuracy and diagnostic validity for both pathological groups.Conclusions: This study represents a novel contribution regarding the adequacy of the FCSRT in terms of construct and diagnostic validities and shows the interest of including both immediate (learning) and delayed (retention) recalls. It gives also new possibilities regarding the use of the FCSRT in the memory assessment of AD spectrum disorders. [ABSTRACT FROM PUBLISHER]

The validity of the Cambridge Neuropsychological Automated Tests has been widely studied, but their reliability has not. This study aimed to estimate the test-retest reliability of these tests in a sample of 34 older adults, aged 69 to 90 years old, without neuropsychiatric diagnoses and living in retirement homes in the district of Lisbon, Portugal. The battery was administered twice, with a 4-week interval between sessions. The Paired Associates Learning (PAL), Spatial Working Memory (SWM), Rapid Visual Information Processing, and Reaction Time tests revealed measures with high-to-adequate test-retest correlations (.71-.89), although several PAL and SWM measures showed susceptibility to practice effects. Two estimated standardized regression-based methods were found to be more efficient at correcting for practice effects than a method of fixed correction. We also found weak test-retest correlations (.56-.68) for several measures. These results suggest that some, but not all, measures are suitable for cognitive assessment and monitoring in this population. [ABSTRACT FROM AUTHOR]

In the present study we analyzed the psychometric characteristics of the MoCA (Portuguese version) using the Rasch model for dichotomous items. The total sample comprised of 897 participants distributed between two main subgroups: (I) healthy group that was comprised of 650 cognitively healthy community dwellers and (II) clinical group that was comprised of 90 patients with Mild Cognitive Impairment, 90 patients with Alzheimer’s disease, 33 patients with frontotemporal dementia, and 34 patients with vascular dementia recruited at a reference dementia clinic. All patients were investigated through a comprehensive neuropsychological assessment, laboratory tests essential to exclude a reversible form of dementia, imaging studies (CT or MRI and SPECT or FDG-PET), Apolipoprotein E allele genotyping and CSF biomarker (A?42,Tau, and P-tau) analyses. The clinical diagnosis was established through the consensus of a multidisciplinary team, based on international criteria. The results demonstrated an overall good fit of both items and the person’s values, a high variability on cognitive performance level, and a good quality of the measurements. The MoCA scores also demonstrated adequate discriminant validity, with high diagnostic value. DIF analyses indicated the generalized validity of the MoCA scores. In conclusion, the results of this study show the overall psychometric adequacy of the MoCA and verify the discriminant and generalized validity of the obtained results. [ABSTRACT FROM PUBLISHER]

Objective: This study aimed to investigate the factor structure of the Coimbra Neuropsychological Assessment Battery (BANC), which is an individually administered battery designed to assess a wide range of neurocognitive functions in children. Method: Using the standardization sample of the BANC, a confirmatory factor analysis and a multiple-group analysis were conducted to examine the factor structure and the measurement invariance of three main domains (Memory, Language, and Attention/Executive Functions) in 833 children aged 7-15 years. Results: Consistent with the BANC's conceptualization, the three-correlated-factor model demonstrated the most adequate fit to the data. The measurement invariance of the three-correlated-factor model across two age-groups (7-9 years and 10-15 years) was supported (configural, metric, and partial scalar invariance). Conclusion: Overall, the BANC shows adequate psychometric properties and provides useful information regarding the children's neuropsychological functioning. [ABSTRACT FROM AUTHOR]

This study investigates the utility of the Portuguese version of Montreal Cognitive Assessment (MoCA) as a screening-method for identifying cognitive dysfunction (CD) in multiple sclerosis (MS). The 118 participants with comprehensive neuropsychological assessment were divided into two subgroups: (I) MS group (n = 59) and (II) control group (n = 59). The MS patients were classified as cognitively intact (n = 26) or impaired (n = 33, 56%). The results indicated that the MoCA is a psychometrically valid instrument in assessment of MS patients. The Multiple Linear Regression analyses highlighted the significant influence of Modified Fatigue Impact Scale and Irregular Word Reading Test on MoCA performance. The MoCA total score showed a good discriminative capacity between cognitively impaired and cognitively intact subjects. In addition, there were significant differences in MoCA cognitive domain scores between groups. The MoCA total score cut-off point for identifying CD in MS patients was a score below 26 points (AUC = 0.837, CI = 0.736–0.937). A proposed EM-MoCA-Subscore for identifying the MS-related cognitive impairment (max. score = 19 points, cut-off <17 points, AUC = 0.871, CI = 0.784–0.958), can reduce administration time for cognitive screening in clinical settings. The MoCA is a useful and sensitive instrument to identify the MS-related cognitive impairment. [ABSTRACT FROM PUBLISHER]

The Selective Reminding Test (SRT) and the Free and Cued Selective Reminding Test (FCSRT) are multitrial memory tests that use a common “selective reminding” paradigm that aims to facilitate learning by presenting only the missing words from the previous recall trial. While in the FCSRT semantic cues are provided to elicit recall, in the SRT, participants are merely reminded of the missing items by repeating them. These tests have been used to assess age-related memory changes and to predict dementia. The performance of healthy elders on these tests has been compared before, and results have shown that twice as many words were retrieved from long-term memory in the FCSRT compared with the SRT. In this study, we compared the tests’ properties and their accuracy in discriminating amnestic mild cognitive impairment (aMCI;n = 20) from Alzheimer disease (AD;n = 18). Patients with AD performed significantly worse than patients with aMCI on both tests. The percentage of items recalled during the learning trials was significantly higher for the FCSRT in both groups, and a higher number of items were later retrieved, showing the benefit of category cueing. Our key finding was that the FCSRT showed higher accuracy in discriminating patients with aMCI from those with AD. [ABSTRACT FROM PUBLISHER]

The Clock Drawing Test has been systematically used to assess visuospatial deficits related to the parietal lobes, but we now acknowledge its much more complex relation with other cognitive abilities. Despite its common use in clinical and investigational practices, no study has developed normative data for the Portuguese population. We present the distribution of clock drawing scores using three scoring systems in a representative community sample of cognitively healthy subjects. We found that the systems were well correlated with each other and with cognitive screening tests widely used and had good psychometric properties. Normative data for the three scoring systems were developed considering age and education. These results allow a more rigorous interpretation of the test performance in clinical context and are especially relevant for epidemiological research. [ABSTRACT FROM AUTHOR]