El impacto del TDAH sobre la lectura / The impact of ADHD on reading

Resumen Más allá de la frecuente coexistencia del trastorno por déficit de atención con hiperactividad (TDAH) y el trastorno específico del aprendizaje de la lectura, la presente revisión pretende examinar la evidencia empírica disponible sobre cómo el TDAH impacta negativamente sobre el aprendizaje de la lectura. Los datos existentes apuntan a que la presencia del trastorno (especialmente los síntomas de falta de atención), puede afectar a i) la correcta adquisición de lectura, ya sea de manera directa o a través de su influencia sobre los precursores de la lectura; ii) las propias habilidades de decodificación (precisión y fluidez lectora), tanto de manera directa como indirecta a través de su influencia sobre procesos cognitivos como la distracción o las funciones ejecutivas; y ii) la comprensión lectora, probablemente de manera indirecta por las dificultades eje cutivas y en la memoria de trabajo verbal características del TDAH. Estas conclusiones presentan importantes implicaciones para caracterizar e intervenir mejor sobre las dificultades lectoras en el TDAH, ya sean clínicas o subclínicas.

Abstract Beyond the frequent coexistence of attention deficit hyperactivity disorder (ADHD) and reading dis order (dyslexia), the present review aims to examine the available empirical evidence on how ADHD negatively impacts on learning to read. Existing data suggest that the presence of the disorder (especially inattention symp toms), may affect i) the correct acquisition of reading, either directly or through its influence on the precursors to reading; ii) decoding skills themselves (reading accuracy and fluency), both directly and indirectly through its influence on cognitive processes such as distractibility or executive functions; and iii) reading comprehension, probably indirectly through the executive and verbal memory difficulties characteristic of ADHD. These findings have important implications for better characterizing and intervening on reading difficulties in ADHD, whether clinical or subclinical.

Study of prefrontal cortex activation characteristics of patients with psychiatric disorders in verbal fluency task using functional near-infrared spectroscopy / 四川精神卫生

BackgroundFunctional near-infrared spectroscopy （fNIRS） is a new generation of imaging tool that can be used to assist the diagnosis of psychiatric disorders. However， whether the patterns of prefrontal cortex activation observed by fNIRS are specific for different psychiatric disorders remains to be explored. ObjectiveTo investigate the characteristics of prefrontal cortex activation in patients with depression， anxiety disorder， bipolar disorder and schizophrenia in verbal fluency task （VFT） using fNIRS. MethodsFrom September to December 2021， 39 patients with schizophrenia， 205 patients with depressive disorder， 212 patients with anxiety disorder and 77 patients with bipolar disorder meeting the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） were recruited in the outpatient and inpatient department of West China Hospital， Sichuan University. fNIRS was used to monitor the prefrontal cortex hemodynamic changes of patients under VFT， and the clinical symptoms of patients were assessed by Symptom Checklist 90 （SCL-90） and Hypomania Checklist-32 items（HCL-32）. Differences in mean oxyhemoglobin （HbO2） concentration and the initial slope from 2 to 7 second during VFT were compared among patients with different diseases， and the correlation between mean HbO2 concentration/initial slope and clinical symptoms was analyzed by partial correlation analysis. ResultsThe concentration of HbO2 in channel 4 （Z=2.828， P=0.028） and channel 6 （Z=2.912， P=0.022） in patients with depression were significantly higher than those in patients with schizophrenia. Patients with anxiety had significantly higher changes in mean HbO2 concentration in channel 4 （Z=3.154， P=0.010）， channel 5 （Z=3.021， P=0.015）， channel 6 （Z=2.980， P=0.017） and of all channels （Z=2.881， P=0.024） than those of schizophrenia patients. There was a statistically significant difference in the initial slope of channel 3 between patients with depressive disorder and those with bipolar disorder （Z=2.691， P=0.039）. Among patients with bipolar disorder， the anger-hostility scores of SCL-90 were negatively correlated with the mean HbO2 concentration changes in channel 4 （r=-0.505， P=0.004）， channel 6 （r=-0.390， P=0.004）， channel 15 （r=-0.546， P=0.002）， channel 16 （r=-0.550， P=0.002） and the mean HbO2 concentration changes of all channels （r=-0.491， P=0.006）. ConclusionPatients with schizophrenia had lower activation in frontopolar and orbitofrontal region than patients with depression and anxiety disorder， and the initial slope of the right frontopolar， inferior frontal and orbitofrontal region in patients with depression is higher than patients with bipolar disorder. In addition， patients with bipolar disorder had less activation in the frontopolar and orbitofrontal lobe， the insular cover of Broca's area and the upper outer frontal cortex， and were more irritable and hostile. ［Funded by 1·3·5 Project for Disciplines of Excellence-Clinical Research Incubation Project， West China Hospital， Sichuan University （number， ZYJC21083）］

Desenvolvimento lexical e gagueira na criança: revisão de escopo / Lexical development and stuttering in children: a scope review

RESUMO Objetivo mapear as publicações que abordam a relação entre habilidade lexical e gagueira em crianças na faixa etária dos 2 anos aos 9 anos. Estratégia de pesquisa busca nas bases de dados Cochrane Library, MEDLINE, via PubMed, Scopus, Web of Science, Embase. Critérios de seleção estudos clínicos comparativos, longitudinais ou caso-controle, que incluíam análise do vocabulário expressivo e receptivo de crianças com gagueira na faixa etária de 2 a 9 anos. Análise dos dados: após a busca inicial com 426 artigos, 42 foram selecionados para leitura na íntegra, dos quais, 16 atenderam aos critérios de elegibilidade. Resultados a maior parte dos registros analisados referiu haver relação entre desenvolvimento ou desempenho lexical e gagueira em crianças. No entanto não houve consenso sobre a relação entre maior ou menor desenvolvimento lexical. Conclusão o mapeamento dos estudos incluídos indicou que não há evidências suficientes que relacionem gagueira e desenvolvimento lexical.

ABSTRACT Purpose to search and analyze publications that address the relationship between lexical ability and stuttering in children aged 2 to 9 years old. Research strategy search in Cochrane Library, MEDLINE via PubMed, Scopus, Web of Science, EMBASE databases. Selection criteria comparative, longitudinal or case-control clinical studies that included analysis of the expressive and receptive vocabulary of children with stuttering aged between 2 and 9 years. Results most of the analyzed studies report a relationship between lexical development or performance and stuttering in children, however there is no consense about the relationship between greater or lesser lexical development. Conclusion there is not enough evidence to relate stuttering and lexical development. More studies are needed in order to understand the relationship between lexical performance and stuttering in children.

Perfil da fluência na fala espontânea, leitura e no reconto de textos de adultos que gaguejam / Profile of fluency in spontaneous speech, reading, and retelling of texts by adults who stutter

RESUMO Objetivo descrever o perfil da fluência em relação à tipologia das disfluências, velocidade e frequência de rupturas na fala espontânea, na leitura e no reconto; comparar o perfil da fluência em adultos que gaguejam na fala espontânea, na leitura e no reconto de texto. Método O trabalho é um estudo transversal comparativo com amostra composta por 15 adultos que gaguejam de ambos os sexos, com formação superior ou equivalente ao ensino fundamental II completo. Foram coletadas amostras nas tarefas de fala espontânea, leitura e reconto de texto por meio de video chamadas realizadas individualmente. As 200 primeiras sílabas expressas de cada tarefa foram transcritas e analisadas segundo o Protocolo de Avaliação do Perfil da Fluência (PAPF). O estudo comparou a frequência das disfluências comuns e gagas e a velocidade nas tarefas pesquisadas. Adotou-se o teste de Kruskal & Wallis em conjunto com o de comparações múltiplas de Duncan para comparar as medianas e verificar possíveis diferenças entre as tarefas pesquisadas com nível de significância de 5%. Resultados A tarefa de leitura apresentou menor número de disfluências comuns e percentual de descontinuidade de fala em relação às tarefas de fala espontânea e reconto. Não foram encontradas diferenças estatisticamente significantes entre as disfluências gagas nas três tarefas pesquisadas. Conclusão Este trabalho mostrou que existem diferenças na ocorrência das disfluências comuns - hesitações, interjeições e revisões - e no percentual de descontinuidade de fala durante a leitura oral de adultos que gaguejam em relação à fala espontânea e ao reconto de texto.

ABSTRACT Purpose to describe the profile of fluency concerning the typology of disfluencies, speed, and frequency of disruptions in spontaneous speech, reading, and retelling; to compare the fluency profile in adults who stutter in spontaneous speech, reading, and retelling of text. Methods The present work is a cross-sectional comparative study with a sample composed of 15 adults who stutter of both sexes, with higher education or equivalent to complete elementary school II. Samples were collected in the tasks of spontaneous speech, reading, and text retelling through video calls made individually with the participants. The first 200 syllables expressed in each task were transcribed and analyzed according to the Fluency Profile Assessment Protocol (FPAP). The study compared the frequency of common and stuttering disfluencies and the speed in the different tasks surveyed. The Kruskal & Wallis test was used together with Duncan's multiple comparisons test to compare the medians and verify possible differences between the tasks researched with a significance level of 5%. Results The reading task presented a lower number of common disfluencies and a percentage of speech discontinuity about spontaneous speech and retelling tasks. No statistically significant differences were found between stuttering disfluencies in the three tasks surveyed. Conclusion This study showed that there are differences in the occurrence of common disfluencies - hesitations, interjections, and revisions - and in the percentage of speech discontinuity during an oral reading of adults who stutter concerning spontaneous speech and text retelling.

Terapia fonoaudiológica intensiva com adultos que gaguejam: estudo preliminar / Intensive speech-language pathology therapy with adults who stutter: preliminary study

RESUMO Objetivo Comparar os resultados da fluência e da autopercepção do impacto da gagueira na vida de adultos que gaguejam, antes e depois de terapia fonoaudiológica intensiva. Método Trata-se de estudo descritivo longitudinal com coleta de dados antes e após terapia fonoaudiológica intensiva de quatro pacientes com gagueira. O programa de terapia intensiva constituiu-se em trinta encontros, de uma hora cada, realizados em cinco sessões individuais na semana. As amostras de fala coletadas antes e após a terapia foram analisadas por dois juízes especialistas em Fluência. A análise descritiva dos dados foi realizada por meio da distribuição de frequência das variáveis categóricas e análise das medidas de tendência central e de dispersão das variáveis contínuas. A verificação da concordância entre as análises realizadas pelos dois juízes foi realizada por meio do coeficiente de correlação intraclasse (CCI). Foi realizada também a análise de correlação pelo coeficiente de correlação de Spearman, entre as variáveis da amostra de fala e os escores do OASES-A. Resultados Houve redução do percentual de descontinuidade da fala e do percentual de disfluências gagas, aumentando o fluxo de palavras por minuto dos participantes. Na análise descritiva do OASES-A observou-se que em todas as partes do questionário, houve diminuição do grau de impacto da gagueira na vida dos participantes. Conclusão Verificou-se melhora de todas variáveis analisadas após terapia intensiva. Observou-se melhora na fluência da fala e redução do impacto da gagueira na vida dos participantes, sugerindo a relevância da proposta de terapia fonoaudiológica intensiva na gagueira.

ABSTRACT Purpose To compare the results of fluency and self-perception of the impact of stuttering on the lives of adults who stutter, before and after undergoing intensive speech-language pathology therapy. Methods This is a descriptive and longitudinal study with data collection before and after intensive therapy in four patients who stutter. The intensive care program consisted of thirty one-hour sessions held in five individual sessions a week. Speech samples collected before and after therapy were analyzed by two fluency experts. Descriptive data analysis was performed through the frequency distribution of categorical variables and analysis of measures of central tendency and dispersion of continuous variables. The verification of agreement between the evaluations carried out by the two judges was performed using the intraclass correlation coefficient (ICC). Correlation analysis was also performed using Spearman's rank correlation coefficient between the variables in the speech sample and the OASES-A scores. Results There was a reduction of the percentage of stuttering disfluencies, increasing the flow of words per minute of the participants. The descriptive analysis of the OASES-A showed a decrease in the degree of impact of stuttering on the participants' lives in all parts of the questionnaire. Conclusion There was an improvement in all variables analyzed after intensive care, including an improvement in speech fluency and a reduction in the impact of stuttering on the participants' lives, which suggests the relevance of the intensive speech therapy proposal for stuttering.

Three verbal fluency tasks: Normative data and convergent validity in Argentines over 50 years / Três tarefas de fluência verbal: dados normativos e validade convergente em argentinos com mais de 50 anos

ABSTRACT Verbal fluency tasks are frequently used in neuropsychological assessment, standing out for their easy application and good sensitivity to early cognitive impairment. However, in Argentina, the availability of updated norms is limited, especially for the action fluency variant. There is also little evidence of validity. Objectives: The aim of this study was to obtain Argentine norms for three verbal fluency tasks and to analyze their convergent validity. Methods: Using a nonprobability sampling method, 303 Argentines from a nonclinical population (age mean=66.8, 50-91 years) were recruited to participate in this study. Those with medical conditions that could compromise neuropsychological performance were excluded. Three verbal fluency tasks (i.e., phonological, semantic, and action), the Montreal Cognitive Assessment (MoCA) test, and the Digit Span-WAIS III test were administered. Correlations and multiple regressions were subsequently performed. Results: Education and age significantly explained 11.8% of the variance in phonological fluency, 15.8% of the variance in semantic fluency, and 20.2% of the variance in action fluency. Hence, the normative data varied according to educational level and age group, with normal performance limit values between 9 and 14 for phonological fluency, 11 and 18 for semantic fluency, and 8 and 17 for action fluency. Positive correlations were obtained between all verbal fluency tasks, as well as between the MoCA test and the Digit Span test. Conclusions: This study supports the applicability of three verbal fluency tasks in an Argentine context by providing age- and education-corrected norms and acceptable evidence of convergent validity.

RESUMO As tarefas de fluência verbal são frequentemente utilizadas na avaliação neuropsicológica, destacando-se pela facilidade de aplicação e boa sensibilidade ao comprometimento cognitivo incipiente. No entanto, na Argentina, a disponibilidade de padrões atualizados é limitada, especialmente pela variante de fluência de ações. Assim sendo, a evidência de validade é escassa. Objetivos: Obter normas argentinas para três tarefas de fluência verbal e analisar sua validade convergente. Métodos: Usando um método de amostragem não probabilística, 303 argentinos de uma população não clínica (idade M=66,8, 50-91 anos) foram recrutados para participar deste estudo. Foram excluídos aqueles com condições médicas que pudessem comprometer o desempenho neuropsicológico. Três tarefas de fluência verbal (ou seja, fonológica, semântica e ações), o teste Montreal Cognitive Assessment (MoCA) e o teste Digit Span-WAIS III foram administrados. Correlações e regressão múltipla foram realizadas posteriormente. Resultados: A escolaridade e a idade explicaram significativamente 11,8% da variância da fluência fonológica, 15,8% da variância da fluência semântica e 20,2% da variância da fluência de ações. Assim, os dados normativos variaram de acordo com a escolaridade e a faixa etária, com limite de desempenho normal entre 9 e 14 para fluência fonológica, 11 e 18 para fluência semântica e 8 e 17 para fluência de ações. Foram obtidas correlações positivas entre todas as tarefas de fluência verbal, bem como entre estas, o teste MoCA e o Digit Span. Conclusões: Este estudo apoia a aplicabilidade de três tarefas de fluência verbal no contexto argentino, fornecendo normas corrigidas por idade e educação e evidências aceitáveis de validade convergente.

Las relaciones entre prosodia y comprensión lectora en alumnos hispanohablantes: revisión sistemática y metaanálisis / Relations between prosody and reading comprehension in Spanish-speaking students: systematic review and meta-analysis

Resumen La fluidez ha sido considerada como uno de los factores relevantes que interviene en la comprensión lectora. Actualmente se incluye en la fluidez, además de la velocidad y la precisión, la prosodia como uno de los componentes que actúa de forma preponderante en la construcción del significado de la lectura. El propósito de este estudio fue realizar una revisión sistemática y un metaanálisis para determinar, por un lado, la situación de la agenda investigativa en la materia y, por el otro, mensurar la magnitud de la relación entre prosodia y comprensión lectora en alumnos hablantes nativos del español. Se realizó para ello un rastreo bibliográfico en las bases de datos Dialnet, Redalyc, SciELO, ERIC, Scopus y PubMed, sin restricciones temporales. En la revisión sistemática se incluyeron 18 estudios. Con los estudios correlacionales (n = 12) se llevó a cabo un metaanálisis multinivel, en el que se examinaron 59 coeficientes de correlación. El análisis mostró una asociación significativa entre prosodia y comprensión lectora (t(58) = 9.77, p < .001) con un efecto moderado de .46 (Z de Fisher = .49 [95 % CI = .39, .59]). Ni el nivel escolar al que asisten los alumnos (primario o secundario), ni el nivel en el que se evaluó la comprensión (oración o texto) moderaron la relación entre las variables. En suma, los resultados sostienen que las habilidades prosódicas contribuyen al procesamiento semántico de las oraciones y textos en español, más allá del nivel educativo del que se trate.

Abstract Fluency has been considered one of the relevant factors involved in reading comprehension, by providing a bridge between decoding and comprehension. At present, fluency includes, alongside rate and accuracy, prosody as one the parts which plays a preponderant role in the construction of meaning during the reading process. Prosodic reading is the use of oral language features when reading a text, such as pausing, stress and intonation, in order that the text will be read aloud with the tonal and rhythmic characteristics of speech. Furthermore, prosodic reading makes it possible to organize word sequences into syntactically cohesive units of meaning. The aim of this study was to conduct a systematic review and meta-analysis, firstly, in order to determine the situation of research articles which enquire into the relation between prosody and reading comprehension, and secondly, to measure the significance of that relation in students who are native speakers of Spanish. To that end, a bibliographic search was performed without time restrictions in the following databases: Dialnet, Redalyc, SciELO, ERIC, Scopus and PubMed. The systematic review included 18 studies. The qualitative synthesis showed four categories of articles: (1) validation studies of instruments to assess reading fluency; (2) intervention studies on different prosodic aspects and enquiries into their impact on reading comprehension; (3) comparisons of good and poor comprehenders; and (4) correlational studies. A multilevel meta-analysis was performed in the correlational studies (n = 12), examining 59 correlation coefficients. The analysis showed a significant association between reading comprehension and prosody (t(58) = 9.77, p < .001) with a moderate effect of .46 (z = .49 [95 % CI = .39, .59]). Once outlier values had been removed, no variation was found in the size of the estimated effect (r = .46). Two additional models were adjusted, including as moderating variables, respectively, the type of assessment performed on comprehension (sentence or text level) and the educational level (primary or secondary). The results obtained from these models suggest the association between comprehension and prosody is neither moderated by the type of assessment carried out (F(1, 57) = 1.51, ρ = .22), nor by the educational level (F(1, 57) = 0.10, ρ = .75). In summary, the meta-analysis showed a moderate relation between prosody and reading comprehension. These relations continued beyond the level at which the latter variable (sentence or text) was examined, and throughout the school trajectory. In other words, and in contrast to other aspects of fluency, such as accuracy and rate, prosody seems to maintain its contribution to comprehension. In sum, the findings support the claim that suprasegmental skills, both at lexical level (i. e. the skills related to the identification, stress and manipulation of stressed syllables in words) and at metrical level (the capabilities responsible for processing intonation, rhythm and pausing when reading), contribute to the semantic processing of sentences and texts in Spanish, regardless of the educational level under analysis. These results should be moderated given the limited number of studies found and the smaller amount of research carried out at secondary school level. In spite of these limitations, the relationships observed among the variables studied support the importance of prosodic reading to psychoeducational diagnosis and intervention in reading comprehension, and they provide significant background for future research.

Fluência de leitura, reconhecimento de palavras e compreensão leitora em alunos do 4º ao 9º ano do ensino fundamental: revisão sistemática / Fluidez lectora, reconocimiento de palabras y comprensión lectora en estudiantes de 4° a 9° año de educación primaria: revisión sistemática / Reading Fluency, Word Recognition and Reading Comprehension of Students From the 4th to the 9th Grade of Elementary School: Systematic Review

O processamento da leitura é resultado da interação de distintos processos cognitivos, como reconhecimento de palavras, compreensão oral e fluência. Há evidências sobre a importância da fluência para predizer a com-preensão de leitura, mas ainda não é claro seu papel ao longo do desenvolvimento. Essa revisão sistemática analisou estudos nacionais e internacionais sobre a re-lação das habilidades de reconhecimento de palavras e fluência de leitura com a compreensão de leitura em alunos do 4º ao 9º ano. A revisão foi conduzida de acordo com a metodologia prisma e utilizou a base de dados PubMed, de 2000 a setembro de 2019. Foram incluídos artigos que respondiam à pergunta norteadora e atendiam à temática estabelecida pelos descritores e palavras-chave. Foram encontrados 992 artigos, dos quais 904 foram excluídos pelo título e resumo e 56 pela leitura do texto completo. Isto possibilitou a análise de 32 artigos. Os resultados sugerem que, diferentemente do reconhecimento de palavras, a habilidade de fluência de leitura tende a manter relação significativa com a compreensão de leitura no decorrer do segundo ciclo do Ensino Fundamental.

El procesamiento de la lectura es el resultado de la interacción de diferentes procesos cognitivos, como el reconocimiento de palabras, la comprensión oral y la fluidez. Existe evidencia sobre la importancia de la fluidez en la predicción de la comprensión lectora, pero a lo largo del desarrollo su papel no está claro. Esta revisión sistemática analizó estudios nacionales e internacionales sobre la relación entre las habilidades de reconocimiento de palabras y fluidez lectora con la comprensión lectora en estudiantes de 4° a 9° grado. La revisión se realizó de acuerdo con la metodología prisma y utilizó la base de datos PubMed, desde el 2000 hasta septiembre de 2019. Fueron incluidos artículos que respondieron a la pregunta guía y cumplieron con la temática establecida por los descriptores y palabras clave. Se encontraron 992 artículos, de los cuales 904 fueron excluidos por título y resumen, y 56 por lectura de texto completo. Esto permitió el análisis de 32 artículos. Los resultados sugieren que, a diferencia del reconocimiento de palabras, la habilidad de fluidez lectora tiende a mantener una relación significativa con la comprensión lectora durante el segundo ciclo de la escuela primaria.

Text processing results from the interaction of different cognitive processes, such as word recognition, listening comprehension, and fluency. There is evi-dence relating to the importance of fluency in pre-dicting reading comprehension, but its role during the course of development is still uncertain. The present systematic review has analyzed national and inter-national research on the relationship between word recognition skills and reading fluency with reading comprehension in students from the 4th to 9th grade. The review was conducted according to theprismamethodology and employed the PubMed database from 2000 to September 2019. The chosen papers answered the orienting question and corresponded to the topic established by the descriptors and keywords. We found 992 articles, of which 904 were excluded by reading the titles and abstracts and 56 by reading the full texts. It was possible to analyze 32 papers. The results suggest that, unlike word recognition, the ability to read fluently tends to uphold a significant relationship with reading comprehension during the second cycle of Elementary School.

Understanding speech disorders for clinical practice

Speech is the vocal utterance of language and it is considered disordered in three underlying ways: voice, articulation, and fluency, its disorder is to be studied from same pattern. The features that should be considered in determining a voice disorder are: Volume: how loudly or softly we speak, Pitch: how pleasant or unpleasant Quality: the highness or lowness of one’s voice, Rate: the speed at which one speaks. Homeoapthic repertory shows these symptoms, but caution is mechanical problem should not consider as dynamic derangement.

Características fonológicas en población escolar con dislexia: Un modelo de ecuaciones estructurales / Phonological features in a school population with dyslexia: A structural equation model

Resumen Introducción: El trastorno específico del aprendizaje es una entidad nosológica del neurodesarrollo, las manifestaciones clínicas se hacen evidentes en la etapa escolar y son persistentes en el transcurso de la vida. La dislexia (DS) se caracteriza por una afectación en la comprensión y fluidez del proceso lector, asociada a déficits neurocognitivos. Objetivo: Analizar. la relación existente entre fluidez fonológica, repetición, denominación y comprensión verbal en niños con diagnóstico de DS. Método: Se empleó una muestra de N=114 personas con diagnóstico de DS escolarizados, en edades entre 7 y 16 años y un. muestreo no probabilístico. Construimos un modelo de ecuaciones estructurales (MEE) en el software RCran 4.0.4, para analizar la relación entre las variables latentes (fluidez fonológica, fluidez semántica, repetición de pseudopalabras, repetición de frases, denominación y comprensión verbal), a través de los resultados de pruebas psicométricas estandarizadas; Test de Fluencia Verbal, Test de Boston, Evaluación Neuropsicológica Infantil y Escala Weschler IV de Inteligencia. Resultados: Las covarianzas entre fluidez fonológica y todos los componentes del lenguaje (LG) fueron positivas; fluidez semántica (σxy=0,55), repetición de pseudopalabras (σxz=0,53), repetición de frases (σxw=0,64), denominación del LG (σxv=0,60), comprensión verbal (σxy=0,57), lo que indica una relación directa. En las personas con DS, a menor fluidez fonológica mayores deficiencias del LG. Conclusión: En la DS la fluidez fonológica y semántica es limitada y se relaciona de manera directa con las manifestaciones clínicas de este trastorno del neurodesarrollo (TN).

Abstract Introduction: The specific learning disorder is a nosological entity of neurodevelopment, the clinical manifestations become evident in the school stage and are persistent throughout life. Dyslexia (DS) is characterized by an impairment in the comprehension and fluency of the reading process, associated with neurocognitive deficits. Objective: To analyze the relationship between phonological fluency, repetition, naming and verbal comprehension in children diagnosed with dyslexia (DS). Method: A sample of (N=114) school patients with DS diagnosis between the ages of 7 and 16 years, selected by non-probability sampling, was used. We built a structural equation model (MEE) in RCran 4.0.4 software, to analyze the relationship between the latent variables (phonological fluency, semantic fluency, pseudoword repetition, sentence repetition, naming and verbal comprehension), through the results of standardized psychometric tests; Verbal Fluency Test, Boston Test, Child Neuropsychological Assessment and Weschler Intelligence Scale IV. Results: Covariances between phonological fluency and all language (LG) components were positive; semantic fluency (σxy=0.55), pseudoword repetition (σxz=0.53), sentence repetition (σxw=0.64), LG naming (σxv=0.60), verbal comprehension (σxy=0.57), indicating a direct relationship. In people with DS, the lower the phonological fluency the greater the language deficits. Conclusion: In DS, phonological and semantic fluency is limited and is directly related to the clinical manifestations of this neurodevelopmental disorder (TN).

Effects of transcranial direct current stimulation on the picture naming and phonemic fluency of aphasics / 中华物理医学与康复杂志

Objective:To observe any effect of transcranial direct current stimulation (tDCS) on the speed and accuracy of picture naming and on the phonological fluency of aphasic stroke survivors.Methods:Twenty-four stroke survivors with aphasia were randomly divided into an observation group and a control group, each of 12. In addition to language training and picture naming training, the observation group received 20 minutes of tDCS over the left dorsolateral prefrontal cortex (DLPFC) daily, 5 days a week for 2 weeks. The control group was given sham stimulation. Before and after the 2 weeks of treatment, both groups were tested for picture naming and phonological fluency.Results:Significant improvement in the number of accurately pronounced high-frequency words and in reaction time was observed in both groups, but the observation group′s average reaction time for high-frequency words was significantly shorter than the control group′s average. The observation group′s average reaction time for low-frequency words had also improved significantly. After the 2 weeks of treatment, the phonological fluency of the observation group was significantly better than before the treatment and better than that of the control group.Conclusions:tDCS applied over the left DLPFC of stroke survivors with aphasia can promote lexical retrieval and strengthen their executive and control functioning.

Subjective visual quality, reading fluency and patient satisfaction with the extended depth of focus IOL / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the subjective visual quality, reading fluency and patient satisfaction after a unilateral or bilateral implantation of the Tecnis Symfony extended depth of focus intraocular lens(IOL)with cataract.<p>METHODS: The retrospective analysis on the 48 patients(71 eyes)with cataract phacomulsification surgery in our hospital, which were randomly divided into two groups. The bilateral group with 23 patients(46 eyes)bilateral implanted the Symfony extended depth of focus IOL, the unilateral group with 25 patients(25 eyes)implanted the Symfony IOL in one eye and an aspherical monofocal IOL in the other eye. The uncorrected distance visual acuity(UDVA), uncorrected intermediate distance visual acuity(UIVA), uncorrected near distance visual acuity(UNVA), and best corrected distance visual acuity(BCVA)were measured 3, 6mo after surgery. The contrast sensitivity, reading fluency, reading speed, patient satisfaction and the occurrence of complications were also observed.<p>RESULTS: In the unilateral group, there were no significant differences in the UDVA and BCVA between an eye with the Symfony IOL and an eye with monofocal IOL 3mo after surgery(P>0.05). After 6mo of surgery, UDVA were significantly better than pre-operation in two groups, average visual acuity of LogMAR was under 0.1. There were no significant differences in UDVA, BCVA, UIVA and UNVA between two groups(P>0.05). The patients'far, intermediate, and near distances satisfaction were higher after 3mo of surgery. There were no statistically significant differences in spatial frequency contrast sensitivity between the two groups under photopic/mesopic conditions and mesopic with glare 6mo after surgery. The scores of satisfactions for reading fluency were better in the bilateral group than in the unilateral group(P>0.05). After 6mo, the reading speed of binocular group was slightly higher than the unilateral group(P<0.05), but there was no significant difference between two groups(P >0.05).<p>CONCLUSION:The Symfony extended depth of focus IOL provides good far, intermediate, and near visual acuity in the bilateral group and the unilateral group, while maintaining the same level of visual quality. In both groups over 90% patients were spectacle independent. Symfony IOL has widely adaptability and highly predictability, patients can obtain better satisfactions for reading fluency and reading speed. It is more suitable for intermediate vision.

Changes of brain oxygenated hemoglobin concentration in adolescent patients with depression under speech fluency task / 中华行为医学与脑科学杂志

Objective:To explore the characteristics and differences of oxygenated hemoglobin responses in different brain regions in adolescent depressive disorder patients and healthy adolescents during speech fluency task based on functional near-infrared spectroscopy imaging.Methods:From March 2021 to June 2021, twenty-nine adolescents with depression(depressed group) and 26 healthy adolescents(normal group) were enrolled. The severity of depression was assessed by Hamilton depression scale, and the speech fluency task was performed by functional near-infrared spectroscopy brain imaging, and the relative concentrations of oxyhemoglobin in the prefrontal and bilateral temporal lobes were measured.SPSS 26.0 statistical software was used for data analysis, chi-square test was used for gender count data. The t-test was used for comparison of two groups. The measurement data that did not conform to normal distribution were compared between the two groups by Mann-Whitney U test. Results:In the speech fluency task, there was no significant difference in the concentration of oxygenated hemoglobin in prefrontal and left temporal between the depressed group and the normal group (both P>0.05); the oxygenated hemoglobin concentration in the right temporal lobe(-9.179(-22.231, 4.789)) of depressed group was significantly lower than that of the normal group (12.754(-9.438, 35.008)), and the difference was statistically significant ( U=538.00, P<0.05). The oxygenated hemoglobin concentration in right temporal lobe of depressed group had no correlation with the score of Hamilton depression rating scale ( r=0.092, P>0.05). Conclusion:The right temporal lobe function of adolescent depression patients is lower than that of healthy controls during speech fluency tasks, which provides a basis for study of the relationship between depression and some cognitive sensitivity impairment and the function of right temporal lobe.

Development of diagnosis, assessment and intervention solution for speech fluency disorder using WHO-FICs / 中国康复理论与实践

ObjectiveTo explore the diagnoses of diseases and functioning of speech fluency disorder, analyze the main assessment content, and construct framework of intervention solution based on International Classification of Diseases 11th Revision (ICD-11), International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHIβ-3). MethodsThe diagnoses of diseases and functioning was discussed with ICD-11 and ICF. The assessment tools were analyzed with ICF. A holistic intervention solution was constructed with ICF and ICHIβ-3. ResultsSpeech fluency disorder is classified as 6A01.1 developmental speech fluency disorder for ICD-11. The related diseases include 6A01.0 developmental speech sound disorder, 6A01.2 developmental language disorder, cerebral palsy, MA80.0 aphasia, MA80.1 dysphasia and MA80.2 dysarthria, etc. For ICF, the categories related to speech fluency disorder might be s3 structures invovled in voice and speech; b3 voice and speech functions, especially b330 fluency and rhythm of speech functions; d1 learning and applying knowledge, d3 communication, especially d330 speaking and d355 discussion, d7 interpersonal interactions and relationships, and d9 community, social and civic life. A holistic intervention solution for speech fluency disorder was developed, involving in body structure, body function, activities and participation, and environmental factors, including assessment, training and treatment, educational counseling, and psychological and social support, etc. ConclusionA framework of diagnosis, assessment and rehabilitation has been constructed for speech fluency disorder.

Reading Fluency of Higher Education Students / Fluência Leitora de Estudantes do Ensino Superior / Fluidez Lectora de Estudiantes de Educación Superior

Abstract The literature that links career development with reading skills is scarce. This study seeks to fill this gap, for which the reading fluency of college students was analyzed, taking into account the choice of more/less desirable courses. Desirability is based on the classifications for college access. 211 students participated in the study, 132 female, attending four courses: Mechanical Engineering, Health, Psychology, and Education, in three Portuguese Public Universities. The instruments used were the sociodemographic form and the Teste de Idade de Leitura (Reading Age Test - TIL). The results indicated that students attending less desirable courses (i.e., Education and Health) are significantly less fluent and; students who score lower on reading fluency are more likely to belong to the Education course. This study stresses the importance of the distribution of students by the different areas of studies should not reflect reading fluency asymmetries.

Resumo A literatura que articula o desenvolvimento de carreira com a leitura é escassa. Este estudo teve como objetivo analisar a fluência leitora de estudantes universitários, considerando a escolha de cursos mais/menos desejados. A desejabilidade tem por base as classificações de acesso ao Ensino Superior. Participaram 211 estudantes, 132 de sexo feminino, a frequentar quatro cursos: Engenharia Mecânica, Saúde, Psicologia e Educação, em três instituições públicas de ensino superior portuguesas. Os instrumentos utilizados foram ficha sociodemográfica e Teste da Idade de Leitura- TIL. Os resultados indicaram que estudantes de cursos menos desejados (i.e., Educação e Saúde) são significativamente menos fluentes e; estudantes com menor fluência leitora são mais prováveis de pertencerem à Educação. Este estudo destaca a importância da distribuição pelas diferentes áreas de estudo não ser um espelho de assimetrias ao nível de competências leitoras.

Resumen La literatura que vincula desarrollo profesional con habilidades lectoras es escasa. Este estudio busca llenar este vacío, analizando la fluidez lectora de estudiantes universitarios en cursos más/menos deseables. La deseabilidad de los cursos se basa en las clasificaciones de acceso a la Universidad. Participaron 211 estudiantes, 132 mujeres, de cuatro cursos: Ingeniería Mecánica, Salud, Psicología y Educación, en tres universidades públicas portuguesas. Los instrumentos utilizados fueron la ficha sociodemográfica y el Test de Edad Lectora - TIL. Los resultados indican que los estudiantes de cursos menos deseables (Educación y Salud) son significativamente menos fluentes y; estudiantes con puntuación más baja en fluidez tienen más probabilidades de pertenecer al curso de Educación. Este estudio destaca la importancia de que la distribución por las diferentes áreas de estudio en la universidad no sea un espejo de asimetrías en el nivel de habilidades lectoras.

Clustering and switching in verbal fluency: a comparison between control and individuals with brain damage / Clustering e switching na fluência verbal: comparação entre controles e indivíduos com prejuízo cerebral

ABSTRACT Purpose The aim of this study is to analyze and compare the performance and strategies used by control subjects and patients with unilateral brain damage on phonemic and semantic Verbal Fluency tasks. Methods The sample consisted of 104 participants divided into four groups (26 with left hemisphere damage and aphasia- LHDa, 28 with left hemisphere damage and no aphasia- LHDna, 25 with right hemisphere damage- RHD and 25 neurologically healthy control subjects). All participants were administered the phonemic ("M" letter-based) and semantic (animals) verbal fluency tasks from the Montreal-Toulouse Language Assessment Battery (MTL-BR). Results Patients in the LHDa group showed the worst performance (fewer words produced, fewer clusters and switches) in both types of fluency task. RHD group showed fewer switching productions when compared with controls and LHDna had fewer words productions than controls in the first 30 seconds block. Conclusion Our findings suggest that the LHDa group obtained lower scores in most measures of SVF and PVF when compared to the other groups.

RESUMO Objetivo analisar e comparar o desempenho e as estratégias utilizadas por indivíduos controle e pacientes com lesão cerebral unilateral em tarefas de Fluência Verbal fonêmica e semântica. Método A amostra foi composta por 104 participantes, divididos em quatro grupos (26 com lesão no hemisfério esquerdo e afasia - LHEa, 28 com lesão no hemisfério esquerdo e sem afasia - LHEna, 25 com lesão no hemisfério direito - LHD e 25 controles neurologicamente saudáveis). Todos os participantes realizaram tarefas de fluência verbal fonêmica - FVF (com letra "M") e semântica- FVS (animais) da Bateria Montreal-Toulouse de Avaliação da Linguagem (MTL-BR). Resultados Pacientes do grupo LHEa apresentaram pior desempenho (menos palavras produzidas, menos clusters e switching) nos dois tipos de tarefas de fluência. O grupo LHD mostrou menos produções de switching quando comparado aos controles. O grupo LHEna teve menos produções de palavras que os controles no primeiro bloco de 30 segundos. Conclusão Nossos achados concluem que o grupo LHEa obteve escores mais baixos na maioria das medidas de FVS e FVF quando comparado aos demais grupos.

Stuttering intervention in children: an integrative literature review / Intervención de la tartamudez en niños: una revisión integrativa de la literatura

ABSTRACT Purpose: to describe intervention methodologies implemented in recent years in stuttering children. Methods: a search was performed for empirical articles on interventions in stuttering children aged 2.5 to 7 years. The search was carried out in Embase, WOS, Pubmed, and Scopus, considering articles published between January 2014 and June 2020. Literature Review: 11 articles were selected out of the 1,099 retrieved. Different approaches were observed, of which the Lidcombe program showed the most evidence. Most studies were conducted on English-speaking children and participants were assessed regarding linguistic and non-linguistic aspects. All studies considered parental involvement in the intervention. No investigation took measurements for more than 24 months. Individual interventions predominated. Conclusion: good therapeutic results were found in all reviewed interventions. Research comparing two types of treatments did not find one to be superior to the other.

RESUMEN Objetivo: describir las metodologías de intervención implementadas durante los últimos años en niños con tartamudez Métodos: se realizó la búsqueda de artículos empíricos de tratamiento en niños con tartamudez entre los 2.5 a 7 años. Se consideraron artículos publicados entre enero del año 2014 a junio del año 2020. La búsqueda se realizó en las bases de datos Embase, WOS, Pubmed y Scopus. Junto a lo anterior se realizó un análisis de las referencias de los artículos seleccionados. Revisión de la Literatura: se seleccionaron 11 artículos de 1.099 revisados. Se observaron distintas propuestas de intervención de las cuales el Programa Lidcombe es el que mayor evidencia presenta. La mayoría de las investigaciones fueron realizadas en hablantes de lengua inglesa. Los participantes son evaluados tanto en aspectos lingüísticos como no lingüísticos. Todos consideraron la participación de los padres en la intervención. No hubo investigaciones con mediciones a más de 24 meses. Predomina la modalidad de intervención individual. Conclusión: se evidencian buenos resultados terapéuticos en todas las intervenciones revisadas. En las investigaciones que compararon dos tipos de tratamiento no se observó la superioridad de uno por sobre otro.

O Impacto do Programa "Ainda Estou a Aprender" na Fluência Leitora dos Alunos com Dificuldades / The Impact of the Program "I'm Still Learning" on Reading Fluency of Students with Difficulties / El Impacto del Programa "Todavía estoy aprendiendo" en la Fluidez Lectora de Estudiantes con Dificultades

As estratégias de intervenção no âmbito das dificuldades na aprendizagem da leitura constituem o foco deste trabalho. No panorama nacional, a escassez desses recursos educativos, associada ao fraco investimento na sua validação empírica, orientaram o nosso interesse para a análise desta temática. O recente programa Ainda Estou a Aprender (AEA) é uma ferramenta que tem como objetivo avaliar e intervir na aprendizagem da leitura, mas não se conhecem estudos que atestem a sua eficácia. Neste contexto, desenvolvemos um estudo com 44 alunos do 2º ano de escolaridade com dificuldades na aprendizagem da leitura, que distribuímos aleatoriamente por dois grupos, experimental e controle, no sentido de medir o impacto do programa AEA na fluência leitora. Ao grupo experimental foi aplicado o AEA, individualmente ou em pequeno grupo, em 18 sessões de 30 minutos durante seis semanas. O grupo de controle não seguiu o programa. O desempenho dos dois grupos foi monitorizado em três momentos (pré-teste, pós-teste e follow-up). Os resultados demonstram que os alunos do grupo experimental registaram um desempenho manifestamente superior na fluência (h2= .30), assumindo-se como uma prova da eficácia da intervenção. (AU)

Intervention strategies in the context of difficulties in learning to read are the focus of this work. In the national panorama, the scarcity of these educational resources, associated with the low investment in their empirical validation, guided our interest in analyzing this theme. The recent program "I'm Still Learning" is a tool that aims to assess and intervene in learning to read, but there are no known studies attesting to its effectiveness. In this context, we developed a study with 44 2nd grade students with difficulties in learning to read, which we randomly distributed into two groups, experimental and control, as to measure the impact of the program on reading fluency. The "I'm Still Learning" was applied to the experimental group, individually or in a small group, in 18 sessions of 30 minutes during six weeks. The control group did not follow the program. The performance of both groups was monitored at three times (pre-test, post-test and follow-up). The results demonstrate that the students in the experimental group registered a manifestly superior performance in fluency (h2 = .30), assuming this as a proof of the effectiveness of the intervention. (AU)

Las estrategias de intervención en el contexto de las dificultades para aprender a leer son el foco de este trabajo. En el panorama nacional, la escasez de estos recursos educativos, asociada a la baja inversión en su validación empírica, orientó nuestro interés por analizar este tema. El reciente programa "Todavía estoy aprendiendo" es una herramienta que tiene como objetivo evaluar e intervenir en el aprendizaje de la lectura, pero no se conocen estudios que atesten su eficacia. En este contexto, desarrollamos un estudio con 44 alumnos de segundo año con dificultades para aprender a leer, que distribuimos aleatoriamente en dos grupos, experimental y control, para medir el impacto del programa en la fluidez lectora. El "Todavía estoy aprendiendo" se aplicó al grupo experimental, individualmente o en grupo reducido, en 18 sesiones de 30 minutos, durante seis semanas. El grupo de control no siguió el programa. El desempeño de ambos grupos se controló en tres momentos (preprueba, posprueba y seguimiento). Los resultados demuestran que los estudiantes del grupo experimental registraron un desempeño manifiestamente superior en fluidez (h2 = .30), asumiendo esto como prueba de la efectividad de la intervención. (AU)

Avaliação de um programa informatizado para promoção do repertório de ler com compreensão / Evaluation of a computerized program for the development of a reading comprehension repertoire

A leitura está presente em várias situações do cotidiano, como na aquisição de conteúdos acadêmicos e em situações práticas do dia-a-dia, portanto, quem a compreende apresenta maior autonomia para interagir com o ambiente. O objetivo deste estudo foi avaliar a eficiência do Módulo 3, parte do Currículo de Ensino "Aprendendo a ler e a escrever em pequenos passos", na promoção da leitura com compreensão e da fluência de leitura. O Módulo 3 era composto por 15 livros com a finalidade de promover comportamentos de identificar fatos explícitos nos textos, fazer inferências, identificar o tema da história e aprender vocabulário contextual. Participaram do estudo 11 crianças do ensino fundamental, separadas em grupo controle e experimental. Foram utilizadas medidas de compreensão textual e de fluência de leitura antes e após o procedimento de ensino, as quais foram analisadas com o programa estatístico R Core Team. Foi demonstrado aumento significativo na medida de compreensão de textos para as crianças do grupo experimental, quando comparados os resultados com o grupo controle. Sobre a fluência de leitura, não houve diferença significativa entre as medidas na comparação entre os grupos, entretanto o grupo experimental apresentou aumento significativo da medida quando comparado com ele mesmo.

Reading is present in many situations of our everyday life such as in the acquisition of academic contents and in our daily practical situations; however, those who understand it shows more autonomy to interact with the environment. The objective of this study was to evaluate the efficiency of Module 3, part of the Teaching Curriculum "Learning to read and write in small steps", towards the improvement of the reading comprehension and reading fluency. Module 3 includes 15 books with the objective to promote the identification of explicit facts in the texts, to make inferences, to identify the theme of the story and to learn contextual vocabulary. Eleven elementary school children participated in the study divided into a control group and an experimental group. The study adopted text comprehension reading fluency measures before and after the teaching procedure, analyzed by the R Core Team statistical program. Results showed significant increase in the text comprehension measure for children from the experimental group when compared to the results from the control group. In regards to reading fluency, there was no significant difference between the comparative measures between the groups; however, the experimental group showed significant increase in this measure, when compared to itself.

Velocidad de la marcha y cognición en adultos mayores en atención secundaria de salud / Velocidade da marcha e cognição em idosos da atenção secundária em saúde / Gait speed and cognition in elderly users of secondary care service

Objetivo: analizar la asociación entre la velocidad de la marcha y la cognición de adultos mayores que se encuentran en asistencia ambulatoria geriátrica y gerontológica. Materiales y método: estudio cuantitativo transversal realizado con 407 adultos mayores (≥ 60 años) atendidos en el Centro Ambulatorio de Geriatría y Gerontología del municipio de São José dos Pinhais, Paraná (Brasil). La condición de fragilidad física se evaluó utilizando el fenotipo de fragilidad y el cribado cognitivo mediante el Mini-Mental State Examination y el test de fluencia verbal semántica. El análisis univariado se realizó mediante una prueba de chi-cuadrado con nivel de significación estadístico de p ≤ 0,05. Resultados: del total de participantes, se observaron 226 (55,5 %) adultos mayores prefrágiles, 238 (58,5 %) reportaron deterioro cogntivo, 90 (22 %) de la fluidez verbal semántica y 205 (50,4 %) presentaron velocidad de la marcha reducida, variable que registró una asociación significativa con el deterioro cognitivo (p = 0,003) y las alteraciones de la fluencia verbal semántica (p < 0,001).Conclusiones: los resultados señalan la necesidad de implementar la evaluación de la velocidad de la marcha en adultos mayores como parte de la práctica clínica de geriatría y gerontología. Este componente revela un posible deterioro cognitivo y permite la realización de acciones que puedan perfeccionar el manejo de los cuidados ante la fragilidad física en adultos mayores.

Objetivo: analisar a associação entre a velocidade da marcha e a cognição de idosos em assistência ambulatorial de geriatria e gerontologia. Materiais e método: estudo quantitativo transversal, realizado com 407 idosos (≥ 60 anos), atendidos no Ambulatório de Geriatria e Geron-tologia, do município de São José dos Pinhais, Paraná, Brasil. A condição de fragilidade física foi avaliada mediante o fenótipo de fragilidade e o rastreio cognitivo pelo Mini-Exame do Estado Mental e Teste de Fluência Verbal Semântica. A análise univariada foi realizada por teste de quiquadrado com nível de significância estatístico de p ≤ 0,05. Resultados:do total de participantes, foram observados 226 (55,5 %) idosos pré-frágeis, 238 (58,5 %) apresentaram declínio cognitivo, 90 (22 %) comprometimento na fluência verbal semântica e 205 (50,4 %) velocidade da marcha reduzida, variável que registrou associação significativa com o comprometimento cognitivo (p = 0,003) e alterações da fluência verbal semântica (p < 0,001). Conclusões: os resultados apontam para a necessidade de implementar na prática clínica de geriatria e gerontologia a avaliação da velocidade da marcha em idosos. Esse componente revela possibilidades de comprometimento cognitivo e faculta ações que possam aprimorar a gestão de cuidados diante da fragilidade física em idosos

Objective: To study the association between gait speed and cognition in elderly patients undergoing geriatric and gerontological outpatient treatment. Materials and method:Quantitative and cross-sectional study with 407 elderly patients (≥60 years) treated at the Geriatrics and Gerontology Outpatient Clinic in the town of São José dos Pinhais, Paraná (Brazil). Physical frailty condi-tion was assessed using the frailty phenotype and the cognitive assessment by means of the Mini Mental State Examination and the Semantic Verbal Fluency Test. The univariate analysis was performed using a chisquare test with a level of statistical significance of p ≤ 0.05. Results: Out of the total participants, we observed that 226 (55.5%) elderly patients were pre-frail, 238 (58.5%) had cognitive impairments, 90 (22%) showed impaired semantic verbal fluency, and 205 (50.4%) decreased gait speed. This last variable showed a significant association with cognitive decline (p = 0.003) and changes in semantic verbal fluency (p < 0.001). Conclusions: Our results indicate the need of implementing gait speed assessment in elderly patients in the geriatrics and gerontology clinical practice. This component reveals a possible cognitive deterioration and enables us to develop actions that may improve care management in the face of physical frailty in elderly individuals.