ABSTRACT
Introduction: The Frontal Assessment Battery (FAB) is a for the assessment of executive functions. We investigated its validity and reliability and proposed normative data in a representative sample of older adults. Method: 391 healthy elderly subjects and 93 Alzheimer's disease (AD) patients performed the FAB. Internal consistency, convergent correlations, ROC curve and logistic regression were used to assess its psychometric properties. Results: We found good internal consistency, significant correlations with other tests and moderate accuracy (64%) for AD diagnosis. The use of specific subtests increased diagnostic potential (75%). Normative data stratified by age and education were proposed. Conclusion: The FAB showed adequate psychometric properties. The normative values stratified by age and education can improve its clinical use for neuropsychological assessment.
Introdução: A Bateria de Avaliação Frontal (BAF) é um teste de rastreio para o exame das funções executivas. Investigou-se sua validade e fidedignidade e propuseram-se dados normativos em uma amostra representativa de idosos. Método: 391 idosos saudáveis e 93 pacientes diagnosticados com doença de Alzheimer (DA) realizaram a FAB. Consistência interna, correlações convergentes, curva ROC e regressão logística compuseram a avaliação das propriedades psicométricas do teste. Resultados: Foi encontrada boa consistência interna, correlações significativas com outros testes e acurácia moderada (64%) para o diagnóstico de DA. O uso de subtestes específicos aumentou o potencial diagnóstico (75%). Normatização estratificada por idade e escolaridade foi proposta. Conclusão: A BAF apresentou propriedades psicométricas adequadas. Os valores normativos estratificados por idade e escolaridade podem melhorar o uso desse instrumento no exame neuropsicológico.
Subject(s)
Humans , Aged , Alzheimer Disease , Executive FunctionABSTRACT
This study aimed to investigate whether the demographic variable-adjustment and supplementation of Frontal Assessment Battery (FAB) score can improve the screening ability of Mini-Mental State Examination (MMSE) for dementia and its subtypes. Five hundred forty-one non-demented comparison (NC) and 474 dementia (320 Alzheimer's disease [AD]; 139 non-Alzheimer's disease dementia [NAD]; and 15 mixed AD-NAD dementia) individuals living in the community were included. Education-adjusted MMSE (MMSE-edu) score showed significantly better screening accuracy for overall dementia, AD, and NAD than MMSE raw score. FAB-supplemented MMSE (MMSE-FAB) score had significantly better screening ability for NAD, but not for overall dementia and AD, than MMSE raw score alone. Additional supplementation of FAB to MMSE-edu further increased the ability for overall dementia or NAD screening, but not for AD screening. Further education adjustment of MMSE-FAB also improved its ability for overall dementia, AD, and NAD screening. These results strongly support the usefulness of education-adjustment and supplementation of frontal function assessment to improve screening performance of MMSE for dementia and its subtypes, NAD in particular.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Alzheimer Disease/complications , Area Under Curve , Dementia/complications , Demography , Diagnosis, Differential , Neuropsychological Tests , ROC CurveABSTRACT
Background: Type 2 diabetes mellitus may be associated with cognitive decline (CD) in older subjects. Aim: To determine if CD is more common among diabetic subjects that their non-diabetic counterparts. Material and Methods: Using a case-control design, 17 diabetic patients with a median age of 73 years (nine females) and 21 non diabetic subjects with a median age of 72 years (17 females), with a similar educational background, were studied. Cognitive status was assessed using the Mini mental State Examination (MMSE), using a cutoff point of 23, and the Frontal Assessment Battery (FAB), that evaluated conceptualization, mental flexibility, motor initiative, sensibility to interference, inhibitory control, and environmental autonomy. The presence of any mental or organic cerebral disease, sensorial impairment or illiteracy were considered exclusion criteria. Results: Fifty nine percent of diabetic subjects and 24 percent of their non-diabetic counterparts, had a MMSE below the cutoff point (p = 0.03). An abnormal FAB was found in 29 and 14 percent of diabetic and non-diabetic subjects, respectively (p = NS). Both tests were abnormal in 29 and 5 percent of diabetic and non-diabetic subjects, respectively (p = 0.05). Conclusions: In this group of subjects, CD was more common among diabetics than their non-diabetic counterparts.