Diagnosing dementia and normal aging: clinical relevance of brain ratios and cognitive performance in a Brazilian sample

Abstract

The main objective of the present study was to evaluate the diagnostic value (clinical application) of brain measures and cognitive function. Alzheimer and multiinfarct patients (N = 30) and normal subjects over the age of 50 (N = 40) were submitted to a medical, neurological and cognitive investigation. The cognitive tests applied were Mini-Mental, word span, digit span, logical memory, spatial recognition span, Boston naming test, praxis, and calculation tests. The brain ratios calculated were the ventricle-brain, bifrontal, bicaudate, third ventricle, and suprasellar cistern measures. These data were obtained from a brain computer tomography scan, and the cutoff values from receiver operating characteristic curves. We analyzed the diagnostic parameters provided by these ratios and compared them to those obtained by cognitive evaluation. The sensitivity and specificity of cognitive tests were higher than brain measures, although dementia patients presented higher ratios, showing poorer cognitive performances than normal individuals. Normal controls over the age of 70 presented higher measures than younger groups, but similar cognitive performance. We found diffuse losses of tissue from the central nervous system related to distribution of cerebrospinal fluid in dementia patients. The likelihood of case identification by functional impairment was higher than when changes of the structure of the central nervous system were used. Cognitive evaluation still seems to be the best method to screen individuals from the community, especially for developing countries, where the cost of brain imaging precludes its use for screening and initial assessment of dementia.

Distinguishing between Vascular Dementia and Alzheimer's Disease by Means of the WAIS: A Meta-analysis

“…Inappropriate age and severity of dementia matching was present in 14 studies, which were therefore excluded from the meta-analysis (Almkvist, Backman, Basun & Wahlund, 1993;Chaves et al, 1999;Crawford, Parker & Besson, 1988;Gainotti, Parlato, Monteleone & Carlomagno, 1992;Gandolfo, Vecchia, Moretti, Brusa & Scotto, 1985;Gfeller & Rankin, 1991;Hagberg & Gustafson, 1985;Hier, Warach, Gorelick & Thomas, 1989;Inzelberg, Shapira & Korczyn, 1990;Mazzucchi et al, 1987;McCleary, Dick, Buckwalter, Henderson & Shankle, 1996;Neshige, Barrett & Shibasaki, 1988;Perez et al, 1975;Rabey, Neufeld, Treves, Sifris & Korczyn, 1996). Due to inadequate data reports, two more studies were excluded (Carlesimo, Fadda, Lorusso & Caltagirone, 1994;Fahlander et al, 2002).…”

Cognitive Performance of Patients with Epilepsy and Calcified Neurocysticercotic Lesions: A Case–Control Study

“…A battery of memory, visuospatial abilities, calculation, abstraction, praxis, and gnosis tests (15,16) were applied to assess cognition, including the Mini-Mental State Examination (MMSE) (17). Copying pictures of a house and a clock (15,16) was used to evaluate visuoconstructional abilities.…”

“…Copying pictures of a house and a clock (15,16) was used to evaluate visuoconstructional abilities. The spatial recognition span test (18) (SRS) was used to test visual memory span.…”

“…The spatial recognition span test (18) (SRS) was used to test visual memory span. Immediate memory was assessed by the digit span (DS) and word span (WS) (15,16). Logical memory consisted of a short story narrative that was tested immediately (immediate logical memory, ILM) and 20 min later (delayed logical memory, DLM) (15,16).…”

Avaliação do desempenho cognitivo de pacientes com Neurocisticercose

“…Considerando os pontos de corte de cada teste cognitivo, ou seja, os escores considerados alterados de acordo com a bateria de teste 92,93 , pode-se notar um elevado número de pacientes com NCC com resultados alterados nos diversos testes cognitivos. A tabela 6 apresenta, em número e freqüência, os escores alterados nos diversos testes cognitivos nos três grupos estudados.…”