Maicon Rodrigues Albuquerque

Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds

Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer’s disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity.

Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people

OBJECTIVE To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs) based on the Katz and Lawton indices for Alzheimers disease (AD) and mild cognitive impairment (MCI). METHODS In this study, 85 patients with MCI and 93 with AD, stratified by age (≤ 74 years, > 74 years), completed the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis), reliability (internal consistency), and criterion-related validity (receiver operating characteristic analysis and logistic regression) were assessed. RESULTS Three factors of ADL (self-care, domestic activities, and complex activities) were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL). The components showed good internal consistency (> 0.800) and moderate (younger participants) or high (older participants) accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. CONCLUSION The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD.

Impairment of fine motor dexterity in mild cognitive impairment and Alzheimer’s disease dementia: association with activities of daily living

Objective: Cognitive impairment is a hallmark of mild cognitive impairment (MCI) and Alzheimer’s disease dementia (AD). Although the cognitive profile of these patients and its association with activities of daily living (ADLs) is well documented, few studies have assessed deficits in fine motor dexterity and their association with ADL performance. The objective of this research paper is to evaluate fine motor dexterity performance among MCI and AD patients and to investigate its association with different aspects of ADLs. Methods: We assessed normal aging controls, patients with multiple- and single-domain amnestic MCI (aMCI), and patients with mild AD. Fine motor dexterity was measured with the Nine-Hole Peg Test and cognitive functioning by the Mattis Dementia Rating Scale. We analyzed the data using general linear models. Results: Patients with AD or multiple-domain aMCI had slower motor responses when compared to controls. AD patients were slower than those with single-domain aMCI. We found associations between cognition and instrumental ADLs, and between fine motor dexterity and self-care ADLs. Conclusion: We observed progressive slowing of fine motor dexterity along the normal aging-MCI-AD spectrum, which was associated with autonomy in self-care ADLs.

Assessment of the accuracy of a new tool for the screening of smartphone addiction

Objective To translate, adapt and validate the Smartphone Addiction Inventory (SPAI) in a Brazilian population of young adults. Method We employed the translation and back-translation method for the adaptation of the Brazilian version SPAI (SPAI-BR). The sample consisted of 415 university students. Data was collected through an electronic questionnaire, which consisted of the SPAI-BR and the Goodman Criteria (gold standard). The retests were carried out 10–15 days after the initial tests with 130 individuals. Results The SPAI-BR maintained semantic, idiomatic and conceptual equivalences from the original scale. The Confirmatory Factor Analysis confirmed the One-factor model of the SPAI with good fit indexes (x2 = 767.861, CFI = 0.913, TLI = 0.905, RMSE = 0.061, WRMR = 1.465). The Kuder-Richardson Coefficient showed good internal consistency. The analysis of the ROC curve established an area under the curve of 86.38%. The Intraclass-Correlation Coefficient of 0.926 between the test and the retest demonstrated an excellent temporal stability. The high correlation between SPAI-BR and the Goodman Criteria (rs = 0.750) established the convergent validity. Conclusion The SPAI-BR is a valid and reliable tool for the detection of Smartphone Addiction in Brazilian university students.

Análise dos padrões fundamentais de movimento em escolares de sete a nove anos de idade

Uma das fases de desenvolvimento motor na infância, no qual se adquire os padroes fundamentais de movimento, estende-se aproximadamente dos dois aos sete anos de idade. O objetivo do presente estudo foi investigar o estagio de tais padroes (saltar, correr, chutar, arremessar e receber) de alunos praticantes de educacao fisica escolar, do 3o. periodo do ensino infantil, 1a. e 2a. series do ensino fundamental. Os dados foram filmados e posteriormente analisados conforme protocolo proposto por McClenaghan e Gallahue (1985). Os resultados mostraram que o grupo do 3o. periodo apresentou os componentes dos padroes de movimento no estagio elementar e o grupo da 1a. serie encontrou-se em um processo de transicao entre o estagio elementar e maduro. Por fim, o grupo da 2a. serie apresentou os componentes dos padroes no estagio maduro. Os resultados sugerem que o estagio maduro foi atingido apenas entre oito e nove anos de idade, o que contradiz alguns modelos descritivos (Gallahue & Ozmun, 1998; Tani et al., 1988).

Factor Analysis of the Brazilian Version of UPPS Impulsive Behavior Scale

Objective: To examine the internal consistency and factor structure of the Brazilian adaptation of the UPPS Impulsive Behavior Scale. Methods: UPPS is a self-report scale composed by 40 items assessing four factors of impulsivity: (a) urgency, (b) lack of premeditation; (c) lack of perseverance; (d) sensation seeking. In the present study 384 participants (278 women and 106 men), who were recruited from schools, universities, leisure centers and workplaces fulfilled the UPPS scale. An exploratory factor analysis was performed by using Varimax factor rotation and Kaiser Normalization, and we also conducted two confirmatory analyses to test the independency of the UPPS components found in previous analysis. Results: Results showed a decrease in mean UPPS total scores with age and this analysis showed that the youngest participants (below 30 years) scored significantly higher than the other groups over 30 years. No difference in gender was found. Cronbach’s alpha, results indicated satisfactory values for all subscales, with similar high values for the subscales and confirmatory factor analysis indexes also indicated a poor model fit. The results of two exploratory factor analysis were satisfactory. Conclusion: Our results showed that the Portuguese version has the same four-factor structure of the original and previous translations of the UPPS.

Efeitos do conhecimento de resultados autocontrolado na aprendizagem motora

The purpose of this study was to examine three different strategies to provide knowledge of results (KR), yoked paired by trial and yoked paired by average of total frequency of KR in random practice. The sample was composed by 45 volunteers, distributed into three groups (n=15 subjects). The task consisted of press three keys, 2, 4, 8 and 6 in the numeric keypad of the computer in three different total time (700, 900 and 1100 ms) in random practice. The experiment consisted of acquisition phase and delay retention and transfer test. The data analysis was conducted by ANOVA and the results were not demonstrated difference between groups. The results showed no effect of self-controlled frequency of KR to the motor learning when using random practice. In addition, a new possibility to be used the yoked group was presented.

Cross-cultural adaptation to the Brazilian Portuguese language of the Waisman Activities of Daily Living (W-ADL) for adolescents and adults with developmental disabilities

Waisman Activities of Daily Living (W-ADL) is a free and brief measure of activities daily living (ADL) for adolescents and adults with developmental disabilities. However, its use is limited in non-English-speaking countries. For this reason, translation, cross-cultural adaptation, and validation for other languages are needed. Thus, this study aimed to perform a translation and cross-cultural adaptation and validation of the W-ADL from English to Portuguese language. We used a rigorous approach for translating and adapting the scale, which included a committee of six experts to assess content validity. We also conducted interviews with 62 caregivers of people with a medical diagnosis of Autism spectrum disorder (ASD) or Down syndrome (DS) with different age groups who responded about the person with ASD or DS in their care. Our results include all steps from the translation and cross-cultural adaptation process. Item Content Validity Index showed that items 5 and 16 showed values not acceptable in “relevance” and “theoretical dimension”. On the other hand, the scale content validity index indicated acceptable value. Furthermore, our results showed that our version had acceptable reliability, did not presented floor and ceiling effects, and was able to discriminate subjects from different age groups, as expected. In conclusion, the two versions of the Portuguese version of the W-ADL Scale (15 items and 17 items) demonstrated the acceptable validity and reliability measurement to evaluate ADL for adolescents and adults with developmental disabilities. However, the 15-item version seems to be the best option for Portuguese language speakers.

Cross-cultural adaptation, validity, and reliability of the Parenting Styles and Dimensions Questionnaire – Short Version (PSDQ) for use in Brazil

Objective: The Parenting Styles and Dimensions Questionnaire (PSDQ) is used worldwide to assess three styles (authoritative, authoritarian, and permissive) and seven dimensions of parenting. In this study, we adapted the short version of the PSDQ for use in Brazil and investigated its validity and reliability. Methods: Participants were 451 mothers of children aged 3 to 18 years, though sample size varied with analyses. The translation and adaptation of the PSDQ followed a rigorous methodological approach. Then, we investigated the content, criterion, and construct validity of the adapted instrument. Results: The scale content validity index (S-CVI) was considered adequate (0.97). There was evidence of internal validity, with the PSDQ dimensions showing strong correlations with their higher-order parenting styles. Confirmatory factor analysis endorsed the three-factor, second-order solution (i.e., three styles consisting of seven dimensions). The PSDQ showed convergent validity with the validated Brazilian version of the Parenting Styles Inventory (Inventário de Estilos Parentais – IEP), as well as external validity, as it was associated with several instruments measuring sociodemographic and behavioral/emotional-problem variables. Conclusion: The PSDQ is an effective and reliable psychometric instrument to assess childrearing strategies according to Baumrind’s model of parenting styles.

Confirmatory factor analysis of the general activities of daily living scale: further evidences of internal validity

The assessment of older adults with neurocognitive disorders involves the investigation of functional impairment. Usually, this is conducted by examining activities of daily living (ADL), everyday activities that should be performed without great difficulties by the patients. The most common method for measuring ADL is the use of scales and questionnaires, since they are mainly brief, low cost, and accurate. In a previous issue of Revista Brasileira de Psiquiatria, we presented the General Activities of Daily Living Scale (GADL), an instrument to assess different aspects of ADL in older adults. The GADL emphasized activities commonly assessed in clinical/research settings in Brazil, showing evidence of validity and reliability. At the time, an exploratory factor analysis suggested a three-factor structure based on activity complexity (self-care, domestic, and complex activities) as the latent structure of ADL in our sample. The GADL three-factor structure also met evidence of external validity, with each GADL factor differentially associated with complex (i.e., cognitive functioning) and more simple (i.e., finger dexterity) tasks. However, Confirmatory Factor Analysis (CFA) can provide further evidence for the suggested three-factor GADL model. In this letter, we tested the GADL three-factor hypothesis in a larger and more heterogeneous sample of older adults (n=578: 369 women) using CFA. We used a conjoined dataset of three research projects, approved by the local ethics committees of two universities in Belo Horizonte, Brazil. Participants or their caregivers, in the case of dementia, gave written consent for participation. Mean participant age was relatively high (76.067.0 years) and mean education predominately low (4.3364.21 years). Participants had a diagnosis of minor (n=247) or major neurocognitive disorder (n=228) irrespective of etiological stratification, other mental disorders coursing with cognitive-functional complaints (n=46), or were considered healthy controls (n=66). We stratified the sample based on clinical dementia rating (CDR) scores. Table 1 shows a brief description of the sample, according to CDR and GADL scores. Confirmatory analysis was performed using MPlus 6.1 software. We used a diagonally weighted least squares method, which is commonly adopted to analyze ordinal data. Factors were defined as in the original study: Selfcare (dressing/undressing, using the toilet, showering, transferring to toilet, feeding), Domestic (washing/ironing, household chores, using the telephone, preparing meals), and complex (financial control, shopping, controlling medication, using transportation). As expected in CFA, we used different fit indexes to test the model: the root mean square error of approximation (RMSEA, desired values o 0.06), the comparative fit index and the TuckerLeis index (CFI and TFI, desired values 4 0.95), and w/degrees of freedom (w/df, desired values o 3). Standardized estimates (R) and factor correlations are shown in Figure 1. Our results indicated an adequate model fit for the three-factor model: RMSEA = 0.059, CFI/TLI = 0.984/0.980, and w/df = 2.83, showing convergence with our previous research. Most factor loads were above 0.6, showing a strong relationship with each factor. The only