Silvia Mejia

Prevalence of Attention-Deficit/Hyperactivity Disorder Symptoms in 4- to 17-Year-Old Children in the General Population

The purposes of this study were (a) to estimate the prevalence of Attention-Deficit/Hyperactivity Disorder (AD/HD) symptoms in the general preschool and school population; and (b) to analyze the influence of gender, age, and socioeconomic status (SES) variables on AD/HD symptoms. Out of the 80,000 preschool and schoolchildren living in Manizales, Colombia, a random sample of 540 children was selected. Two gender, three age (4- to 5-year olds, 6- to 11 -year olds, and 12- to 17-year olds), and three SES (low, middle, and high) groups were used. The 18 DSM-IV symptoms corresponding to AD/HD Criterion A were assessed on a scale of 0 (never) to 3 (almost always). All three demographic variables established statistically significant differences: AD/HD symptoms were more frequent in 6-to 11-year-old, low-SES, male participants. DSM-IV Criterion A for AD/HD was fulfilled by 19.8% of the boys and 12.3% of the girls. However, this difference was marginally significant only in the AD/HD Subtype I: Combined. It was concluded that demographic variables are significant correlates of the AD/HD diagnosis. The prevalence found in this study was higher than usually reported, even though only the symptomatic DSM-IV AD/HD criterion was analyzed. We failed to confirm the assumed AD/HD gender ratio.

Executive Dysfunctions in Children with Attention Deficit Hyperactivity Disorder

One hundred and twenty-four male children ranging in age from seven to 12 years-old were selected. The sample was divided into two groups: (1) sixty-two with attention deficit hyperactivity disorder (ADHD) children; and (2) sixty-two normal matched controls (N-ADHD). Three tests were individually administered: (1) Wisconsin Card Sorting Test (WCST); (2) Verbal fluency and semantics (animals and fruits); and, (3) Picture Arrangement subtest of the WISC-R. For all the test scores, statistically significant differences were found between both ADHD and N-ADHD groups. Two separate factor analyses were performed, using the normal and ADHD groups. Four factors were found for the N-ADHD group, which accounted for 85.7% of the variance. The factor structure presented some similarities in both groups: Factor 2, 3 and 4 in the control group corresponded to factors 1, 2 and 3 in the ADHD group. Nonetheless, in the ADHD group Factor 1 (Abstraction and Flexibility Factor) was absent. Results are interpreted as supporting the hypothesis of executive dysfunction in children with ADHD.

Individual differences in memory and executive function abilities during normal aging.

The purpose of this study was to analyze the effects of some individual variables on memory and executive function test performance in normal aging individuals. Sixty subjects (21 males and 39 females), with a mean age of 69.66 (SD = 7.09) were selected. The following neuropsychological tests were selected. The following neuropsychological tests were administered: Associative Learning and Logical Memory from the Wechsler Memory Scale (WMS) (Wechsler, 1945), Associative Memory with Semantic Enhancement Test (AMSET) (Pineda, Galeano and Giraldo, 1991), Wisconsin Card Sorting Test (WSCT) (Heaton, 1981), and Verbal Fluency (phonologic and semantic). The effects of demographic (age, education, and sex) and some individual variables (academic history, working history, physical activity, and leisure activities) were measured. Age and education effects on test scores were observed, but no sex effect was found. Working history and leisure activities established significant differences in some test scores. A multiple regression analysis was performed. Not only demographic variables, but also individual variables were associated with memory, and albeit at a lesser extend, with executive function test scores. It was emphasized that not only demographic factors, but also individual variables have a significant effect on cognitive changes observed during normal aging.

Nongenetic factors as modifiers of the age of onset of familial Alzheimer's disease

OBJECTIVE The purpose of this research was to identify environmental and personal factors that could be related to the variability in the age of onset of familial Alzheimers disease (FAD) (36-62 years). METHODS A sample was taken of 49 subjects with FAD and with the mutation E280A in the presenilin-1 gene on chromosome 14; the sample was divided into two subgroups: 27 individuals with age of onset of the disease between 36 and 46 years (early onset) and 22 individuals whose disease began between 47 and 62 years (late onset). Information on environmental and personal factors was collected by means of a questionnaire answered by the patients if their clinical condition allowed it, or by their relatives; such information was organized in a categorical way. Comparisons between the two groups for each categorical variable were done by means of the chi-square test. Noncollinear variables that showed statistical significance were included as independent variables in a logistic regression analysis to predict their association with early onset of the disease. RESULTS Only 5 of the 140 studied variables were different between the two groups in univariate analysis: education, surgical history, type of stressful event, depression, and affective losses. The logistic regression model was constituted by education, depression, and affective losses. High-level education had approximately 15 times more probability of association with an early onset of the disease; both the history of affective losses and depressive symptoms had 4 times more probability of a similar association. CONCLUSIONS The association of high-level education and early onset of the disease could be related to an earlier detection of symptoms, in turn determined by greater intellectual and environmental demands. The occurrence of depression and affective losses has been considered a prodromic manifestation of the disease. Our findings are evidence of high clinical heterogeneity even in a genetically homogeneous group.

Cognition, functional status, education, and the diagnosis of dementia and mild cognitive impairment in Spanish-speaking elderly.

A group of 314 Spanish-speaking elders were classified in 55 participants with mild to moderate dementia, 74 participants with mild cognitive impairment (MCI), and 185 control participants, according to clinical evaluation derived. Sensitivity, specificity, and detection characteristics of frequently cognitive and functional tests were calculated in comparison with the clinical evaluation: Minimental State Examination, Brief Neuropsychological Test Battery, Short Blessed test, Pfeffer Functional Activities Questionnaire, and Blessed Dementia Scale. Influence of education on sensitivity and specificity values varied along the tests. For all the cognitive and functional measures, a great number of MCI participants who fulfilled Mayos (Mayos Clinical School) clinical criteria (Petersen et al., 1999) were misclassified as controls and a few were misclassified as demented. Level of education plays a very important role in both cognitive and functional assessment. The cognitive tests that are commonly used to screen demented patients may fail to detect MCI particularly in high-functioning individuals as well as those who are well educated.

The Boston Diagnostic Aphasia Examination-Spanish Version: The influence of demographic variables

The Boston Diagnostic Aphasia Examination Battery (BDAE) is one of the most widely used aphasia tests worldwide. Information about general population performance, however, is limited. This paper analyzes the effects of gender, age, socioeconomic status (SES), academic achievement, and occupation on the BDAE Spanish version. The BDAE was administered to a randomized sample of 156 occupationally active 19-60-year-old participants (75 male and 81 female) from two SES groups. Gender and age had a significant effect on some reading and writing subtests. Body-part naming and mechanics of writing scores were significantly decreased in the low SES group. Education had a significant impact over most of the BDAE subtests. A stepwise regression model showed that academic achievement was best able to predict the variance in BDAE scores with a low (< 15%) to modest (> 17%) but significant capability (F MANOVA p < .01). A factor analysis disclosed 7 factors that explained 67% of the total variance.

Neurobehavioral Assessment of Attention Deficit Hyperactivity Disorder in a Colombian Sample

We present a factor analytic study of the Conners Rating Scales for parents and teachers in this article. A comparison is established with the original factor analytic studies (Conners, 1979a, 1979b) and the results obtained by Farré-Riba and Narbona (1997), using a Spanish sample. Five hundred and forty children, ages 4 to 17, were randomly selected in Manizales, Colombia. The shortened Spanish version of the Conners Parents Rating Scale (CPRS; Conners, 1979a) and the Conners Teacher Rating Scale (CTRS; Conners, 1979b) were used. Parsimonious factor analyses for both scales were developed. Three stable factors were found in the CPRS: hyperactivity, somatic symptoms, and inattention. Twenty-two out of 48 items were significantly saturated by these 3 factors. In the CTRS, 4 different factors were found that accounted for 63.5% of the total variance: uncontrolled temperament, inattention, hyperactivity, and difficulties in social relationships. Twenty out of 28 items were significantly saturated by these 3 factors. Factor structure was closer to the Spanish Farré-Riba and Narbona report than to the original findings. We concluded that the CPRS and the CTRS Spanish versions, when used by Colombian children and adolescents, do not seem to evaluate exactly the same underlying behavioral dimensions. We propose selecting only 22 items of the CPRS and 20 items of the CTRS (brief versions) for further epidemiological and clinical use.

Neurobehavioral Characteristics of Adolescents with Behavioral Dysregulation Disorder

Background There is growing recognition that violence and other forms of conduct problems increase during adolescence. The exact relationship between biological, psychological, and social variables has not been defined yet. Objectives To analyze whether Intelligence Quotients (IQS), neurological history, child behavioral problems, executive functions, and soft neurological signs (SNS) can differentiate between undisciplined and unreliable adolescents (Behavioral Dysregulation Disorder subjects, BDD) and normal controls. Method Twenty-five 13 to 16-year-olds, adolescents with BDD and 25 matched controls were used in this study. WISC-R, executive function assessment, neurological history, child behavioral problems, and SNS scores were analyzed using a Multivariate Analysis of Variance (MANOVA). A Multiple Regression Stepwise with Criteria Probability of F Analysis was used for predicting criteria variable variance-Results WISC-R Verbal 1Q (VIQ), Information, Similarities, and Vocabulary subtests presented statistically significant differences between BDD and controls (p <. 001). No Performance IQ (P1Q) variables established significant differences between both groups. Executive function scores did not detect significant differences between groups either. Prenatal, neonatal, and neurological history scores were similar between both groups. Two child behavioral problem variables were significantly different, with higher scores in BDD group: use of weapons and drug-use (p <. 05). A Multiple Regression Stepwise (Criteria Probability of F <. 05) model, entering the predictive variables in each domain

Comparative Analysis of Cognitive Impairment Among Mexicans and Spanish-Speaking Immigrant’s Elders

Objectives: This study aims to compare the prevalence of cognitive impairment among older Mexicans and Spanish-speaking U.S. immigrants. Methods: The relationship of cognitive impairment with social and demographic variables was explored using data from five different population based survey studies. Results: Prevalence rates increased with age, with low educational level, didn’t show a clear association with gender and decreased in married subjects. Estimates of cognitive and functional impairment combined are greater in the immigrant samples than those for Mexican residents. Primary memory measures are the least discriminative for cognitive impairment, whereas orientation, attention, and secondary verbal memory measures discriminate better. Discussion: Mexicans and Spanish-speaking USA immigrants have similar prevalence estimates of cognitive impairment. However, prevalence of functional impairment differs between Mexicans and immigrants because of measurement issues and cultural factors.

P2-105: Usefulness of the Spanish Five-Word Memory Test for screening patients with dementia in a clinical setting

groups (AD 93.4%, MCI 53.24% and controls 23.4% p ,000). Euphoria had a very low and a similar prevalence in all groups. The rest of symptoms were more prevalent in AD patients than in MCI patients and controls (p , 000). Apathy was the most prevalent symptom in AD (77.7%) and MCI (36.2%) patients. The prevalence of delusions, hallucinations, apathy, irritability, aberrant motor activity and total prevalence and the NPI mean scores of hallucinations, apathy, disinhibition, aberrant motor activity increased along with the severity of Alzheimer s disease. Conclusions: Neuropsychiatric symptoms were more prevalent in AD and MCI patients than in controls. The prevalence and the mean scores of the majority of symptoms increased along with the severity of the disease. NPI is a useful instrument in the evaluation of behavior in cognitive impairment.