ALESSANDRA FERNANDES BACCARO
Projetos de Pesquisa
Unidades Organizacionais
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
2 resultados
Resultados de Busca
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- Validation of the Brazilian-Portuguese version of the Modified Telephone Interview for cognitive status among stroke patients(2015) BACCARO, Alessandra; SEGRE, Adriana; WANG, Yuan-Pang; BRUNONI, Andre R.; SANTOS, Itamar S.; LOTUFO, Paulo A.; BENSENOR, Isabela M.; GOULART, Alessandra C.AimsTo examine the psychometric properties of the Brazilian version of the Modified Telephone Interview for Cognitive Status (TICS-M) for cognitive impairment in post-stroke patients from the Stroke Mortality and Morbidity Study. MethodsThe original version of the TICS-M was translated and adapted into Brazilian-Portuguese language in 30 non-clinical subjects. After that, two trained researchers applied the TICS-M in 73 stroke participants from the Stroke Mortality and Morbidity Study; however, 12 carried out only the first evaluation and 61 participants completed the follow up: (i) personal interview 6months after stroke; (ii) telephone interview 1week after the first evaluation; and (iii) telephone interview 2weeks after the first evaluation. The reliability of the TICS-M was calculated by test-retest Pearson's correlation, intraclass correlation and Cronbach's alpha coefficient in 61 participants. Also, using data from the same participants, we carried out the analysis of the receiver operating characteristics curve using the Mini-Mental State Examination as a comparison. The structural validity of the TICS-M was assessed through principal components analysis in 103 individuals (30 non-clinical and 73 stroke patients). ResultsTest-retest reliability and intraclass correlation ranged from 0.87 to 0.97 across the evaluations. The Cronbach's alpha was 0.96. Principal components analysis extracted three meaningful domains: working memory, recall memory and orientation. The best cut-off point to screen cognitive impairment was 14 out of 15 (91.5% sensitivity, 71.4% specificity). The area under the curve was 0.89. ConclusionsThe Brazilian version of the TICS-M has been found to be a reliable, stable and homogeneous instrument to screen cognitive impairment in stroke patients. Geriatr Gerontol Int 2015; 15: 1118-1126.
- Does stroke laterality predict major depression and cognitive impairment after stroke? Two-year prospective evaluation in the EMMA study(2019) BACCARO, Alessandra; WANG, Yuan-Pang; BRUNONI, Andre Russowsky; CANDIDO, Miriam; CONFORTO, Adriana Bastos; LEITE, Claudia da Costa; LOTUFO, Paulo A.; BENSENOR, Isabela M.; GOULART, Alessandra C.Depression and cognitive impairment are common conditions following stroke. We aimed to evaluate stroke laterality as predictor of post-stroke depression (PSD) and cognitive impairment (PCI) in a stroke cohort. Major depression (Patient Health Questionnaire-9, score >= 10) and cognitive impairment (Modified Telephone Interview for Cognitive Status, score < 14) were evaluated at 6 months and yearly up to 2 years. Survival analyses were performed by Kaplan-Meier curves and Cox logistic regression models, adjusted for potential confounders (cumulative hazard ratio, HR; 95% confidence interval, CI), for the likelihood of subsequent PSD or PCI progression at 6 months and 2 years, according to stroke laterality (right hemisphere-reference). Among 100 stroke patients, we found 19% had PSD and 38% had PCI 2 years after stroke. Most participants (53%) presented right-sided stroke. However, right-sided stroke was not associated with PSD or PCI. Overall, left-sided stroke was an independent and long-term predictor of PCI, but not of major depression. Left-sided stroke was associated with a high probability of PCI (42.6% and 53.2%, respectively at 6 months and 2 years, p-log-rank: 0.002). The HR of PCI due to left-sided stroke was 3.25 (95% CI, 1.30-8.12) at 6 months and remained almost the same at 2 years (HR, 3.22;95% CI, 1.43-7.28). The risk of having worse cognition status increased by > 3 times, 2 years after stroke. The results support the hypothesis that involvement of networks in the left, but not in the right hemisphere, contribute to long-term cognitive impairment. Lesion laterality did not influence the risk of PSD.