MARIA TERESA CARTHERY GOULART
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- Evolution of language assessment in patients with acquired neurological disorders in Brazil(2014) PARENTE, Maria Alice de Mattos Pimenta; BARADEL, Roberta Roque; FONSECA, Rochele Paz; PEREIRA, Natalie; CARTHERY-GOULART, Maria TeresaThe objective of this paper was to describe the evolution of language assessments in patients with acquired neurological diseases over a period of around 45 years from 1970, when interdisciplinarity in Neuropsychology first began in Brazil, to the present day. The first twenty years of data was based on memories of Speech Pathology University Professors who were in charge of teaching aphasia. We then show the contributions of Linguistics, Cognitive Psychology, as well as Psycholinguistic and Psychometric criteria, to language evaluation. Finally, the current panorama of adaptations and creations of validated and standardized instruments is given, based on a search of the databases Pubmed, Scopus and Lilacs. Our closing remarks highlight the diversity in evaluation approaches and the recent tendency of language evaluations linked to new technologies such as brain imaging and computational analysis.
- Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembe, Brazil(2016) CESAR, Karolina G.; BRUCKI, Sonia M. D.; TAKADA, Leonel T.; NASCIMENTO, Luiz F. C.; GOMES, Camila M. S.; ALMEIDA, Milena C. S.; OLIVEIRA, Maira O.; PORTO, Fabio H. G.; SENAHA, Mirna L. H.; BAHIA, Valeria S.; SILVA, Thais B. L.; IANOF, Jessica N.; SPINDOLA, Livia; SCHMIDT, Magali T.; JORGE, Mario S.; VALE, Patricia H. F.; CECCHINI, Mario A.; CASSIMIRO, Luciana; SOARES, Roger T.; GONCALVES, Marcia R.; MARTINS, Ana C. S.; DARE, Patricia; SMID, Jerusa; PORTO, Claudia S.; CARTHERY-GOULART, Maria T.; YASSUDA, Monica S.; MANSUR, Leticia L.; NITRINI, RicardoBackground:The prevalence of cognitive impairment is insufficiently determined in developing countries. The aim of this study was to ascertain the prevalence of cognitive impairment without dementia and dementia in community-dwelling elderly in Brazil.Methods:This was a single-phase cross-sectional survey of the elderly (aged 60 years and above) living in the municipality of Tremembe, Brazil. Twenty percent of the households with elderly persons were randomly selected from urban and rural areas, to obtain a homogenous representation of all socioeconomic and cultural levels.Results:We assessed 630 individuals [mean age, 71.3 y (7.99); mean years of education, 4.9 (+/- 4.54)] and found prevalence rates of 17.5% (95% confidence interval, 14.6-20.6) for dementia and 19.5% (95% confidence interval, 16.6-22.8) for cognitive impairment without dementia. These prevalence rates were influenced by age (P<0.001) and by educational level (P<0.001). There was no significant sex difference among diagnostic groups (P=0.166). The prevalence of dementia was higher in relatively younger individuals (below 70 y) when compared with other studies. Besides, dementia was associated with low socioeconomic status, stroke, previous psychiatric disorder, alcoholism, and epilepsy.Conclusions:The prevalence of dementia in this study was higher than in other studies, particularly among younger elderly.
bookPart Intervenção neuropsicológica e multidisciplinar nas dislexias adquiridas(2017) CARTHERY-GOULART, Maria Teresa- Cognitive predictors of limited health literacy in adults with heterogeneous socioeconomic backgrounds(2015) APOLINARIO, Daniel; MANSUR, Leticia L.; CARTHERY-GOULART, Maria T.; BRUCKI, Sonia M. D.; NITRINI, RicardoThe purpose of this study was to explore the relationship between health literacy and specific cognitive abilities in hospital users. A neuropsychological battery was administered and the Short Test of Functional Health Literacy in Adults was used to classify individuals as having adequate or limited functional health literacy. Of the 322 participants, 102 (31.7%) presented limited health literacy. Even after adjusting for demographics, years of education, and quality of education, health literacy was strongly associated with measures of cognitive performance, but the strength of association was variable across different cognitive abilities.
- Semantic memory for actions as assessed by the Kissing and Dancing Test: Education and age effects in cognitively healthy individuals(2014) BARADEL, Roberta Roque; SILVA, Henrique Salmazo da; ESTEQUI, Jaqueline Geraldin; PARENTE, Maria Alice de Mattos Pimenta; SATO, João Ricardo; CARTHERY-GOULART, Maria TeresaAction semantics is a relevant part of cognitive-linguistic assessment and the ""Kissing and Dancing Test"" (KDT) has been used extensively for this purpose, evidencing clinical distinctions among brain-damaged patients. To enhance its use, reference values are necessary, especially for populations with heterogeneous educational levels and socioeconomic backgrounds.OBJECTIVE: To analyze the effects of schooling and age on the KDT in cognitively unimpaired individualMETHODS: The KDT was applied to seventy-four healthy subjects. Sociodemographic factors were investigated through correlational and between-group analyses. Reference values according to age and schooling were provided.RESULTSKDT performance correlated significantly with schooling (r=0.757, p<0.01), age (r=-0.496, p<0.01) and socioeconomic status (r=0.418 p<0.01) but these variables were intercorrelated. Correlation with schooling and age remained signifi when controlling for age and socioeconomic status (r=0.530, p<0.01), and for schooling (-0.305,<0.01), respectively. When controlling for schooling, correlation between socioeconomic status and KDT was not significant (p=0.164). Between-group analyses revealed no age effects. Significant differences were found in performance according to educational level. Scores below 39/52 and below 47/52 (percentile 25) for individuals with 8 or less years of schooling and for individuals with 9 or more years of schooling, respectively, seem suggestive of an impairment in Action Semantics Processing and shall be further investigatedCONCLUSION KDT performance was influenced both by age and schooling, indicating the need to consider these demographic features as covariates when analyzing performance on the test and to adjust cut-off scores according to these demographic characteristics in clinical practice.
- Detecting limited health literacy in Brazil: development of a multidimensional screening tool(2014) APOLINARIO, Daniel; MANSUR, Leticia Lessa; CARTHERY-GOULART, Maria Teresa; BRUCKI, Sonia Maria Dozzi; NITRINI, RicardoScreening questions have been proposed as practical tools for detecting limited functional health literacy, but have achieved only moderate accuracy in previous studies. We hypothesized that a combination of screening questions and demographic characteristics could better predict a patients functional health literacy. Three hundred and twenty-two hospital users from So Paulo, Brazil, were interviewed for demographic information and answered questions about literacy habits and perceived difficulties. The Short Test of Functional Health Literacy in Adults was used to classify individuals as having adequate or limited functional health literacy. Of the 322 participants, 102 (31.7) presented limited functional health literacy. The final logistic model included six predictors. The three demographic variables were educational attainment, mothers educational attainment and major lifetime occupation (manual or non-manual). The three questions concerned frequency of use of computers, difficulty with writing that have precluded the individual from getting a better job and difficulty reading the subtitles while watching a foreign movie. A simple score was derived to constitute a practical tool we named the Multidimensional Screener of Functional Health Literacy (MSFHL). The sensitivity of the MSFHL in detecting limited functional health literacy was 81.4 and the specificity was 87.7, with an area under receiver operating characteristic (ROC) curve of 0.93 (95 CI 0.890.95). The MSFHL was better than educational attainment in accurately classifying functional health literacy status (p 0.0018). We have developed a screening tool based on three demographic characteristics and three simple questions which provides an accurate prediction of a patients functional health literacy level.
- Word and pseudoword reading in young adults: an eye-tracking study(2022) MARCHEZINI, Fernanda; CLAESSENS, Peter Maurice Erna; CARTHERY-GOULART, Maria TeresaPurpose: To evaluate and characterize the oculomotor behavior during the reading of words and pseudowords in Brazilian Portuguese organized by frequency, length and regularity and verify its association with performance on neuropsychological tests. Methods: 21 university students, with a mean age of 20.9 years, were submitted to a word and pseudoword reading task (TLPP) from the Anele Battery, in addition to verbal fluency and phonological working memory tests. The patterns of first fixation duration, gaze duration and rate of refixation were studied. Results: The first fixation duration and the gaze duration were significantly lower for words if compared to pseudowords and the gaze duration was also lower for high-frequency and short words. Significant interactions were also found between verbal fluency performance and the first fixation duration. Conclusion: Our results demonstrate the applicability of eye tracking to study reading patterns at the word-level in Brazilian Portuguese. The eye tracker can be an additional tool in the investigation of acquired and developmental reading disorders and can assist in the detection of reading difficulties based on comparisons of the oculomotor behavior between fluent and non-fluent readers.
- Performance of the Visual Analogue Scale of Happiness and of the Cornell Scale for Depression in Dementia in the Tremembé Epidemiological Study, Brazil(2014) CÉSAR, Karolina G.; BRUCKI, Sonia M.D.; TAKADA, Leonel T.; NASCIMENTO, Luiz Fernando C.; GOMES, Camila M.S.; ALMEIDA, Milena C.S.; OLIVEIRA, Maira O.; PORTO, Fábio H.G.; SENAHA, Mirna L.H.; BAHIA, Valéria S.; SILVA, Thaís Bento L.; IANOF, Jéssica N.; SPÍNDOLA, Lívia; SCHMIDT, Magali T.; JORGE, Mário S.; VALE, Patrícia H.F.; CECCHINI, Mário A.; CASSIMIRO, Luciana; SOARES, Roger T.; GONÇALVES, Márcia R.; SMID, Jerusa; PORTO, Claudia S.; CARTHERY-GOULART, Maria Teresa; YASSUDA, Mônica S.; MANSUR, Letícia L.; NITRINI, RicardoDepression is a major growing public health problem. Many population studies have found a significant relationship between depression and the presence of cognitive disorders. OBJECTIVE: To establish the correlation between the Visual Analogue Scale of Happiness and the Cornell Scale for Depression in Dementia in the population aged 60 years or over in the city of Tremembé, state of São Paulo, Brazil. METHODS: An epidemiological survey involving home visits was carried out in the city of Tremembé. The sample was randomly selected by drawing 20% of the population aged 60 years or older from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, and application of both the Cornell Scale and the Analogue Scale of Happiness for psychiatric symptoms. The presence of depressive symptoms was defined as scores greater than or equal to 8 points on the Cornell Scale. RESULTS: A total of 623 subjects were evaluated and of these 251 (40.3%) had clinically significant depressive symptoms on the Cornell Scale, with a significant association with female gender (p<0.001) and with lower education (p=0.012). One hundred and thirty-six participants (21.8%) chose the unhappiness faces, with a significant association with age (p<0.001), female gender (p=0.020) and low socioeconomic status (p=0.012). Although there was a statistically significant association on the correlation test, the correlation was not high (rho=0.47). CONCLUSION: The prevalence of depressive symptoms was high in this sample and the Visual Analogue Scale of Happiness and Cornell Scale for Depression in Dementia should not be used as similar alternatives for evaluating the presence of depressive symptoms, at least in populations with low educational level.
- Semantic memory: Nouns and action verbs in cognitively unimpaired individuals and frontotemporal lobar degeneration(2013) MANSUR, Leticia Lessa; CARTHERY-GOULART, Maria Teresa; BAHIA, Valéria Santoro; BAK, Thomas H.; NITRINI, RicardoABSTRACT Among the instruments to evaluate semantic memory, the Pyramids and Palm Trees (PPT) and the Kissing and Dancing (KDT) tests are widely used but none have a performance referential for cognitively normal and impaired Brazilian populations. Objective: [A] To study these two tests in a sample of young healthy Brazilian individuals living in São Paulo; [B] To apply the results to the evaluation of two cases diagnosed with frontotemporal lobar degeneration. Methods: We evaluated 50 normal participants (41 females and 9 males) aged between 20-63 years, with schooling level of 14-20 years. In addition, two individuals diagnosed with frontotemporal lobar degeneration were examined, one with behavioral-variant frontotemporal dementia and the other with semantic dementia. Results: On the two tests, no effects of age, gender and schooling on the performance of normal individuals were observed. According to the performance of the sample of controls, scores below 46 points on the PPT and below 47 on the KDT are suggestive of deficits in semantic memory. The analyses of both cases indicated double dissociation in establishing associations between nouns and action verbs. Although the two patients had low scores on both tests, the patient with behavioral-variant frontotemporal dementia performed better on the PPT compared to the KDT, while the patient with semantic dementia showed the reverse, performing better on the KDT. Conclusion: The PPT and KDT are suitable tests for use in the Brazilian population, with minimal need for adjustments. They are applicable tools both for cognitive assessment and research in semantic memory. In the present study, we obtained representative values of performance for cognitively unimpaired individuals and demonstrated the utility of these instruments for cognitive assessment of patients with FTLD.
- Semantic Dementia Versus Nonfluent Progressive Aphasia Neuropsychological Characterization and Differentiation(2012) CARTHERY-GOULART, Maria Teresa; KNIBB, Jonathan A.; PATTERSON, Karalyn; HODGES, John R.Background: Early progressive nonfluent aphasia (PNFA) may be difficult to differentiate from semantic dementia (SD) in a nonspecialist setting. There are descriptions of the clinical and neuropsychological profiles of patients with PNFA and SD but few systematic comparisons. Method: We compared the performance of groups with SD (n = 27) and PNFA (n = 16) with comparable ages, education, disease duration, and severity of dementia as measured by the Clinical Dementia Rating Scale on a comprehensive neuropsychological battery. Principal components analysis and intergroup comparisons were used. Results: A 5-factor solution accounted for 78.4% of the total variance with good separation of neuropsychological variables. As expected, both groups were anomic with preserved visuospatial function and mental speed. Patients with SD had lower scores on comprehension-based semantic tests and better performance on verbal working memory and phonological processing tasks. The opposite pattern was found in the PNFA group. Conclusions: Neuropsychological tests that examine verbal and nonverbal semantic associations, verbal working memory, and phonological processing are the most helpful for distinguishing between PNFA and SD.