ALINE THOMAZ SOARES
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- Using temporal orientation, category fluency, and word recall for detecting cognitive impairment: the 10-point cognitive screener (10-CS)(2016) APOLINARIO, Daniel; LICHTENTHALER, Daniel Gomes; MAGALDI, Regina Miksian; SOARES, Aline Thomaz; BUSSE, Alexandre Leopold; AMARAL, Jose Renato das Gracas; JACOB-FILHO, Wilson; BRUCKI, Sonia Maria DozziObjectives: A screening strategy composed of three-item temporal orientation and three-word recall has been increasingly used for detecting cognitive impairment. However, the intervening task administered between presentation and recall has varied. We evaluated six brief tasks that could be useful as intervening distractors and possibly provide incremental accuracy: serial subtraction, clock drawing, category fluency, letter fluency, timed visual detection, and digits backwards. Methods: Older adults (n = 230) consecutively referred for suspected cognitive impairment underwent a comprehensive assessment for gold-standard diagnosis, of whom 56 (24%) presented cognitive impairment not dementia and 68 (30%) presented dementia. Among those with dementia, 87% presented very mild or mild stages (Clinical Dementia Rating 0.5 or 1). The incremental value of each candidate intervening task in a model already containing orientation and word recall was assessed. Results: Category fluency (animal naming) presented the highest incremental value among the six candidate intervening tasks. Reclassification analyses revealed a net gain of 12% among cognitively impaired and 17% among normal participants. A four-point scaled score of the animal naming task was added to three-item temporal orientation and three-word recall to compose the 10-point Cognitive Screener. The education-adjusted 10-point Cognitive Screener outperformed the longer Mini-Mental State Examination for detecting both cognitive impairment (area under the curve 0.85 vs 0.77; p = 0.027) and dementia (area under the curve 0.90 vs 0.83; p= 0.015). Conclusions: Based on empirical data, we have developed a brief and easy-to-use screening strategy with higher accuracy and some practical advantages compared with commonly used tools.
- CAN WE EXCLUDE DEMENTIA IN OLDER ADULTS WITH SUSPECTED COGNITIVE IMPAIRMENT WHO ATTEND THE CLINICAL ENCOUNTER ALONE?(2014) APOLINARIO, Daniel; SOARES, Aline Thomaz; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; BARRETTO-FILHO, Antonio Carlos Pereira; JACOB-FILHO, Wilson
- Characterizing spontaneously reported cognitive complaints: the development and reliability of a classification instrument(2013) APOLINARIO, Daniel; MIRANDA, Rafaela Branco; SUEMOTO, Claudia Kimie; MAGALDI, Regina Miksian; BUSSE, Alexandre Leopold; SOARES, Aline Thomaz; LOPES, Leonardo da Costa; KASAI, Juliana Yumi Tizon; SATOMI, Erika; KIKUCHI, Elina Lika; JACOB-FILHO, WilsonBackground: The characteristics and associated risks of spontaneously reported cognitive complaints have not been investigated due to the lack of a classification instrument. Methods: In phase 1, a classification system with descriptive categories and cognitive domains was developed by experts through a modified Delphi technique. In phase 2, 180 elderly patients seeking medical attention for cognitive complaints provided free reports of their cognitive difficulties and each complaint was recorded verbatim. Three observers were asked to classify each complaint into a descriptive category. Perceived cognitive function was further characterized using the Memory Complaint Questionnaire (MAC-Q). Results: The patients reported 493 spontaneous complaints, with a range of 1-6 complaints per patient and a mean of 2.7 (+/- 1.3). The proportion of complaints that could be classified into a category by each of the three observers varied from 91.9% to 95.7%. Inter-observer agreement assessed using the kappa statistic varied from 0.79 to 1 for descriptive categories and 0.83 to 0.97 for domains. Compared with the MAC-Q, spontaneously reported complaints provided complementary information by avoiding the cueing effect provoked by the questionnaire. The total number of complaints and their occurrences in specific domains were associated with important sociodemographic and clinical factors, indicating that their meaning and associated risks need to be further investigated. Conclusion: The instrument developed in this study proved to be a practical tool for classifying the majority of spontaneously reported cognitive complaints with high reliability. Further studies are needed to investigate clinical usefulness of this approach.