Academic literature on the topic 'Wechsler Memory Scale-Revised (WMS-R)'

This study examined the nature of WMS–R scoring errors made by trainee psychologists and the extent to which errors influenced index scores on this scale Trainee psychologists undertook competency based training exercises for the WMS–R, similar to those devised for the WAIS–R by Fantuzzo, Blakely, and Gorsuch in 1989. A WMS–R training protocol was devised and scored by three experienced psychologists to generate a gold standard protocol. The training protocol was then given to trainee psychologists to score. Scoring errors made by trainees included mathematical and transcription errors, and errors of judgment given failure to apply scoring criteria correctly. Present results are consistent with previous investigations of scoring errors among trainees on Wechsler's intelligence tests, and findings provide a preliminary indication that scoring errors on the WMS–R may alter classification by ability.

✓ This study investigated the performance of patients with minor or mild closed head injury and age/education-matched normal controls on the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Wechsler Memory Scale-Revised (WMS-R). The results demonstrated that the control group had significantly higher scores than the patients with closed head injury on all WAIS-R and WMS-R index scores. Further analysis revealed that the patients with closed head injury showed a greater impairment in delayed memory when directly compared to intellectual performance that was not seen in the control group. These results are discussed in relation to findings in patients with more severe closed head injury, the construction of the WAIS-R and the WMS-R, and the performance patterns of the two groups.

Thirty participants were administered both the Wechsler Memory Scale-Revised (WMS-R) and the Memory Assessment Scales (MAS). Participants' standard (index) scores from each battery were compared across the same four memory constructs: Verbal Memory; Visual Memory; General/Global Memory; and WMS-R Attention and concentration and MAS Short-term Memory. The MAS yielded significantly lower mean standard scores across all four memory constructs. The largest difference between mean standard scores was found on Visual Memory in which the MAS mean was over one standard deviation lower than the WMS-R mean. Correlations between the MAS and the WMS-R mean standard scores were not significant on the Visual Memory and the General/Global Memory construct. Although the WMS-R and the MAS purport to measure the same memory constructs, these results suggest that they are measuring different abilities and are not comparable tests.

The Wechsler Memory Scale—Revised (WMS-R), Wechsler Adult Intelligence Scale-Revised (WAIS-R), and Minnesota Multiphasic Personality Invcntory-2 (MMPI-2) were completed by 88 outpatients at a neuropsychology clinic who had diagnoses of central nervous system dysfunction. Extent of IQ, memory, or attention impairment were associated with elevations on MMPI-2 validity scales. Magnitude of estimated IQ loss separated valid from invalid profile groups more clearly than did obtained Full Scale IQ. Nonresponsivity to item content is probable when the patient scores below 70 on the WMS-R Memory or Attention/Concentration indexes, or earns a WAIS-R IQ that falls 20 points or more below expected premorbid level. These effects appear to be relatively independent of the patient's measured reading or intellectual levels. The MMPI-2 appears to provide valid information about the emotional status of patients with moderate and mild neurocognitive impairment.

Cognitive and neuropsychological tests are often employed to help describe the functioning of patients with multi-infarct dementia (MID) or patients with dementia of the Alzheimer's type (DAT). In this study, the Halstead-Reitan Neuropsychological Battery (HRNB), Wechsler Adult Intelligence Scale-Revised (WAIS-R), and Wechsler Memory Scale (WMS) were completed by 20 MID patients and 62 patients with DAT. Total scores on these measures did not differentiate DAT and MID patients. Contrary to clinical observations, cognitive tasks assessing social judgment did not differentiate between the groups. However, MID patients demonstrated greater variability in test scores. Compared with DAT patients, the MID patients demonstrated better preserved memory as shown on the WMS in comparison to the WAIS-R IQ.

The present analyses provide separate norms for persons ages 56 to 93 years for each story from the Logical Memory subtests of the revised edition of the Wechsler Memory Scale. Norms for immediate (I) and delayed (II) trials are presented. Following our past Mayo's Older Americans Normative Studies (MOANS) methods, we established the need for age adjustments (but not education adjustments) based on multiple regression analyses. Norms with added reliability based on the method of overlapping intervals were developed. We present means and standard deviations for 3-year interval age groups from age 61 to 88 years.

Investigations questioning the ecological validity of standardized neuropsychological instruments have led to the development of tests that are purported to be relevant to everyday functioning. The present investigation examined the relationships of the Rivermead Behavioural Memory Test (RBMT) and the Wechsler Memory Scale-Revised (WMS-R) to estimates of everyday memory functioning, as measured by patient and relative ratings on the Everyday Memory Questionnaire (EMQ). The research participants consisted of a group allegedly exposed to neurotoxicants (n = 29), and a demographically similar comparison group ( n = 20). Results indicated that the two objective memory tests did not significantly differ in their relationships to estimates of everyday memory functioning, and that use of the tests together did not improve prediction of memory complaints over the use of one test alone. In addition, patient and relative ratings were highly correlated. These results are discussed within the context of the validity of patient and relative rating scales as estimates of everyday memory impairment.

The construct of nonverbal memory, as assessed by figural reproduction tests, has recently been questioned by a number of investigators. The purpose of this study was to reexamine this construct and its relationship to right temporal lobe dysfunction. Figural reproduction test scores were examined in 757 epilepsy surgery candidates obtained from 8 epilepsy centers participating in the Bozeman Epilepsy Consortium. All participants exhibited unequivocal evidence of left (LTL) or right (RTL) temporal lobe epilepsy observed in ictal and interictal EEG recordings. All subjects also had IQ scores exceeding 70, right-hand preference, and left hemisphere language dominance confirmed by intracarotid sodium amytal testing. Comparisons of LTL and RTL groups showed no significant differences in scores on the Visual Reproduction subtests from the Wechsler Memory Scale (WMS) or Wechsler Memory Scale–Revised (WMS–R) or on the copy and delayed recall conditions of the Rey–Osterrieth Complex Figure Test (ROCFT). Significant differences were observed among centers on WMS and ROCFT scores, which are likely to be a result of variations in administration and/or scoring procedures. The lack of significant differences between LTL and RTL groups in this large sample raise questions about the nature of nonverbal memory and its relationship to right temporal lobe dysfunction. (JINS, 1997, 3, 435–443.)

IntroductionSchizophrenia is a severe disease which affects different aspects of behavior, including cognitive functions. The most important fields of cognitive disorders in schizophrenia are working memory, vigilance/attention, learning by oral and visual memory, argument and resolving, analysis rate and social knowledge.AimsThis study was designed to assess the effects of fluvoxamine on cognitive functions of schizophrenic patients.MethodThirty-six patients with schizophrenia, all male, were treated with 100 mg fluvoxamine and a second generation anti-psychotic for 4 weeks and before and after treatment, their cognitive functions were assessed by Wechsler-3 memory scale (WMS-revised) and negative symptoms by scale for the assessment of negative symptoms (SANS).ResultsIn our study, the average patients’ scores increased in Wechsler-3 memory scale (WMS-revised) before and after receiving fluvoxamine (P < 0.001). This study couldn’t show a statistically significant difference between the patients’ scores in negative symptoms (SANS test) before and after the treatment course (P = 0.59) There was a negative statistically significant correlation found between WMS score before and after the intervention and the level of education, living area and cigarette smoking. Increasing scores in the test was statistically correlated with lower education, cigarette smoking and living in rural area.ConclusionAugmented treatment with fluvoxamine, probably has effects on some parts of cognitive abilities of male schizophrenic patients which are assessable by Wechsler-3 memory scale. Therefore further studies on evaluation of fluvoxamine effects in other fields of cognitive abilities like concentration and attention in schizophrenic patients are still required.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Made available in DSpace on 2015-12-06T23:46:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2013<br>Associação Fundo de Incentivo à Psicofarmacologia (AFIP)<br>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)<br>O teste Memoria Logica da Bateria Wechsler Memory Scale- Revised (WMS-R), constituido de duas estorias que devem ser recordadas, e um teste amplamente utilizado na pratica clinica como instrumento de avaliacao da memoria episodica verbal. O principal objetivo desse estudo foi analisar as propriedades psicometricas iniciais de seis estorias alternativas desenvolvidas a partir das estorias originais da referida bateria. A importancia da validacao de versoes alternativas deve-se a necessidade de teste-reteste em pacientes pre e pos-cirurgicos. Assim, as estorias originais e as alternativas foram aplicadas em 655 jovens saudaveis, entre 18 e 35 anos de idade, de instituicoes de ensino superior. As estorias foram aplicadas nas salas de aula, sendo requisitada recordacao imediata e tardia de cada estoria. Foi realizada analise do conteudo da recordacao a fim de estabelecer uma tabela apropriada para a correcao das estorias. Paralelamente, o desempenho dos participantes foi comparado a fim de analisar a equivalencia das versoes alternativas e aplicado o metodo de Analise de Teoria de Resposta ao Item (TRI). Os resultados indicaram que quatro estorias se mostraram equivalentes as estorias originais, se aplicadas individualmente, mas se aplicadas em pares todas as estorias alternativas formam pares equivalentes ao par original. A TRI permitiu destacar quais itens possuem maior indice discriminativo. O presente estudo oferece uma alternativa quanto ao uso de testes de memoria, pois as estorias poderao ser aplicadas repetidamente sem os efeitos da pratica, propiciando dados robustos tanto na pratica clinica como para futuros estudos de normatizacao.<br>The Logical Memory Test Battery Wechsler Memory Scale -Revised (WMS -R), consisting of two stories that should be remembered, is a widely used test in clinical practice as a tool for assessment of verbal episodic memory. The main objective of this study was to analyze the psychometric properties of the initial six stories alternatives developed from the original stories of that battery. The importance of validation of alternative versions due to the need for test-retest reliability in patients before and after surgery. Thus, the original stories and the alternatives were applied in 655 healthy young , between 18 and 35 years of age, higher education institution. The stories were applied in classrooms, and required immediate and delayed recall of each story. We performed content analysis of memory in order to establish an appropriate table to correct the stories. In parallel, participants' performance was compared in order to examine the equivalence of alternate versions and applied the method of analysis of Item Response Theory (IRT). The results indicated that four stories proved equivalent to the original stories, if applied individually, but if applied in pairs all stories alternative form pairs equivalent to the original pair. The ITR underscored what items are more discriminating index. This study offers an alternative to the use of memory tests, because the stories may be applied repeatedly without practice effects, providing robust data both in clinical practice and for future studies on regulation.<br>BV UNIFESP: Teses e dissertações

A comprehensive battery of commonly used neuropsychological tests, including the WMS Associate Learning and Visual Reproduction subtests, forming the focus of this study, were administered to a southern African sample (n = 33, age range 18-40). This sample composed of black South African, IsiXhosa speakers with an educational level of Grade 11 and 12, derived through DET and former DET schooling. The gender demographics were as follows; females n = 21 and males n = 12. This sample was purposefully selected based on current cross-cultural research which suggests that individuals matching these above-mentioned demographics are significantly disadvantaged when compared to available neuropsychological norms. This is due to the fact that current norms have been created in contexts with socio-cultural influences; including culture, language and quantity and quality of education distinctly dissimilar to individuals like that composed in the sample. Hence the purpose of this study was fourfold namely; 1) Describe and consider socio-cultural factors and the influence on test performance 2) Provide descriptive and preliminary normative data on this neuropsychologically underrepresented population 3) Compare test performance between age and gender through stratification of the sample and finally to 4) Evaluate the current norms of the two WMS subtests and assess their validity for black South Africans with DET and former DET schooling with comparisons to the results found in the study. Information derived from the statistical analyses indicated that a higher performance in favour of the younger group over the older age range was consistently found for both WMS subtests. With regards to gender, some higher means were evident for the male population in the sample than was produced by the female group. Lastly, due to the fact that most scores derived from the sample were considerably lower when compared to the available norms, it is felt that socio-cultural factors prevalent to this population are a significant cause of lower test performance and thus warrant the development of appropriate normative indicators.

The Wechsler Memory Scale –iii is the newest version of a six-decade old neuropsychological inventory. Since its conception, the Wechsler Memory Scale has been highly utilized by practitioners to accurately assess various memory functions in adult subjects. Revisions made within this inventory include the Faces I subtest, a facial recognition scale, which was added in order to strengthen the instrument’s accuracy at measuring episodic memory. Facial recognition, both cross-race and within-race, has been researched extensively and consistent biases have been found between race of test taker and cross-racial identification. Theories of exposure/contextual interaction (environment) and biological foundations have been the subject of study in the past in order to determine from where these racial identification deficits stem. The current study focuses on revealing bias in the Faces I subtest, regarding to an unequal distribution of racially representative faces in the testing materials. Eighty-eight college students were recruited to view forty-eight pictured faces from the Faces I subtest and determine the racial category to which the pictured face belonged. The subjects’ categorical responses were the basis for calculating a percent agreement score for racial category of each face. It was determined, using the results of subjects’ responses, that the Faces I subtest contained an unequal distribution of racially representative faces in both the Target and Interference testing material. This confirmed the presence of an inherent bias within the subscale. The implications of memory accuracy for the WMS-iii are discussed as it relates to different fields of study, but none more directly than the criminal justice system. Eyewitness testimony is a pivotal evidentiary tool in the criminal justice system, and ramifications of cross-racial identification deficits and biases in the tools to accurately assess memory are increasingly bringing this once heavily relied upon tool into question.

While memory is the faculty that affords us learning, adaptation and development, it is our executive function that oversees, manages and organizes these abilities. Still, there is limited research on the interaction between memory and executive function. The present study investigated this relationship through Principal Components Analysis. Performances on accepted measures of memory and executive function were evaluated in an adult clinical sample. Components were retained using three criteria: a predetermined four-component structure, eigenvalues exceeding a value of one, and parallel analysis. Results demonstrated that a four-component model most accurately represented the data. Analyses also revealed that measures of immediate and delayed memory did not uniquely assess memory but instead loaded onto components associated with visual and verbal processing. The findings were shown to be in support of the brain working in an integrated, systematic manner in which abilities hierarchically ascend from arousal to tertiary function. Consequently, several accepted measures of memory and executive function failed to measure cognitive capacity unique from visual and verbal processing, placing their construct validity and efficacy in question.

Instrumentos de avaliação da memória episódica não verbal são escassos. Além disto, consideramos a crescente necessidade de esforços para a adaptação transcultural de instrumentos de memória para nosso contexto. O subteste Visual Reproduction I e II (Reprodução Visual I e II) faz parte da Wechsler Memory Scale (WMS) e se trata de uma escala mundialmente utilizada e adaptada a diversas culturas, sendo considerada padrão ouro dentre as medidas de avaliação da memória. No presente estudo, utilizamos o subteste Reprodução Visual, da WMS na sua quarta edição (WMS-IV). O Reprodução Visual (RV) é subdividido em três domínios de investigação da memória visual (evocação imediata, evocação tardia e reconhecimento) e uma tarefa opcional para avaliação da percepção visual, habilidades construtivas e atenção aos detalhes (cópia). Além disto, o escore de cada um dos três domínios avaliados podem ser contrastados, de modo que se obtenham informações sobre a retenção, o quanto a memória é melhor ou pior do que as habilidades construtivas e, por último, o quão o sujeito evoca livremente ou precisa de pistas para evocar a informação aprendida. Esta versão da WMS-IV é uma revisão da WMS-III, cujos estudos resultaram em algumas alterações metodológicas e de conteúdo, no sentido de facilitar a análise dos resultados, diminuir os vieses de aplicação e correção. Desta forma, para atingir os propósitos desta pesquisa foram realizados dois estudos: o Estudo 1 teve como objetivo realizar a adaptação transcultural do subteste Visual Reproduction I and II - Wechsler Memory Scale IV (WMS-IV) e apresentar uma versão para uso preliminar no Brasil. O estudo 2 consistiu na avaliação das suas propriedades psicométricas. Participaram do estudo 1 três tradutores com fluência no inglês, que realizaram traduções independentes, dois tradutores profissionais e dois juízes especialistas (um neurologista e uma neuropsicóloga). Os juízes especialistas e um tradutor profissional investigaram a equivalência conceitual, semântica e operacional dos itens. Uma amostra de 24 sujeitos saudáveis responderam ao pré-teste, que consistiu na investigação da compreensão e dificuldade da versão adaptada do Reprodução Visual I e II. No estudo dois, participaram 62 adultos saudáveis e 29 adultos com Acidente vascular cerebral em hemisfério direito, no território da Artéria cerebral média (AVC-ACMHD). Os sujeitos tinham idade entre 20 e 59 anos e as respostas foram consideradas para análises de confiabilidade e validade baseadas em análises estatísticas da teoria clássica (ANOVA, ANCOVA, coeficiente alfa de Cronbach, e correlação de Pearson) e da teoria moderna de testagem (Teoria de Resposta ao Item (TRI) através do modelo de um parâmetro ou método de Rasch). O processo de análise das propriedades psicométricas utilizou a metodologia recomendada pelo American Educational Research Association [AERA], American Psychological Association [APA] e o National council on measure in education [NCME], 2008 indicada pela editora responsável pelos direitos autorais do WMS-IV. Na confiabilidade, foi investigada a consistência interna (coeficiente alfa de Cronbach) e a estabilidade temporal (correlação de Pearson). Na investigação da validade, foram investigados: os processos de resposta, a estrutura interna (correlação de Pearson, Teoria de resposta ao Item pelo método de Rash), a relação com outros instrumentos (Mini Exame do Estado Mental - MEEM e Figuras Complexas de Rey) e a relação com variáveis externas (AVC-ACMHD comparados a controles saudáveis). O índice de consistência interna do subteste foi de 0,92 e a estabilidade teste-reteste mostrou correlação significativa, exceto com a tarefa de evocação tardia. Esses resultados são similares aos do estudo original, sendo, portanto caracterizada a sua equivalência. Os resultados do estudo de validade mostraram que há equivalência em termos de conteúdo.A investigação da estrutura interna pelo coeficiente de correlação de Pearson evidenciou que todas as figuras obtiveram correlação significativa (p<0,001). Ainda mais: correlacionaram-se congruentemente durante toda a tarefa. Na investigação da estrutura interna pelo método de Rasch foi evidenciado que o teste é unidimensional, que a progressão de theta ao longo das categorias de resposta foram como o esperado pelo modelo. A TRI mostrou que a figura mais fácil é a figura 1 da tarefa de evocação imediata e a mais difícil é a figura 5 de evocação tardia. Os índices de correlação theta foram superiores a 0,5, mostrando correlação. No mapa de pessoas-itens as variáveis tenderam a avaliar o constructo em níveis inferiores ao de habilidade dos sujeitos, sugerindo a necessidade de itens avaliando níveis mais altos do constructo. Na análise de validade considerando outras medidas a tarefa de evocação imediata o escore total e evocação tardia apresentaram correlação com o total da tarefa de memória das figuras complexas de Rey. As tarefas de cópia correlacionaram-se com o total de cópia do teste das figuras complexas de Rey. A tarefa de evocação imediata o escore total e evocação tardia apresentaram correlação com o total do MEEM. A análise de covariância mostrou que a escolaridade exerce influência nos escores do RV. Assim, depois de controlada a escolaridade foi evidenciado que os controles tiveram melhor desempenho em todas as tarefas do RV, quando comparados aos pacientes com AVC-ACMHD. Na análise qualitativa, através do escalonamento e contraste dos escores, foi observado que o baixo desempenho dos pacientes com AVC se deve ao fato de que esses pacientes percebem muito mal o item, com pior controle motor, habilidade visuo-construtiva e capacidade de prestar atenção a detalhes. O resultado é uma menor aquisição da informações e as conseqüências são dificuldades na memória episódica não verbal . Os nossos resultados foram demonstrativos de que o RV da WMS- IV, além de culturalmente equivalente em termos de confiabilidade e validade, é adequado para a cultura dos sujeitos e pacientes avaliados em Ribeirão Preto, preciso e válido para o uso no Brasil. Saliente-se a necessidade de estudos normativos com esse subteste.<br>Tools for evaluation of non-verbal episodic memory are scarce. Furthermore, we consider the increasing need for efforts to cross-cultural adaptation of instruments of memory for our context. The subtest Visual Reproduction I and II is part of the Wechsler Memory Scale (WMS), and it is used worldwide scale and adapted to different cultures, and is considered the gold standard among assessment measures of memory. In the present study, we use the Visual Reproduction subtest of WMS in its fourth edition (WMS-IV). The Visual Reproduction (VR) is subdivided into three fields of research in visual memory (immediate recall, delayed recall and recognition) and an optional task to assess visual perception, constructive abilities and attention to detail (copy). Moreover, the score of each of the three domains can be contrasted evaluated in order to obtain information on retention, and the memory is better or worse than the constructive abilities, and finally, how the subject refers freely or need tracks to evoke the information learned. This version of the WMS-IV is a review of the WMS-III, whose studies have resulted in some changes in methodology and content, to facilitate the analysis of results, lower camest application and correction. Thus, to obtain the purposes of this research were carried out two studies: Study 1 was aimed at making cross-cultural adaptation of the subtest \"Visual Reproduction I and II - Wechsler Memory Scale - IV (WMS-IV)\" and present a version for use preliminary in Brazil and the second study consisted of an evaluation of its psychometric properties. The study included a three translators fluent in English, which made independent translations, translators two professional judges and two experts (a neurologist and a neuropsychologist) who performed the conceptual and item equivalence, semantic, and operational. 24 healthy subjects responded to the pretest, which consisted in the investigation of understanding and difficulty of the adapted version of the Visual Reproduction I and II. In the second study, participated in 62 healthy adults and 29 adults with stroke in the right hemisphere in the territory of the middle cerebral artery. All subjects were aged between 20 and 59 years and the responses were considered for analysis of reliability and validity based on statistical analysis of the classical theory (ANOVA, ANCOVA, Cronbach\'s alpha, and Pearsons correlation) and the modern theory testing (Item Theory Response IRT, the model of one parameter or Rasch method). The process of analyzing the psychometric properties following the methodology recommended by the American Educational Research Association [AERA], American Psychological Association [APA] and the National council on education measure in [NCME], 2008 - indicated by the publisher responsible for the copyright of the WMS-IV. In the reliability analysis, we investigated the internal consistency (Cronbach\'s alpha) and temporal stability (Pearsons correlation). To investigate the validity, were considered: the processes of response, the internal structure (Pearsons correlation and IRT), the relationship with other tools (Mini Mental State Exam- MMSE and Rey-Osterrieth Complex Figure Test (ROCF).) and the relationship with external variables (stroke in the right hemisphere in the territory of the middle cerebral artery, compared to healthy controls). The index of internal consistency overall subtest was 0.92 and test-retest stability showed significant correlation, except with the task of delayed recall. These results are similar to the original study, showing thus their equivalence. The results of the validity study showed that there is equivalence in terms of investigating the internal structure and content. Pearson\'s correlation coefficient showed that all the figures obtained significant correlation (p <0.001) and further correlated with each moment congruently the task. In investigating the internal structure by the Rasch method has been shown that the test is one-dimensional that the progression of theta over the response categories was as expected by the model, and show that the figure is the easier task of Figure 1 - immediate recall, and is harder to figure 5- for delayed recall. The theta correlation coefficients were greater than 0.5, showing good correlation. On the map of people-items showed that the variables tended to evaluate the construct at levels below the skill of the subjects, suggesting the need for items assessing higher levels of the construct. In the analysis of validity considering other measures, the total score of immediate recall and delayed recall correlated with the total of memory task of the Rey complex figure copy. The copy of the Visual Reproduction correlated with copy of Rey-Osterrieth Complex Figure Test (ROCF). The task of ROCF immediate recall of the total score and delayed recall correlated with total MMSE. Covariance analysis showed that education exercises influences on scores of the RV. So, after controlled the variable schooling, was evident that the controls performed better than patients with stroke on all Visual Reproduction subtest. The qualitative analysis via scaling contrast scores, shown that low performance of patients with stroke is due the fact they recognize the item very badly, the motor control, visuo-constructive ability and ability to pay attention to details is lowered. Its can occur, may be due apraxia, resulting in lower acquisition of the information, resulting in difficulties in non-verbal episodic memory. Our results showing that the Visual Reproduction subtest of the WMS-IV was considered culturally equivalent in terms of reliability and validity and is appropriate for culture of the subjects and patients evaluated in Ribeirão Preto, valid and reliable for use in Brazil. We emphasize the need of studies regarding to normative data for this subtest.

Tese de doutoramento em Psicologia, na especialidade de Neuropsicologia, apresentada à Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra<br>Apesar de nos últimos anos ter havido em Portugal um grande desenvolvimento no campo da avaliação neuropsicológica de pessoas idosas, no sentido de providenciar instrumentos com normas específicas para diversas populações, alguns deles ainda carecem de estudos sistemáticos com determinados grupos clínicos, de forma a serem maximizadas as potencialidades da sua utilização em contexto clínico. Entre estes grupos encontram-se diferentes tipos de demências. Os neuropsicólogos são, frequentemente, solicitados para diferenciar a doença de Alzheimer (DA) e a demência vascular (DV), as duas causas de demência mais comuns na população idosa. O principal objetivo desta investigação foi o de averiguar se haveria um funcionamento mnésico diferencial na demência vascular subcortical (DVS), um subtipo de DV relativamente homogéneo com uma etiologia mais uniforme e um desfecho mais previsível, e na doença de Alzheimer (DA). Caso este fosse observado, pretendia-se detetar padrões de défice específicos que pudessem contribuir para o diagnóstico diferencial entre estas duas patologias. Administrou-se a Escala de Memória de Wechsler-3ª edição (WMS-III) por constituir uma bateria que avalia várias dimensões da memória em adultos e analisou-se a sua capacidade discriminativa para identificar e diferenciar a DVS da DA. Adicionalmente, aplicou-se a versão portuguesa do Addenbrooke’s Cognitive Examination-Revised (ACE-R), um instrumento de rastreio cognitivo, relativamente ao qual também foi investigada a capacidade de exatidão diagnóstica. A amostra foi constituída por dois grupos clínicos (DVS: n=18; DA: n=36) e um grupo controlo (n=40). Nenhum dos grupos diferia quanto à idade e sexo e os grupos clínicos estavam emparelhados entre si quanto às seguintes variáveis: severidade da doença, funcionamento cognitivo global, sintomatologia depressiva e inteligência pré-mórbida. Os participantes dos grupos clínicos foram recrutados em contexto hospitalar (quatro serviços de neurologia de centros hospitalares) e os participantes controlo saudáveis foram recrutados na comunidade, em instituições de cariz social e/ou recreativo. As comparações do desempenho dos participantes basearam-se em modelos estatísticos não paramétricos (Quade’s rank ANCOVA) devido ao número reduzido e características das distribuições dos resultados obtidos por cada grupo. A exatidão diagnóstica e a capacidade discriminativa dos instrumentos aplicados foram calculadas através de curvas ROC (receiver operating characteristic). Os resultados globais sugerem que os dois grupos clínicos têm um funcionamento mnésico distinto, apresentando dificuldades em diferentes tipos e fases da memória. Assim o grupo com DVS teve um desempenho significativamente superior ao do grupo com DA nos seguintes tipos de memória: auditiva imediata, visual e auditiva diferida, de reconhecimento e memória geral. Os participantes com DA manifestaram problemas ao nível da codificação e consolidação da informação e os participantes com DVS caracterizaram-se por dificuldades na recuperação da mesma. Apesar das limitações da amostra, os resultados obtidos podem fornecem orientações acerca da exatidão diagnóstica e capacidade de diagnóstico diferencial da WMS-III e do ACE-R nestes grupos clínicos.<br>Although in the recent years there has been a great development in the field of neuropsychological assessment of older people in Portugal, providing tools with specific norms for certain populations, a number of these instruments still lack systematic studies with certain clinical groups in order to maximize the potentialities of their use in clinical practice. Among these there are different types of dementia. Neuropsychologists are often asked to differentiate Alzheimer’s disease (AD) and vascular dementia (VD), the two most common causes of dementia in the elderly population. The main goal of this research was to understand if there is a differential memory functioning in subcortical vascular dementia (SVD), a more homogenous VD subtype with a more uniform aetiology and a predictable outcome, and in Alzheimer’s disease. If there was such differention, we would intend to detect patterns of specific deficits which can help in the differential diagnosis between these two pathologies. For that purpose we used the Wechsler Memory Scale – 3rd edition (WMS-III) because it is a battery for adults’ memory assessment, which evaluates several dimensions of this cognitive function, and we analysed its discriminative capacity in detecting and differentiating the SVD from AD. Additionally, we administered the Portuguese version of Addenbrooke’s Cognitive Examination – Revised (ACE-R), a cognitive screening tool. We also evaluated the diagnostic accuracy of this test. The sample was composed by two clinical groups (SVD: n=18; AD: n=36) and one control group (n=40). None of the groups differed in age and sex and the clinical groups were matched in the following variables: disease severity, overall cognitive functioning, depressive symptomatology, and pre-morbid intelligence. The participants of the clinical groups were recruited in the hospital setting (four neurological departments of hospital centres took part in this research) and the control participants were recruited from the community in senior social and/or recreational institutions. The performance comparisons of the subjects were based on nonparametric statistical models (Quade’s rank ANCOVA) due to the small number and specific distribution features of the data obtained from each group. The diagnostic accuracy and discriminative ability of the tools were examined via ROC (receiver operating characteristic) curves. General findings suggest that these two clinical groups have a different memory functioning, presenting difficulties in different memory types and stages. The SVD group had a significantly better performance than the AD group on the following types of memory: auditory immediate, visual and auditory delayed, auditory recognition delayed and general memory. The AD patients showed encoding and consolidation problems and the SVD patients were characterized by difficulties in retrieval. Despite sample limitations, the results obtained could provide some guidelines for the diagnostic accuracy and differential diagnosis ability of the WMS-III and the ACE-R in these clinical groups.<br>Fundação para a Ciência e Tecnologia - SFRH/68763/2010

Children’s urban air pollution exposures result in systemic and brain inflammation and the early hallmarks of Alzheimer’s disease (AD). The apolipoprotein E (APOE) ε4 allele is the most prevalent genetic risk for AD. We assessed whether APOE in healthy children modulates cognition, olfaction, and metabolic brain indices. The Wechsler Intelligence Scale for Children (WISC-R) and the University of Pennsylvania Smell Identification Test were administered to 50 Mexico City Metropolitan Area children (13.4 ± 4.8 years, 28 APOE ε3 and 22 APOE ε4). N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, myo-inositol (mI)/Cr, and NAA/mI were calculated using proton magnetic resonance spectroscopy in the white matter of the frontal and parietal lobes, hippocampus, and pons. APOE ε4 versus ε3 children had a reduced NAA/Cr ratio in the right frontal white matter and decrements on attention, short-term memory, and below-average scores in Verbal and Full Scale IQ (&gt;10 points). APOE modulated the group effects between WISC-R and left frontal and parietal white matter, and hippocampus metabolites. Soap was the predominantly failed odor in urban children and, in APOE ε4 versus ε3 carriers, strongly correlated with left hippocampus mI/Cr ratio. APOE modulates responses to air pollution in the developing brain. APOE ε4 carriers could have a higher risk of developing early AD if they reside in a polluted environment. APOE, cognition, and olfaction testing and targeted magnetic resonance spectroscopy may contribute to the assessment of urban children and their results could provide new paths toward the unprecedented opportunity for early neuroprotection and AD prevention.