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      Psychometric properties of the Brazilian version of Pfeffer's Functional Activities Questionnaire

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          Abstract

          Pfeffer's Functional Activities Questionnaire (FAQ) is one of the most commonly employed tools in studies on pathological cognitive aging. Despite the different versions of the questionnaire translated for use in clinical practice, few studies have analyzed the psychometric properties of the Brazilian version of the FAQ (P-FAQ). Thus, the aim of the present study was to analyze the P-FAQ with regard to internal consistency, factorial structure and associations with demographic factors (age, sex, and schooling), depressive symptoms, cognitive measures and other measures of functionality. One hundred sixty-one older adults were divided into four groups (91 with dementia, 46 with mild cognitive impairment, 11 with psychiatric disorders and 13 healthy controls). All participants were evaluated by cognitive, behavioral and functional tests and scales. Their caregivers answered the P-FAQ. The questionnaire showed high internal consistency (α = 0.91). Factor analysis revealed a two-factor structure, which, accounted for 66% of the total variance. The P-FAQ was not correlated with demographic factors, was weakly correlated with depressive symptoms (ϱ = 0.271, p < 0.01, R 2 = 7%) and strongly correlated with cognitive measures (Matttis Dementia Rating Scale total score: ϱ = −0.574, p < 0.01, R 2 = 33%) as well as complex instrumental activities of daily living (ϱ = −0.845, p < 0.01, R 2 = 71%). Cognitive performance and depression status were independent predictors of P-FAQ scores in regression models. The present findings indicate that the P-FAQ has satisfactory reliability, internal consistency, construct validity and ecological validity. Therefore, this questionnaire can be used in clinical practice and research involving the Brazilian population of older adults.

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          Clock-drawing: is it the ideal cognitive screening test?

          The clock-drawing test has achieved widespread clinical use in recent years as a cognitive screening instrument and a significant amount of literature relates to its psychometric properties and clinical utility. This review aims to synthesize the available evidence and assess the value of this screening test according to well-defined criteria. A Medline and Psycho-info literature search of all languages was done from 1983 to 1998 including manual cross-referencing of bibliographies. A brief summary of all original scoring systems is provided as well as a review of replication studies. Psychometric data including correlations with other cognitive tests were recorded. Qualitative aspects of the test are also described. Among published studies, the mean sensitivity (85%) and specificity (85%) of the clock-drawing test are impressive. Correlations with the Mini-Mental State Examination and other cognitive tests was high, generally greater than r = 0.5. High levels of inter-rater and test-re-test reliability and positive predictive value are recorded and despite significant variability in the scoring systems, all report similar psychometric properties. The clock test also shows a sensitivity to cognitive change with good predictive validity. The clock-drawing test meets defined criteria for a cognitive screening instrument. It taps into a wide range of cognitive abilities including executive functions, is quick and easy to administer and score with excellent acceptability by subjects. Together with informant reports, the clock-drawing test is complementary to the widely used and validated Mini-Mental State Examination and should provide a significant advance in the early detection of dementia and in monitoring cognitive change. A simple scoring system with emphasis on the qualitative aspects of clock-drawing should maximize its utility. Copyright 2000 John Wiley & Sons, Ltd.
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            The Alzheimer's Disease Centers' Uniform Data Set (UDS): the neuropsychologic test battery.

            The neuropsychologic test battery from the Uniform Data Set (UDS) of the Alzheimer's Disease Centers (ADC) program of the National Institute on Aging consists of brief measures of attention, processing speed, executive function, episodic memory, and language. This paper describes development of the battery and preliminary data from the initial UDS evaluation of 3268 clinically cognitively normal men and women collected over the first 24 months of utilization. The subjects represent a sample of community-dwelling, individuals who volunteer for studies of cognitive aging. Subjects were considered "clinically cognitively normal" based on clinical assessment, including the Clinical Dementia Rating scale and the Functional Assessment Questionnaire. The results demonstrate performance on tests sensitive to cognitive aging and to the early stages of Alzheimer disease in a relatively well-educated sample. Regression models investigating the impact of age, education, and sex on test scores indicate that these variables will need to be incorporated in subsequent normative studies. Future plans include: (1) determining the psychometric properties of the battery; (2) establishing normative data, including norms for different ethnic minority groups; and (3) conducting longitudinal studies on cognitively normal subjects, individuals with mild cognitive impairment, and individuals with Alzheimer disease and other forms of dementia.
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              The ecological validity of neuropsychological tests: a review of the literature on everyday cognitive skills.

              Evaluating the ecological validity of neuropsychological tests has become an increasingly important topic over the past decade. In this paper, we provide a comprehensive review of the research on the ecological validity of neuropsychological tests, as it pertains to everyday cognitive skills. This review is presented in the context of several theoretical issues facing ecological validity research. Overall, the research suggests that many neuropsychological tests have a moderate level of ecological validity when predicting everyday cognitive functioning. The strongest relationships were noted when the outcome measure corresponded to the cognitive domain assessed by the neuropsychological tests. Several other factors that may moderate the degree of ecological validity established for neuropsychological tests are in need of further exploration. These factors include the effects of the population being tested, the approach utilized (verisimilitude vs. veridicality), the person completing the outcome measure (significant other vs. clinician), illness severity, and time from injury until evaluation. In addition, a standard measurement of outcome for each cognitive domain is greatly needed to allow for comparison across studies.
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                Author and article information

                Contributors
                Journal
                Front Aging Neurosci
                Front Aging Neurosci
                Front. Aging Neurosci.
                Frontiers in Aging Neuroscience
                Frontiers Media S.A.
                1663-4365
                25 September 2014
                2014
                : 6
                : 255
                Affiliations
                [1] 1Post Graduation Program in Neuroscience, Federal University of Minas Gerais Belo Horizonte, Brazil
                [2] 2Faculty of Humanities, Social Sciences and Health, FUMEC University Belo Horizonte, Brazil
                [3] 3Department of Psychology, Faculty of Medical Sciences of Minas Gerais Belo Horizonte, MG, Brazil
                [4] 4Faculty of Medicine, National Institute of Science and Technology – Molecular Medicine, Federal University of Minas Gerais Belo Horizonte, Brazil
                [5] 5Department of Occupational Therapy, Faculty of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais Belo Horizonte, Brazil
                [6] 6Department of Clinics, Faculty of Medicine, Federal University of Minas Gerais Belo Horizonte, Brazil
                [7] 7Laboratory of Neuropsychological Investigations (LIN), Universidade Federal de Minas Gerais Belo Horizonte, Brazil
                [8] 8Department of Mental Health, Faculty of Medicine, Federal University of Minas Gerais Belo Horizonte, Brazil
                Author notes

                Edited by: Manuel Menéndez-González, Hospital Álvarez-Buylla, Spain

                Reviewed by: Nelson Silva Filho, Universidade Estadual Paulista, Brazil; Tania Álvarez Avellón, Universidad de Oviedo, Spain

                *Correspondence: Luciana de Oliveira Assis, Faculdade de Ciências Humanas, Sociais e da Saúde, Universidade FUMEC, Rua Cobre 200, Cruzeiro, Belo Horizonte, Minas Gerais CEP: 30.310-190, Brasil e-mail: lucianaoassis@ 123456yahoo.com.br

                This article was submitted to the journal Frontiers in Aging Neuroscience.

                Article
                10.3389/fnagi.2014.00255
                4174881
                ec8e6efb-d8ef-42a1-97e3-e97119b13817
                Copyright © 2014 Assis, de Paula, Assis, de Moraes and Malloy-Diniz.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 05 August 2014
                : 08 September 2014
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 47, Pages: 7, Words: 5764
                Categories
                Neuroscience
                Original Research Article

                Neurosciences
                functional assessment,older adult,instrumental activities of daily living,psychometric properties,neuropsychology,validity,reliability

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