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Abstract(s)
Introdução: A demência é uma síndrome clínica adquirida, caracterizada pelo declínio
progressivo de várias funções cognitivas. Os défices são persistentes e têm gravidade
suficiente para interferir nas relações sociais e na capacidade para realizar de um modo
autónomo as actividades de vida diária. Vários estudos demonstraram que défices nas
actividades instrumentais de vida diária (AIVD) predizem significativamente o
desenvolvimento de demência. Para avaliar as AIVD os instrumentos baseados no
desempenho são os mais sensíveis na diferenciação do desempenho entre indivíduos
cognitivamente saudáveis e indivíduos com declínio cognitivo. O objectivo desta
dissertação é traduzir e adaptar a segunda versão da UCSD-Performance-Based Skills
Assessment (UPSA-2), um instrumento baseado no desempenho que avalia as AIVD,
bem como verificar se existem diferenças no desempenho funcional, nos diferentes
estádios do declínio cognitivo.
Metodologia: A amostra foi composta por 81 participantes, 34 participantes do grupo
cognitivamente saudáveis, 23 participantes do grupo com alterações cognitivas ligeiras
e 24 participantes do grupo com alterações cognitivas marcadas.
Resultados: Os resultados totais da UPSA-2 foram significativamente inferiores nos
indivíduos com alterações cognitivas marcadas, do que nos indivíduos com alterações
cognitivas ligeiras, que por sua vez foram inferiores aos resultados dos indivíduos
cognitivamente saudáveis. O resultado total da UPSA-2 está fortemente correlacionado
com o resultado da Escala de Avaliação da Doença de Alzheimer, Subescala Cognitiva
(ADAS-Cog) (r=-0.84/p<0.001) e a Escala de Actividades Instrumentais de Vida Diária
(IADL) (rs=-0.78/p<0.001). Verificou-se ainda que os indivíduos que não apresentaram
alterações funcionais na IADL, apresentaram alterações em vários domínios da UPSA-2.
Conclusão: A UPSA-2 tem propriedades discriminativas relativamente ao desempenho
funcional dos indivíduos sem alterações cognitivas, dos indivíduos com alterações
cognitivas ligeiras e marcadas. Este estudo veio demonstrar que a UPSA-2 tem maior
sensibilidade na avaliação das AIVD, do que um instrumento de autoavaliação. Permite
ainda evidenciar a existência de uma forte associação entre o desempenho cognitivo e o
desempenho funcional.
Introduction: Dementia is an acquired clinical syndrome, characterized by a progressive decline of several cognitive areas. Deficits are persistent and severe enough to interfere with social relations and with the ability to perform independently the activities of daily living. Several studies showed that impairment in instrumental activities of daily living (IADL) predict significantly dementia development. In order to evaluate IADL, performance-based instruments showed to be more sensitive differentiating cognitive healthy subjects from cognitive impairment subjects. The aim of this dissertation is to translate and adapt the second version of UCSD-PerformanceBased Skills Assessment (UPSA-2), a performance-based instrument developed for assessing IADL and to verify if exists differences in functional ability in the different stages of cognitive decline. Methodology: The sample was composed by 81 subjects, 34 subjects from the cognitively healthy group, 23 from the mild cognitive impairment group and 24 from the severe cognitive impairment group. The subjects were distributed between the groups according to the established inclusion criteria. Results: UPSA-2 final results were significantly lower in severe cognitive impairment subjects, than mild cognitive impairment subjects, which in turn were lower than cognitively healthy subjects. UPSA-2 final result is strongly correlated with the Alzheimer’s Disease Cooperative Study scale, Cognitive sub-scale (ADAS-Cog) (r=- 0.84/p<0.001) and the Instrumental Activities of Daily Living scale (IADL) (rs=- 0.78/p<0.001). We also have verified that subjects without functional impairments in IADL scale, showed impairments in the UPSA-2 several domains. Conclusion: UPSA-2 is a functional assessment tool that discriminates the functional performance of cognitively healthy subjects, from the performance of mild and severe cognitive impairment subjects. This study showed that UPSA-2 has more sensibility in IADL assessment, than a self-report measure. Also, highlights the strong association between cognitive and functional performance.
Introduction: Dementia is an acquired clinical syndrome, characterized by a progressive decline of several cognitive areas. Deficits are persistent and severe enough to interfere with social relations and with the ability to perform independently the activities of daily living. Several studies showed that impairment in instrumental activities of daily living (IADL) predict significantly dementia development. In order to evaluate IADL, performance-based instruments showed to be more sensitive differentiating cognitive healthy subjects from cognitive impairment subjects. The aim of this dissertation is to translate and adapt the second version of UCSD-PerformanceBased Skills Assessment (UPSA-2), a performance-based instrument developed for assessing IADL and to verify if exists differences in functional ability in the different stages of cognitive decline. Methodology: The sample was composed by 81 subjects, 34 subjects from the cognitively healthy group, 23 from the mild cognitive impairment group and 24 from the severe cognitive impairment group. The subjects were distributed between the groups according to the established inclusion criteria. Results: UPSA-2 final results were significantly lower in severe cognitive impairment subjects, than mild cognitive impairment subjects, which in turn were lower than cognitively healthy subjects. UPSA-2 final result is strongly correlated with the Alzheimer’s Disease Cooperative Study scale, Cognitive sub-scale (ADAS-Cog) (r=- 0.84/p<0.001) and the Instrumental Activities of Daily Living scale (IADL) (rs=- 0.78/p<0.001). We also have verified that subjects without functional impairments in IADL scale, showed impairments in the UPSA-2 several domains. Conclusion: UPSA-2 is a functional assessment tool that discriminates the functional performance of cognitively healthy subjects, from the performance of mild and severe cognitive impairment subjects. This study showed that UPSA-2 has more sensibility in IADL assessment, than a self-report measure. Also, highlights the strong association between cognitive and functional performance.
Description
Keywords
Actividades instrumentais de vida diária Avaliação funcional Declínio cognitivo UPSA Instrumental activities of daily living Functional assessment Cognitive decline