Advisor(s)
Abstract(s)
Enquadramento Teórico: A Memória Prospectiva é a memória para intenções
futuras, sendo considerada uma capacidade fundamental para a autonomia,
particularmente na terceira idade. A literatura sugere que os pacientes com Defeito
Cognitivo Ligeiro (DCL), um estado que precede frequentemente os quadros
demenciais, apresentam precocemente défices de Memória Prospectiva, pelo que a
avaliação da referida função poderá contribuir para um diagnóstico precoce desta
patologia, motivando uma intervenção mais eficaz no combate ao declínio cognitivo a
esta associado.
Apesar das evidências encontradas em contexto laboratorial, na prática clínica
escasseiam ferramentas ecológicas e abrangentes de avaliação de MP,
particularmente no contexto português. O Teste de Memória para Intenções (MIST)
(Raskin, 2004) é uma prova de avaliação de MP desenvolvida recentemente que
parece colmatar esta lacuna na prática clínica, uma vez que tem revelado boas
características psicométricas, bem como utilidade clínica em diferentes patologias.
O objectivo do presente estudo consiste em testar a utilidade clínica de uma versão
portuguesa do MIST numa amostra de pacientes com DCL e participantes saudáveis,
visando averiguar a pertinência de uma futura validação deste teste para a população
portuguesa.
Metodologia: Numa amostra de conveniência foram incluídos 68 participantes,
dos quais 28 pacientes com DCL e 40 participantes saudáveis, a quem foi aplicado o
MIST, bem como uma bateria de testes e questionários neuropsicológicos.
Resultados: Os resultados revelaram que o desempenho no MIST total dos
participantes saudáveis é significativamente superior ao dos pacientes com DCL,
particularmente na componente prospectiva. Contudo, todos os participantes
apresentaram um pior desempenho nas componentes prospectivas do MIST do que
na componente retrospectiva. Por outro lado, nas tarefas de MP imediata, todos os
participantes revelaram mais dificuldades nas tarefas baseadas no tempo, do que nas
baseadas em eventos. De referir também que a natureza do padrão de erros nas
tarefas imediatas do MIST diferiu significativamente entre os dois grupos. Por fim, o
desempenho no MIST total demonstrou estar correlacionado com medidas de atenção,
funcionamento executivo e memória retrospectiva.
Discussão: A presente investigação sugere que a versão portuguesa do MIST
constitui uma ferramenta útil para a prática clínica, uma vez que se revelou adequada
para distinguir o desempenho de participantes saudáveis daquele apresentado por
pacientes com DCL. Dado que a literatura que sustenta estes resultados tem sido
essencialmente reportada em contexto laboratorial, as evidências nesta investigação
reportadas surgem como uma potencial mais-valia no estudo clínico da MP. Mais se
acrescenta que os resultados demonstram que o MIST permite diferenciar o
desempenho dos participantes em função da natureza e das componentes das tarefas
de MP, sendo as evidências encontradas compatíveis com a literatura, particularmente
com a Teoria dos Multi-Processos.
Em conclusão, os resultados sugerem que a versão portuguesa do MIST reúne
as condições necessárias para constituir uma ferramenta clínica útil, detalhada e
ecológica de avaliação da MP, justificando uma eventual validação deste teste para a
população portuguesa num futuro próximo
Theoretical Background: Prospective Memory (PM) is defined as the memory for future intentions and it is considered a fundamental requirement for autonomy, especially for the elderly. Theoretical background suggests that patients with Mild Cognitive Impairment (MCI), a condition that frequently precedes dementia, present premature PM deficits, indicating that PM assessment in these patients may contribute to an early diagnosis of the condition, motivating a more effective intervention against the associated cognitive impairment. However, some literature indicates that the tools used today in clinical practice for PM assessment still lack in scope and ecological validity, particularly in the Portuguese context. The Memory for Intentions Test (MIST) (Raskin, 2009) is a recently-developed PM assessment tool, providing useful measures to respond to this clinical hiatus, since it has already revealed adequate psychometric characteristics, as well as clinical utility for various pathologies. This project’s goal is to test the clinical utility of a Portuguese version of the MIST in a sample with MCI and healthy patients, ascertaining the relevance of a future validation of this test for the Portuguese population. Methodology: A convenience sample composed of 68 participants, 40 healthy participants and 28 MCI patients, was recruited for this project. The MIST and a neuropsychological battery were administered to all participants. Results – Results showed performance in the MIST to be significantly better for healthy patients than for MCI patients, particularly for the prospective component. However, all participants presented a worse performance on prospective components of the MIST than on the retrospective component. Additionally, a repeated measures ANOVA revealed that all participants showed greater difficulties in time-based tasks than on the event-based tasks. Finally, correlation analyses indicated that the MIST total score was significantly associated with attentional, executive and retrospective memory measures. Discussion: This investigation suggests that this Portuguese-translated version of the MIST is clinically useful for the clinical practice, having proven to distinguish healthy participants PM performance from that of MCI patients. Given that these evidences have mainly been found in laboratorial context, this investigation’s results seem to constitute a significant clinical gain in the PM’s context. Furthermore, results showed that the MIST is able to differentiate participants’ performance as a function of the nature of the PM tasks, as well as its components. These findings are consistent with existing literature, especially that relating to Multi- Process Theory. In conclusion, the results of this study indicate that the Portuguese version of the MIST gathers the necessary requirements to be considered a useful, detailed and ecological clinical tool to assess PM, constituting a basis for a future validation of the MIST for the Portuguese population.
Theoretical Background: Prospective Memory (PM) is defined as the memory for future intentions and it is considered a fundamental requirement for autonomy, especially for the elderly. Theoretical background suggests that patients with Mild Cognitive Impairment (MCI), a condition that frequently precedes dementia, present premature PM deficits, indicating that PM assessment in these patients may contribute to an early diagnosis of the condition, motivating a more effective intervention against the associated cognitive impairment. However, some literature indicates that the tools used today in clinical practice for PM assessment still lack in scope and ecological validity, particularly in the Portuguese context. The Memory for Intentions Test (MIST) (Raskin, 2009) is a recently-developed PM assessment tool, providing useful measures to respond to this clinical hiatus, since it has already revealed adequate psychometric characteristics, as well as clinical utility for various pathologies. This project’s goal is to test the clinical utility of a Portuguese version of the MIST in a sample with MCI and healthy patients, ascertaining the relevance of a future validation of this test for the Portuguese population. Methodology: A convenience sample composed of 68 participants, 40 healthy participants and 28 MCI patients, was recruited for this project. The MIST and a neuropsychological battery were administered to all participants. Results – Results showed performance in the MIST to be significantly better for healthy patients than for MCI patients, particularly for the prospective component. However, all participants presented a worse performance on prospective components of the MIST than on the retrospective component. Additionally, a repeated measures ANOVA revealed that all participants showed greater difficulties in time-based tasks than on the event-based tasks. Finally, correlation analyses indicated that the MIST total score was significantly associated with attentional, executive and retrospective memory measures. Discussion: This investigation suggests that this Portuguese-translated version of the MIST is clinically useful for the clinical practice, having proven to distinguish healthy participants PM performance from that of MCI patients. Given that these evidences have mainly been found in laboratorial context, this investigation’s results seem to constitute a significant clinical gain in the PM’s context. Furthermore, results showed that the MIST is able to differentiate participants’ performance as a function of the nature of the PM tasks, as well as its components. These findings are consistent with existing literature, especially that relating to Multi- Process Theory. In conclusion, the results of this study indicate that the Portuguese version of the MIST gathers the necessary requirements to be considered a useful, detailed and ecological clinical tool to assess PM, constituting a basis for a future validation of the MIST for the Portuguese population.
Description
Keywords
Memória Prospectiva Defeito cognitivo ligeiro Prospective Memory Mild cognitive impairment MIST