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Advisor(s)
Abstract(s)
Objetivos: O objetivo principal do estudo é comparar os desempenhos no teste do
desenho do relógio (TDR) e no teste da cópia do cubo (TCC) em sujeitos com parecer
clínico de défice cognitivo ligeiro (DCL) e de demência ligeira (DL), para verificar se
algum dos dois testes se revela mais eficaz no rastreio do defeito cognitivo.
Adicionalmente, o estudo propõe-se comparar sistemas de cotação de diferentes
complexidades para observar se um sistema mais complexo é mais discriminativo do
defeito cognitivo do que outros mais simples. Métodos: Realizou-se um estudo
retrospetivo com base nos processos de pacientes da consulta externa de
neuropsicologia de uma instituição de referência na área da região de Lisboa, constando
de 59 participantes, 37 com DCL e 22 com DL. Usaram-se 4 sistemas de cotação de
diferentes complexidades para cada teste: análise clínica, perfil de execução, análise de
segmentos e análise de erros. Resultados: Verificou-se que em ambos os testes as
médias foram significativamente superiores nos sujeitos com parecer clínico de DCL
relativamente aos sujeitos com parecer clínico de DL em todos os sistemas de cotação.
As pontuações obtidas no TCC revelaram-se significativamente mais baixas do que as
obtidas no TDR para 3 dos 4 sistemas de cotação usados. As pontuações obtidas em
ambos os testes mostraram ser significativamente diferentes nos 4 sistemas de cotação
usados, tendo-se verificado que o sistema de maior complexidade foi o mais
discriminativo do defeito cognitivo (tendo os 4 sistemas de cotação dentro de cada teste
revelado correlações muito altas e significativas entre si). Conclusões: Os resultados
deste estudo apontam que embora ambos os testes sejam capazes de diferenciar os
sujeitos com parecer clínico de DCL dos sujeitos com parecer clínico de DL, o TCC
aparenta ser mais eficaz do que o TDR no rastreio do defeito cognitivo, já que apresenta
pontuações significativamente mais baixas do que o TDR em ambos os pareceres
clínicos. Os resultados são indicativos de que um sistema de cotação mais complexo
aparenta ser mais discriminativo do defeito cognitivo relativamente a sistemas menos
complexos, tanto para o TDR, como para o TCC. No entanto, o presente estudo, dada a
reduzida dimensão da amostra e sendo um estudo exploratório, não possui consistência
para generalização de resultados, sugerindo-se a realização de investigação com uma
maior dimensão da amostra para confirmação e generalização das conclusões.
Aim: The main aim of the study is to compare the performances in the clock drawing test (CDT) and in the cube copying test (CCT) in subjects with mild cognitive impairment (MCI) and mild dementia (MD), to verify if any of these tests is more effective in the screening of cognitive impairment. Additionally, the study proposed to compare different complexity scoring systems to observe if a more complex system is more able to discriminate cognitive impairment then simplest ones. Methods: A retrospective study was held based on the clinical processes of outpatients of a reference institution in the field of neuropsychology in the area of Lisbon, with 59 participants, 37 with MCI and 22 with MD. Four scoring systems of different complexities were used for each test: clinical analysis, execution profile, segments analysis and error analysis. Results: The means were significantly superior for MCI in all scoring systems, for both CDT and CCT. The scores on the CCT were significantly lower than the scores on the CDT in three of the four scoring systems used. The scores in both tests were significantly different in the four scoring systems used, and the more complex system in both tests showed to be more able to discriminate cognitive impairment (the four scoring systems in each test revealed high and significant inter-correlations). Conclusions: The results of the study suggest that even though both tests are able to differentiate the subjects with MCI from the subjects with mild dementia, the CCT appears to be more effective than the CDT in the screening of cognitive impairment, since it shows scores significantly lower than the CDT for both clinical situations. The results indicate that a more complex scoring system appears to be more effective in the screening of cognitive impairment than less complex scoring systems. However, studies with larger samples have to be undertaken to verify and generalize the conclusions.
Aim: The main aim of the study is to compare the performances in the clock drawing test (CDT) and in the cube copying test (CCT) in subjects with mild cognitive impairment (MCI) and mild dementia (MD), to verify if any of these tests is more effective in the screening of cognitive impairment. Additionally, the study proposed to compare different complexity scoring systems to observe if a more complex system is more able to discriminate cognitive impairment then simplest ones. Methods: A retrospective study was held based on the clinical processes of outpatients of a reference institution in the field of neuropsychology in the area of Lisbon, with 59 participants, 37 with MCI and 22 with MD. Four scoring systems of different complexities were used for each test: clinical analysis, execution profile, segments analysis and error analysis. Results: The means were significantly superior for MCI in all scoring systems, for both CDT and CCT. The scores on the CCT were significantly lower than the scores on the CDT in three of the four scoring systems used. The scores in both tests were significantly different in the four scoring systems used, and the more complex system in both tests showed to be more able to discriminate cognitive impairment (the four scoring systems in each test revealed high and significant inter-correlations). Conclusions: The results of the study suggest that even though both tests are able to differentiate the subjects with MCI from the subjects with mild dementia, the CCT appears to be more effective than the CDT in the screening of cognitive impairment, since it shows scores significantly lower than the CDT for both clinical situations. The results indicate that a more complex scoring system appears to be more effective in the screening of cognitive impairment than less complex scoring systems. However, studies with larger samples have to be undertaken to verify and generalize the conclusions.
Description
Keywords
Rastreio cognitivo TDR TCC DCL Demência ligeira Sistemas de cotação de diferentes complexidades Cognitive screening CDT CCT MDI Mild dementia Scoring systems of different complexities