Cognitive assessment instruments used in elderly Brazilians in the last five years

Martins, Núbia Isabela Macêdo; Caldas, Priscila Romão; Cabral, Etenildo Dantas; Lins, Carla Cabral dos Santos Accioly; Coriolano, Maria das Graças Wanderley de Sales

doi:10.1590/1413-81232018247.20862017

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REVIEW • Ciênc. saúde colet. 24 (7) • July 2019 • https://doi.org/10.1590/1413-81232018247.20862017 copy

Cognitive assessment instruments used in elderly Brazilians in the last five years

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Detecting and monitoring cognitive deficits in elderly populations are necessary, as they can impact individuals´ functionality. This integrative review aims to analyze the scientific production on the use of cognitive assessment instruments in Brazilian elderly individuals through articles published in the last five years, indexed in the Web of Science, Pubmed, Scopus and Bireme databases. Inclusion criteria were original articles published in English and Portuguese from 2012 to 2016, the age criterion to define elderly individuals and scores higher than 6 in the adapted CASP. The exclusion criterion was conference abstracts submitted for publication. The final sample consisted of 100 articles. Sixty-one cognitive assessment instruments were used in the studies, especially the Mini-Mental State Examination. This review features the use of cognitive instruments in the Brazilian literature, their different versions and domains evaluated. The literature includes a large number of instruments. The most used tests were the MMSE (version proposed by Brucki et al.), the Verbal Fluency Test (“animal” category) and the Digit Span Memory Test (forward span and backward span). The findings presented in this review are relevant not only for observational and experimental research but also for clinical practice.

Elderly; Geriatric assessment; Cognition

Instrument	N (%)	Use	Domains assessed	Versions	n	%
MMSE	90 (90%)	Sample selection Screening Correlation with scores of other tests To evaluate effects of intervention To evaluate association and risk To aid in diagnostic procedures To compare means between groups To follow-up on the evolution of the disease	Temporal orientation Spatial orientation Immediate and delayed memory Attention Calculation Language Constructive praxis	Brucki et al., 2003	31	34,4
				Bertolucci et al., 1994	15	16,7
				Lourenço e Veras, 2006^a	10	11,1
				Folstein et al., 1975	8	8,9
				Almeida, 1998	6	6,7
				Icaza e Albala, 1999	5	5,6
				Herrera et al., 2002	3	3,3
				Castro-Costa et al., 2008	2	2,2
				Bottino et al., 2001	2	2,2
				Kochhann et al.	1	1,1
				Nitrini et al., 2007	1	1,1
				Nitrini et al., 1994	1	1,1
				Seabra et al., 1990	1	1,1
				Not mentioned	4	4,4
Verbal Fluency Test	24 (24%)	Sample selection Screening Correlation with scores of other tests To evaluate effects of intervention To evaluate association and risk To aid in diagnostic procedures To compare means between groups To follow-up on the evolution of the disease To evaluate executive functions	Language Semantic memory Executive functions	Semantic (animals)	16	66,7
				Semantic(animalsb and fruitsa)	2	8,3
				Semantic (animals and supermarket)	1	4,2
				Semantic (no category)	3	12,5
				Phonemic(F,A,Sa)	4	16,7
				Phonemic (A,F)	2	8,3
				Phonemic (no categories)	1	4,2
				Free choice	1	4,2
				Not mentioned	1	4,2
Digit Span Memory Test ^a	15 (15%)	Correlation with scores of other tests To evaluate effects of intervention To aid in diagnostic procedures To evaluate association To compare means between groups	Attention Concentration Learning Working memory Executive functions	-	-
CAMCOG-R^b	13 (13%)	Screening Correlation with scores of other tests To evaluate effects of intervention To aid in diagnostic procedures To evaluate association To compare means between groups	Temporal orientation Spatial orientation Immediate and delayed memory Attention Calculation Language Executive functions Constructive praxis Praxis	-	-
CDR^a	10 (10%)	Sample selection Screening To aid in diagnostic procedures To classify severity of dementia	Memory Orientation Executive function (problem solving)	-	-
CDT	10 (10%)	Sample selection Screening Correlation with scores of other tests To compare means between groups To aid in diagnostic procedures To evaluate association	Visuospatial skills Constructive praxis Executive functions Attention	Sunderland et al., 1989^a	5	50,0
				Shulman et al., 1993^a	3	30,0
				Mendez et al., 1992^b	2	20,0
				Freedman et al., 1994	1	10,0
				Shulman e Silver, 1986	1	10,0
				Shulman, 2000	1	10,0
TMT^b	9 (9%)	Sample selection Screening To compare means between groups To aid in diagnostic procedures To evaluate association To evaluate effects of intervention To evaluate executive functions	Attention Executive functions	TMT A e B	8
TMT^b	9 (9%)		Attention Executive functions	TMT A	1
RAVLT^a	8 (8%)	To compare means between groups To aid in diagnostic procedures To evaluate effects of intervention To evaluate association Correlation with scores of other tests	Recent memory Episodic memory Learning	-
MoCA^a	8 (8%)	Screening To evaluate association To evaluate effects of intervention Correlation with scores of other tests	Constructive praxis Attention Executive functions Immediate and delayed memory Language Orientation	-
IQCODE^a	8 (8%)	Sample selection Screening To aid in diagnostic procedures To evaluate association To evaluate effects of intervention Correlation with scores of other tests	Not applicable as it evaluates the cognitive decline through an interview with caregiver	-
BCSB^a	5 (5%)	Screening To evaluate association To aid in diagnostic procedures	Language Immediate and delayed memory Calculation Executive functions Constructive praxis	-
RBMT^a	4 (4%)	Screening To evaluate association To evaluate effects of intervention	Memory	-
BNT^a	4 (4%)	To evaluate association To evaluate effects of intervention	Language	-
FOME^a	3 (3%)	Screening To evaluate association	Learning Episodic memory Language Executive functions	-
WCST^a	3 (3%)	To evaluate effects of intervention	Executive functions	-
List of words	3 (3%)	To evaluate effects of intervention To evaluate association	Immediate and delayed memory Learning	-
LCT^a	3 (3%)	Sample selection Screening To evaluate association	Orientation Language Immediate and delayed memory	-
Vocabulary Subtest of the WAIS-III test^a	3 (3%)	To evaluate effects of intervention To evaluate association To aid in diagnostic procedures	Language Semantic memory	-
Digit Symbol-Coding subtest of WAIS-III test^a	3 (3%)	To evaluate effects of intervention Correlation with scores of other tests To aid in diagnostic procedures	Attention Visuospatial skills Memory	-
Corsi block-tapping test	2 (2%)	To compare means between groups To evaluate effects of intervention	Working memory Executive functions	-
SKT^a	2 (2%)	Screening To evaluate association To evaluate effects of intervention	Attention Concentration Executive functions Immediate and delayed memory Recognition	-
FAB^a	2 (2%)	Correlation with scores of other tests	Executive functions	-
MAC-Q^b	2 (2%)	To evaluate association To evaluate effects of intervention	Prospective memory
MDRS^b	2 (2%)	To aid in diagnostic procedures	Working memory Executive functions Attention Praxis	-
SMMSE^b	2 (2%)	To evaluate association	Constructive praxis Language Attention Memory Verbal fluency	-
TN-LIN^a	2 (2%)	To compare means between groups Correlation with scores of other tests	Semantic memory Language	-
Verbal Paired Associates of the WMS-R^b	2 (2%)	To evaluate effects of intervention To evaluate association	Immediate and delayed memory	-
PDMT	2 (2%)	To evaluate association and risk	Immediate and delayed memory	-
Stick Design Test^b	2 (2%)	To compare means between groups Correlation with scores of other tests	Visuospatial skills	-
Symbol search subtest of WAIS-III^a	2 (2%)	To evaluate effects of intervention	Attention Executive functions	-
Cookie Theft picture test of the Boston Diagnostic Aphasia Examination	2 (2%)	To evaluate effects of intervention	Language	-
CANSMCI-BR^a	1 (1%)	Screening	Memory Language Executive function	-
ADAS-Cog^b	1 (1%)	Screening To evaluate association	Immediate and delayed memory Language Visuospatial skills Ideomotor and constructive praxis	-
CERAD^b	1 (1%)	To evaluate association	*Includes Verbal Fluency Tests; MMSE; Boston Naming Test; Word List: Visuoconstructive Skills	-
The Arizona Battery for Communication Disorders of Dementia	1 (1%)	To evaluate association	Language Episodic memory Visuospatial skills Constructive praxis	-
TROG-2	1 (1%)	To evaluate association	Language	-
Community Screening Instrument for Dementia	1 (1%)	Screening To evaluate association	Language Memory Praxis Orientation	-
Metamemory Adulthood Questionnaire^a	1 (1%)	To evaluate effects of intervention	Metamemory	-
MSEQ^a	1 (1%)	To evaluate effects of intervention	Memory	-
Raven’s Progressive Matrices Test^b	1 (1%)	To evaluate association	Executive functions	-
Stroop test^a	1 (1%)	To compare means between groups	Executive functions	-
Similarities subtest of WAIS-III^a	1 (1%)	To compare means between groups	Language Executive functions	-
Information subtest of WAIS-III^a	1 (1%)	To evaluate effects of intervention	Immediate memory	-
Cube design subtest of WAIS-III^a	1 (1%)	To evaluate association	Visuospatial skills Executive functions	-
Matrix reasoning subtest of WAIS-III^a	1 (1%)	To aid in diagnostic procedures	Executive functions	-
Comprehension subtest of WAIS-III^a	1 (1%)	To aid in diagnostic procedures	Executive functions	-
Arithmetic subtest of WAIS-III^a	1 (1%)	To evaluate effects of intervention	Attention Calculation	-
Letter-number sequencing subtest of WAIS-III^a	1 (1%)	To evaluate effects of intervention	Working memory	-
Logical memory subtest I and II of WMS-R^b	1 (1%)	To evaluate effects of intervention	Episodic memory Ability to recall	-
Delay Visual Memory task	1 (1%)	To evaluate association	Episodic memory	-
Short form of WAIS-III^a	1 (1%)	To evaluate association	Attention Executive functions Working memory Episodic memory Calculation Language	-
NEUPSILIN test^a	1 (1%)	To evaluate effects of intervention	Attention Orientation Working memory Episodic, semantic and prospective memory Calculation Language Praxis Executive functions	-
Groton Maze Learning Test; Set-Shifting test, One-back and Two-back tests	1 (1%)	To evaluate effects of intervention	Attention Working memory Executive functions	-
Five-digit test^a	1 (1%)	To compare means between groups	Executive functions	-
Concentrated Attention Test (Toulouse-Piéron) ^b	1 (1%)	To evaluate effects of intervention	Attention	-
Buschke Selective Reminding Test ^b	1 (1%)	To evaluate association	Episodic memory	-
Token Test –short version^a	1 (1%)	To compare means between groups	Semantic memory Language	-
Delayed recall of simple pictures	1 (1%)	To aid in diagnostic procedures	Delayed memory	-
Labyrinth Test	1 (1%)	To aid in diagnostic procedures	-	-
Tower of Hanoi^b	1 (1%)	To evaluate association	Executive functions	-
Test of Variables of Visual Attention ^l	1 (1%)	To evaluate association	Attention	-

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

NIM Martins designed, outlined, analyzed and interpreted the data and drafted the article. PR Caldas conducted data analysis. ED Cabral performed the critical review of the article. CCSA Lins contributed to the article design and critical review. MGWS Coriolano contributed to the concept, design, interpretation of data and critical review of the article.

Attention	MMSE; Digit Span Memory Test; CAMCOG-R; CDT: TMT; MoCA; Digit Symbol-Coding Subtest, Symbol search and Arithmetic Subtest of WAIS-III; SKT; MDRS; SMMSE; CERAD; Short form of WAIS-III; NEUPSILIN test; Concentrated Attention Test of Toulouse-Piéron; Groton Maze Learning Test; Set-Shifting test, One-back and Two-back tests; Test of variables of Visual Attention
Orientation	MMSE; CAMCOG-R; CDR: MoCA; LCT; CERAD; NEUPSILIN test; Community Screening Instrument for Dementia
Language	MMSE; Verbal fluency Test; CAMCOG-R; MoCA; BCSB; BNT; FOME; LCT; SMMSE; TN-LIN; CANSMCI-BR; ADAS-Cog; CERAD; Cookie Theft picture test of the Boston Diagnostic Aphasia Examination; The Arizona Battery for Communication Disorders of Dementia; TROG-2; Community Screening Instrument for Dementia; Similarities subtest of WAIS-III; NEUPSILIN test; Short Form of WAIS-III; Token Test
Memory	MMSE; Verbal fluency Test; Digit Span Memory Test; CAMCOG-R; CDR; RAVLT; MoCA; BCSB; RBMT; FOME- list of words; LCT; Vocabulary, Digit Symbol-Coding Subtest, Information, Number and Letter Sequencing subtests of WAIS-III; Corsi block-tapping test; SKT; MAC-Q; MDRS; SMMSE; TN-LIN; Verbal Paired Associates I and II and Logical Memory I and II of WMS-III; PDMT; CANSMCI-BR; CERAD; ADAS-Cog; The Arizona Battery for Communication Disorders of Dementia; Community Screening Instrument for Dementia; MSEQ; Metamemory in Adulthood Questionnaire; Delayed Visual Memory task; Short form of WAIS-III; NEUPSILIN test; Groton Maze Learning Test; Set-Shifting test, One-back and Two-back tests; Buschke Selective Reminding Test; Token Test; Delayed recall of simple pictures
Executive functions	Verbal fluency Test; Digit Span Memory Test; CAMCOG-R; CDR; CDT; TMT; MoCA; BCSB; FOME; WCST; Corsi block-tapping test; SKT; FAB; MDRS; Symbol Search, Cube Design, Comprehension, Matrix reasoning subtests of WAIS-III; CANSMCI-BR; CERAD; Short term of WAIS-III; NEUPSILIN test; Groton Maze Learning Test; Set-Shifting test, One-back and Two-back tests; Five-digit test; Tower of Hanoi
Praxis	MMSE; CDT; CAMCOG-R; MoCA; BCSB; MDRS; SMMSE; ADAS-Cog; CERAD; The Arizona Battery for Communication Disorders of Dementia; Community Screening Instrument for Dementia; NEUPSILIN test
Visuospatial skills	CDT; Digit Symbol-Coding and Cube Design subtests of WAIS-III; Stick Design Test; ADAS-Cog; CERAD;
Calculation	MMSE; CAMCOG-R; CERAD; Arithmetic subtest of WAIS-III; Short form of WAIS-III; NEUPSILIN test