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Typical performance of elderly patients with Alzheimer disease on the Wisconsin Card Sorting Test (WCST)

Desempenho típico de idosos com doença de Alzheimer no Teste Wisconsin de Classificação de Cartas

Abstract

The Wisconsin Card Sorting Test (WCST) is a neuropsychological assessment tool designed to assess executive functions, frequently used in cases of cognitive disorders. However, Brazilian neuroscientific settings lack standardization studies of psychological assessment instruments, especially in the neuropsychological area. Thus, the assessment of clinical groups including dementias and particularly Alzheimer´s disease (AD) patients, may be compromised by the lack of analytical references.

Objective:

To characterize the performance of elderly patients with Alzheimer´s disease on the WCST, aiming at establishing preliminary evaluative norms.

Method:

Thirty-six elderly patients (mean age of 75.8 years) with mild AD from a teaching hospital were assessed using the printed form of the WCST.

Results:

The elderly patients with AD had impaired performance on the various WCST technical indicators, highlighting cognitive deficit with traces of stereotyped behavior and failures in working memory, conceptualization and learning. The results allowed preliminary norms to be defined for elderly AD patients on the various WCST indicators, grading their performance in eight diagnostic areas and yielding the identification of different levels of impairment of executive functions in these elderly patients.

Conclusions:

The results demonstrated specific aspects of performance on the WCST by elderly people with AD, highlighting the effect of the disease on cognitive performance and executive functioning. Those normative references, although preliminary make a significant contribution to the neuropsychological assessment of AD patients in the Brazilian context, within the informative scope of the WCST.

Key words:
Alzheimer´s disease; neuropsychological assessment; Wisconsin Card Sorting Test; executive functions; memory disorder; elderly people.

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br