Brief cognitive assessment of Alzheimer's disease in advanced stages: Proposal for a Brazilian version of the Short Battery for Severe Impairment (SIB-8)

Wajman, José Roberto; Bertolucci, Paulo Henrique Ferreira

doi:10.1590/S1980-57642013DN70200005

ABSTRACT

The measurement of cognitive abilities of patients with severe dementia can serve a wide range of methodological and clinical needs. Objective: To validate a proposed severe impairment battery SIB-8 for a Brazilian population sample as part of the neuropsychological assessment of patients with Alzheimer's disease (AD) in advanced stages. Methods: After a systematic process of translation and back-translation, the SIB-8 was applied to 95 patients with AD at different stages; moderate, moderately severe and severe according to FAST subdivisions (5, 6 and 7), with scores on the Mini-Mental State Examination (MMSE) of between 5 and 15 and followed by the Division of Behavioral Neurology and the Center for Aging Brain of the Federal University of São Paulo - UNIFESP. Results: Inferential data revealed that the SIB-8 instrument behaved differently at each stage of the disease with a statistical value of sensitivity p<0.001, gradually reflecting the expected course of the dementia, inherent with the decline of cognitive functions. Conclusion: Findings indicated that the SIB-8 is a useful tool for the evaluation and prospective comparison of AD patients in advanced stages, retaining its original characteristics in our population.

Key words:
cognitive assessment; severe impairment; dementia; Alzheimer's disease

RESUMO

A quantificação da capacidade cognitiva de pacientes com demência grave pode ser útil para suprir amplas necessidades metodológicas e clínicas. Objetivo: Foi proposta a validação da bateria para comprometimento grave SIB-8 para uma amostra populacional Brasileira como parte integrante da avaliação neuropsicológica de pacientes com doença de Alzheimer (DA) em fases avançada. Métodos: Após sistemático processo de tradução e retrotradução, a SIB-8 foi aplicada em 95 pacientes com DA nas fases moderada, moderadamente grave e grave conforme as subdivisões 5, 6 e 7 da escala FAST, com escore no Mini-Exame do Estado Mental (MEEM) entre 5 e 15 e acompanhados junto ao Setor de Neurologia do Comportamento e do Núcleo de Envelhecimento Cerebral da Universidade Federal de São Paulo - UNIFESP. Resultados: Dados inferenciais revelaram que o instrumento SIB-8 comportou-se de maneira diferente em cada uma das fases da doença com valor estatístico de sensibilidade de p<0,001, relacionando gradualmente o curso esperado da demência, com o inerente declínio das funções cognitivas. Conclusões: Achados indicam a SIB-8 como uma ferramenta útil na avaliação e comparação prospectiva junto a pacientes com DA em fases avançadas, mantendo suas características originais também em nossa população.

Palavras-chave:
Avaliação cognitiva; comprometimento grave; demência; doença de Alzheimer

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REFERENCES

Morris J, Edland S, Clarck C, et al. The consortium to establish a registry for Alzheimers disease (CERAD). Part IV. Neurology 1993;43:2457-2465.
Saxton J, McGonigle-Gibson K, Swihart A, et al. Assessment of the severely impaired patient: description and validation of a new neuropsychological test battery. J Consult Clin Psychology 1990;2:298-303.
Bonds MW, Salmon DP, Butters N. Neuropsychological features of memory disorders in Alzheimer's disease. In: Alzheimer`s disease. New York, Raven Press Ltd; 1994:41-63.
Albert M, Cohen C. The test for severe impairment: an instrument for the assessment of patients with severe cognitive dysfunction. J Amer Ger Society 1992;40:449-453.
Auer SR, Sclan SG, Yaffee RA, et al. The neglected half of Alzheimer Disease: Cognitive and Functional of severe dementia. J Amer Ger Society1994;42:1266-1272.
Hughes CP, Berg L, Danziger WL. A new clinical scale for the staging dementia. Alzheimer Dis Assoc Disord 1982;140:566-572.
Sclan SG, Reisberg B. Functional assessment staging (FAST) in Alzheimer's disease: reliability, validity, and ordinality. Int Psychogeriatr 1992;4 (Suppl. 1):55-69.
Stuss DT, Meiran N, Guzman A, et al. Do long tests yield more accurate diagnosis of dementia than shorts tests? A comparison of 5 neuropsychological tests. Arch Neurology 1996;53:1033-1039.
Saxton J, Kastango KB, Hugonot-Diener L, et al. Development of a short form of the Severe Impairment Battery. Am J Geriatr Psychiatry 2005;13:999-1005.
Qazi A, Richardson B, Simmons P, et al. The Mini-SIB: a short scale for measuring cognitive function in severe dementia. Int J Geriatr Psychiatry 2005;20:1001-1002.
Schmitt FA, Ashford W, Ernesto C, et al. The Severe Impairment Battery: concurrent validity and the assessment of longitudinal change in Alzheimer's disease. Alzheimer Dis and Assoc Disord 1997;11:51-56.
Geldemacher DS, Frolich L, Doody RS, et al. Realistic expectations for treatment success in Alzheimer`s disease. J Nutr Health Aging 2006; 10:417-429.
Winblad B, Brodaty H, Gauthier S, et al. Pharmacotherapy of Alzheimer's disease: is there a need to redefine treatment success? Int J Geriatr Psychiatry2001;16:653-666.
Schmitt FA, Saxton JA, Xu Y, et al. A brief instrument to assess treatment response in the patient with advanced Alzheimer's disease. Alzheimer Dis Assoc Disord2009;23: 377-383.
Wajman JR, Bertolucci PHF. Comparison Between neuropsychological evaluation instruments for severe dementia. Arq Neuropsiquiatr 2006;64:736-740.
Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.
Hughes CP, Berg L, Danziger WL, et al. A new clinical scale for the staging of dementia. Br J Psychiatry 1982;140:566-572.
deJonghe JF, Wetzels RB, Mulders A, et al. Validity of the Severe Impairment Battery Short Version. J Neurol Neurosurg Psychiatry 2009; 80:954-959.
Inn-Sook Ahn, Ji Hae Kim, Hyoung Mo Ku, et al. Reliability and Validity of the Severe Impairment Battery (SIB) in Korean Dementia Patients. J Korean Med Sci 2006;21:506-517.

Publication Dates

Publication in this collection
Apr-Jun 2013

History

Received
28 Nov 2012
Accepted
22 Feb 2013

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] Morris J, Edland S, Clarck C, et al. The consortium to establish a registry for Alzheimers disease (CERAD). Part IV. Neurology 1993;43:2457-2465.

[2] Saxton J, McGonigle-Gibson K, Swihart A, et al. Assessment of the severely impaired patient: description and validation of a new neuropsychological test battery. J Consult Clin Psychology 1990;2:298-303.

[3] Bonds MW, Salmon DP, Butters N. Neuropsychological features of memory disorders in Alzheimer's disease. In: Alzheimer`s disease. New York, Raven Press Ltd; 1994:41-63.

[4] Albert M, Cohen C. The test for severe impairment: an instrument for the assessment of patients with severe cognitive dysfunction. J Amer Ger Society 1992;40:449-453.

[5] Auer SR, Sclan SG, Yaffee RA, et al. The neglected half of Alzheimer Disease: Cognitive and Functional of severe dementia. J Amer Ger Society1994;42:1266-1272.

[6] Hughes CP, Berg L, Danziger WL. A new clinical scale for the staging dementia. Alzheimer Dis Assoc Disord 1982;140:566-572.

[7] Sclan SG, Reisberg B. Functional assessment staging (FAST) in Alzheimer's disease: reliability, validity, and ordinality. Int Psychogeriatr 1992;4 (Suppl. 1):55-69.

[8] Stuss DT, Meiran N, Guzman A, et al. Do long tests yield more accurate diagnosis of dementia than shorts tests? A comparison of 5 neuropsychological tests. Arch Neurology 1996;53:1033-1039.

[9] Saxton J, Kastango KB, Hugonot-Diener L, et al. Development of a short form of the Severe Impairment Battery. Am J Geriatr Psychiatry 2005;13:999-1005.

[10] Qazi A, Richardson B, Simmons P, et al. The Mini-SIB: a short scale for measuring cognitive function in severe dementia. Int J Geriatr Psychiatry 2005;20:1001-1002.

[11] Schmitt FA, Ashford W, Ernesto C, et al. The Severe Impairment Battery: concurrent validity and the assessment of longitudinal change in Alzheimer's disease. Alzheimer Dis and Assoc Disord 1997;11:51-56.

[12] Geldemacher DS, Frolich L, Doody RS, et al. Realistic expectations for treatment success in Alzheimer`s disease. J Nutr Health Aging 2006; 10:417-429.

[13] Winblad B, Brodaty H, Gauthier S, et al. Pharmacotherapy of Alzheimer's disease: is there a need to redefine treatment success? Int J Geriatr Psychiatry2001;16:653-666.

[14] Schmitt FA, Saxton JA, Xu Y, et al. A brief instrument to assess treatment response in the patient with advanced Alzheimer's disease. Alzheimer Dis Assoc Disord2009;23: 377-383.

[15] Wajman JR, Bertolucci PHF. Comparison Between neuropsychological evaluation instruments for severe dementia. Arq Neuropsiquiatr 2006;64:736-740.

[16] Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189-198.

[17] Hughes CP, Berg L, Danziger WL, et al. A new clinical scale for the staging of dementia. Br J Psychiatry 1982;140:566-572.

[18] deJonghe JF, Wetzels RB, Mulders A, et al. Validity of the Severe Impairment Battery Short Version. J Neurol Neurosurg Psychiatry 2009; 80:954-959.

[19] Inn-Sook Ahn, Ji Hae Kim, Hyoung Mo Ku, et al. Reliability and Validity of the Severe Impairment Battery (SIB) in Korean Dementia Patients. J Korean Med Sci 2006;21:506-517.

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