Visual reproduction test in normal elderly: Influence of schooling and visual task complexity

Brito-Marques, Paulo Roberto de; Cabral-Filho, José Eulálio; Miranda, Rafael Moura

doi:10.1590/S1980-57642012DN06020005

ABSTRACT

Tests of visual reproduction are used to assess visual memory. However, when the test is based on geometrical elements results could be influenced by schooling.

Objective:

To evaluate the influence of different schooling levels on performance of a visual reproduction task.

Methods:

A sample of 253 individuals (66 male and 187 female), aged 60 to 92 years were evaluated on a visual reproduction task comprising three geometric pictures of increasing complexity. Each individual was shown a picture for 8 to10 seconds and a drawing of it was then immediately elicited. Four groups were defined according to the following schooling levels: illiterate, 1 to 4 years, 5 to 8 years and over 8 years. Individual performance was measured by summing the items correctly reproduced for the three pictures.

Results:

A significant difference for age was found between the illiterate and other three schooling groups. The reproduction of picture one was better reproduced than pictures 2 and 3 for all schooling levels (p<0.001). Pictures 2 and 3 did not differ among the schooling levels. Picture reproduction among the schooling levels showed that the group with over 8 years of schooling performed better on pictures 1 and 2 (p<0.001) but not on picture 3.

Conclusion:

Individuals aged 60 years or older, with 8 years' schooling or less, showed a reduced capacity to reproduce geometric pictures of a high degree of complexity. Clinical evaluations that use geometrical tests could be misinterpreted when not controlled for schooling level.

Key words:
visual reproduction; visual memory; schooling.

RESUMO

Teste de reprodução visual é usado para avaliar a memória visual, baseado em elementos geométricos e o resultado deve ser influenciado pela escolaridade.

Objetivo:

Avaliar os diferentes níveis de escolaridade durante a reprodução de tarefas visuais.

Métodos:

Uma amostra de 253 indivíduos (66 masculinos e 187 femininos), com idade entre 60 e 92 anos, foi avaliada em uma tarefa de reprodução visual composta por três desenhos geométricos de crescente complexidade. Cada indivíduo foi exposto a cada desenho geométrico de uma vez, e esse desenho foi reproduzido após 10 segundos de observação. Quatro grupos foram designados de acordo com o seguinte nível de escolaridade: analfabeto, 1 a 4 anos, 5 a 8 anos, e acima de 8 anos de escolaridade. A performance dos indivíduos foi medida pelos itens corretamentes reproduzidos.

Resultados:

Uma significante diferença da idade foi encontrada entre pacientes analfabetos e os outros três grupos de escolaridades diferentes. O desenho 1 foi reproduzido melhor do que os desenhos 2 e 3 em todos os níveis de escolaridade (p<0,001). Os desenhos 2 e 3 não diferiram em nenhum nível de escolaridade. A reprodução de um desenho entre níveis de escolaridade mostrou que o grupo acima de 8 anos de escolaridade realizou melhor nos desenhos 1 e 2 (p<0,001), mas não foi no desenho 3.

Conclusão:

Indivíduos com idade de 60 anos ou mais com até 8 anos de escolaridade mostrou capacidade diminuída na reprodução de desenhos geométricos de alto grau de complexidade. A avaliação clínica usando testes geométricos poderia ser mal interpretada quando a escolaridade não estiver de acordo com o grau de complexidade do teste.

Palavras-chave:
reprodução visual; memória visual; escolaridade.

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REFERENCES

Lezak MD, Howieson DB, Loring DW. Neuropsychological assessment. Fourth edition, Oxford: Oxford University Press; 2004:1016.
Wolfe JM. Visual memory: what do you know about what you saw? Curr Biol 1998;8:303-304.
Kandel ER, Schwartz JH, Jessell TM. Essentials of neural science and behavior. Connecticut, Appleton & Lange; 1995:743.
Feinberg TE, Farah MJ. Behavioral neurology and neuropsychology. New York, McGraw-Hill; 1997:872.
Mesulam MM. Principles of behavioral and cognitive neurology. 2a ed. Oxford, Oxford University Press; 2000:540.
Luria AR. The neuropsychology of memory. Washington, Winston & Sons, 1976:372.
Goetz CG. Textbook of clinical neurology. 3a ed., Philadelphia, Saunders Elsevier; 2007:1364.
Squire LR. Mechanism of memory. Science 1986;232:1612-619.
Banich MT Neuropsychology: the neural bases of mental function. Boston, Houghton Mifflin Company; 1997:638.
Fuster JM. The prefrontal cortex: anatomy, physiology, and neuropsychology of the frontal lobe. 3a ed. Lippincott - Raven, Philadelphia; 1997:333.
Burgess PW, Alderman N, Evans J, et al. The ecological validity of tests of executive functions. J Int Neuropsychol Soc 1998;4:547-558.
Gainotti G, Tiacci C. Patterns of drawing disability in right and left hemispheric patients. Neuropsychologia 1970;8:379-384.
Wechsler D. Wechsler Memory Scale-Revised manual. San Antonio: Psychological Corporation; 1987.
Grossi D, Correra G, Calise C, et al. Evaluation of the influence of illiteracy on neuropsychological performance by elderly persons. Percept Mot Skills 1993;77:859-866.
Manly JJ, Jacobs DM, Sano M, et al. Effect of literacy on neuropsychological test performance in nondemented, education-matched elders. J Int Neuropsychol Soc 1999;5:191-202.
Ribeiro AF, Freitas MIA, Radanovic M, Mansur LL. The generation of visual inferences in normal elderly: influence of schooling and visual complexity. Dement Neuropsychol 2010;4:194-201.
Brito-Marques PR, Cabral-Filho JE. The role of education in Mini-Mental State Examination: a study in Northeast Brazil. Arq Neuropsiquiatr 2004;62:206-211.
Brito-Marques PR, Cabral-Filho JE. Influence of age and schooling on the performance in a modified Mini-Mental state examination version: a study in Brazil Northeast. Arq Neuropsiquiatr 2005;63:583-587.
Gabriel P, Conboy J. Atenção e memória visual na população idosa: uma associação entre as habilidades literárias sob condições de interferência. Cuad Neuropsicol 2010;4:186-201.
Brito-Marques PR, Vieira-Mello RJ, Montenegro L. Classic Pick's disease type with ubiquitin positive and tau-negative inclusions: case report. Arq Neuropsiquiatr 2001;59:128-133.
Brito-Marques PR, Vieira-Mello RJ, Montenegro L. Nightmares without atonia as an early symptom of diffuse Lewy bodies disease. Arq Neuropsiquiatr 2003;61:936-941.
Brito-Marques PR, Vieira-Mello RJ, Montenegro L, Aragão MFV. Clinicopathologic analysis of progressive non-fluent aphasia and corticobasal degeneration: case report and review. Dement Neuropsychol 2011;5:135-141.

Publication Dates

Publication in this collection
Apr-Jun 2012

History

Received
26 Nov 2011
Accepted
02 Feb 2012

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

[1] Lezak MD, Howieson DB, Loring DW. Neuropsychological assessment. Fourth edition, Oxford: Oxford University Press; 2004:1016.

[2] Wolfe JM. Visual memory: what do you know about what you saw? Curr Biol 1998;8:303-304.

[3] Kandel ER, Schwartz JH, Jessell TM. Essentials of neural science and behavior. Connecticut, Appleton & Lange; 1995:743.

[4] Feinberg TE, Farah MJ. Behavioral neurology and neuropsychology. New York, McGraw-Hill; 1997:872.

[5] Mesulam MM. Principles of behavioral and cognitive neurology. 2a ed. Oxford, Oxford University Press; 2000:540.

[6] Luria AR. The neuropsychology of memory. Washington, Winston & Sons, 1976:372.

[7] Goetz CG. Textbook of clinical neurology. 3a ed., Philadelphia, Saunders Elsevier; 2007:1364.

[8] Squire LR. Mechanism of memory. Science 1986;232:1612-619.

[9] Banich MT Neuropsychology: the neural bases of mental function. Boston, Houghton Mifflin Company; 1997:638.

[10] Fuster JM. The prefrontal cortex: anatomy, physiology, and neuropsychology of the frontal lobe. 3a ed. Lippincott - Raven, Philadelphia; 1997:333.

[11] Burgess PW, Alderman N, Evans J, et al. The ecological validity of tests of executive functions. J Int Neuropsychol Soc 1998;4:547-558.

[12] Gainotti G, Tiacci C. Patterns of drawing disability in right and left hemispheric patients. Neuropsychologia 1970;8:379-384.

[13] Wechsler D. Wechsler Memory Scale-Revised manual. San Antonio: Psychological Corporation; 1987.

[14] Grossi D, Correra G, Calise C, et al. Evaluation of the influence of illiteracy on neuropsychological performance by elderly persons. Percept Mot Skills 1993;77:859-866.

[15] Manly JJ, Jacobs DM, Sano M, et al. Effect of literacy on neuropsychological test performance in nondemented, education-matched elders. J Int Neuropsychol Soc 1999;5:191-202.

[16] Ribeiro AF, Freitas MIA, Radanovic M, Mansur LL. The generation of visual inferences in normal elderly: influence of schooling and visual complexity. Dement Neuropsychol 2010;4:194-201.

[17] Brito-Marques PR, Cabral-Filho JE. The role of education in Mini-Mental State Examination: a study in Northeast Brazil. Arq Neuropsiquiatr 2004;62:206-211.

[18] Brito-Marques PR, Cabral-Filho JE. Influence of age and schooling on the performance in a modified Mini-Mental state examination version: a study in Brazil Northeast. Arq Neuropsiquiatr 2005;63:583-587.

[19] Gabriel P, Conboy J. Atenção e memória visual na população idosa: uma associação entre as habilidades literárias sob condições de interferência. Cuad Neuropsicol 2010;4:186-201.

[20] Brito-Marques PR, Vieira-Mello RJ, Montenegro L. Classic Pick's disease type with ubiquitin positive and tau-negative inclusions: case report. Arq Neuropsiquiatr 2001;59:128-133.

[21] Brito-Marques PR, Vieira-Mello RJ, Montenegro L. Nightmares without atonia as an early symptom of diffuse Lewy bodies disease. Arq Neuropsiquiatr 2003;61:936-941.

[22] Brito-Marques PR, Vieira-Mello RJ, Montenegro L, Aragão MFV. Clinicopathologic analysis of progressive non-fluent aphasia and corticobasal degeneration: case report and review. Dement Neuropsychol 2011;5:135-141.

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