Escala de flutuação cognitiva em demências: versão adaptada para o contexto brasileiro e investigação de evidências de validade de conteúdo

Abstract

Cognitive fluctuations (CF) are defined as spontaneous and transient variations in alertness and cognition, occurring in the most common dementias. CF are associated with worsening clinical course of dementias and neuropsychological functioning. The accuracy in the identification of CF represents an important clinical challenge, and the failure to recognize them may contribute to a poor differential diagnosis. Among the available tools, the Dementia Cognitive Fluctuation Scale (DCFS) was created to evaluate CF. In the brazilian literature, there is a lack of known studies about scales that evaluate CF. The current study aimed adapt transculturally and to investigate evidences of content validity of the DCFS. Transcultural adaptation encompassed 6 stages: (1) translation the instrument from the source language to the target language; (2) synthesis of the translated versions; (3) concordance analysis of the synthesis by judges, (4) assessment of the instrument by the target population; (5) back-translation, and (6) pre-test. A preliminary study was conducted with the administration of the DCFS and a cognitive and neuropsychiatric assessment protocol. Sixty-two older adults participated in this study, divided in 4 groups: healthy older adults (n = 35), mild cognitive impairment (MCI) (n = 11), Alzheimer’s disease dementia (ADD) (n = 10), and vascular dementia (VD) (n = 6). Preliminary results indicated dementia groups (ADD e VD) presented significantly more indicators of CF when compared to healthy older adults and MCI. In the three clinical groups (MCI, ADD and VD), it was verified that higher levels of FC correlated to the worse performance in semantic memory and verbal fluency. However, due to the small samples, it was not possible to investigate the construct validity initially aimed, which is considered as essential in posterior studies to support the use of the scale. This study achieves results in presenting the DCFS to the brazilian context and offers CF indicators in the evaluated groups, emphasizing the need for subsequent psychometric investigations.