Evidências de validade do inventário de sintomas pré-frontais para população idosa com e sem a doença de Alzheimer

Abstract

Aging causes a series of psychological, biological and social changes in the life of individuals. Constantly, a decline in cognitive functions is observed, which can be a possible risk factor for the development of Alzheimer’s disease (AD). For the diagnosis of AD one of the resources used by clinicians has been cognitive screening tests. The use of clinical interviews and behavioural inventories are also seen as relevant, in this aspect, an instrument of Spanish origin stands out, naming Prefrontal Symptoms Inventory (PSI). Therefore, the aim of this study was to adapt this instrument to Brazilian Portuguese and to look for evidences of validity for the elderly population with and without dementia. For this, the PSI-20 was initially adapted idiomatically and culturally and subsequently applied to 256 elderly with and without the diagnosis of probable AD, aged over 60 years of both sexes, and at least one year of formal schooling. The participants also answered a clinical interview, the Mini Mental State Examination (MMSE), the Frontal Assessment Battery (FAB) and the Geriatric Depression Scale (GDS). The results showed satisfactory adjustment indexes and adequate reliability (Ω of 0.83 and α = 0.80) for the unifactorial model. The non clinical group exhibited significant correlations between the PSI16, the GDS-15, the MMSE, the FAB and their six subtests, however in the clinical group there were negative correlation only among the PSI-16, the MMSE, the BAF and the conceptualization subtest. In the comparison between the groups, statistic differences were found, with the clinical sample showing higher punctuation in the PSI-16. When checking the accuracy of the PSI to the diagnosis of probable AD. In the total sample, the cutting point of the PSI-16 was >19 points, with sensibility (SE) of 72%, and specificity (ES) of 68% (moderate). The accuracy of the FAB was similar to the one of the PSI-16 and the MMSE displayed SE (80%) and ES (72%) higher. The accuracy, the SE and the ES in the group with high schooling level was superior for all the instruments, when compared with the low schooling level. Regarding the division between the ages of the participants, the accuracies of the PSI-16 and of the MMSE remained similar, the SE of all the instruments increased and the ES obtained a decline, considering elderly people aged more than 70 years old. Therefore, the PSI-16 may be used as a valid and reliable tool for the clinical use in the population of elderly people with and without pathology, being a self report suitable instrument to track behavioural problems related to the prefrontal cortex.