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The Stick Design Test on the assessment of older adults with low formal education: evidences of construct, criterion-related and ecological validity

Published online by Cambridge University Press:  02 August 2013

Jonas Jardim de Paula ,
Mônica Vieira Costa ,
Matheus Bortolosso Bocardi ,
Mariana Cortezzi ,
Edgar Nunes De Moraes  and
Leandro Fernandes Malloy-Diniz
Jonas Jardim de Paula*
Affiliation:
Laboratory of Neuropsychological Investigations (LIN), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil INCT de Medicina Molecular, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil
Mônica Vieira Costa
Affiliation:
Laboratory of Neuropsychological Investigations (LIN), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil INCT de Medicina Molecular, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil
Matheus Bortolosso Bocardi
Affiliation:
Laboratory of Neuropsychological Investigations (LIN), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil INCT de Medicina Molecular, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil
Mariana Cortezzi
Affiliation:
Programa de Pós-Graduação em Neurociências, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
Edgar Nunes De Moraes
Affiliation:
Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
Leandro Fernandes Malloy-Diniz
Affiliation:
Laboratory of Neuropsychological Investigations (LIN), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil INCT de Medicina Molecular, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brazil Departamento de Saúde Mental, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
*
Correspondence should be addressed to: Jonas Jardim de Paula, Av Alfredo Balena, 190, Belo Horizonte-MG, CEP 30130-100, Brazil. Phone: +55-31-9990-2760; Fax: +55-31-9990-2760. Email: jonasjardim@gmail.com.
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Abstract

Background:

The assessment of visuospatial abilities is usually performed by drawing tasks. In patients with very low formal education, the use of these tasks might be biased by their cultural background. The Stick Design Test was developed for the assessment of this population. We aim to expand the test psychometric properties by assessing its construct, criterion-related and ecological validity in older adults with low formal education.

Method:

Healthy older adults (n = 63) and Alzheimer's disease patients (n = 92) performed the Stick Design Test, Mini-Mental State Examination, Digit Span Forward and the Clock Drawing Test. Their caregivers answered Personal Care and Instrumental Activities of Daily Living). Construct validity was assessed by factor analysis, convergent correlations (with the Clock Drawing Test), and divergent correlations (with Digit Span Forward); criterion-related validity by receiver operating characteristic curve analysis and binary logistic regression; and Ecological validity by correlations with ADL.

Results:

The test factor structure was composed by one component (R2 = 64%). Significant correlations with the Clock Drawing Test and Digit Span Forward were found, and the relationship was stronger with the first measure. The test was less associated with formal education than the Clock Drawing Test. It classified about 76% of the participants correctly and had and additive effect with the Mini-Mental State Examination (84% of correct classification). The test also correlated significantly with measures of ADL, suggesting ecological validity.

Conclusions:

The Stick Design Test shows evidence of construct, criterion-related and ecological validity. It is an interesting alternative to drawing tasks for the assessment of visuospatial abilities.

Keywords

Alzheimer’s disease (AD)cognitive assessmenteducationneuropsychological testingpsychogeriatrics
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 12 , December 2013 , pp. 2057 - 2065
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Ardila, A.et al. (2010). Illiteracy: the neuropsychology of cognition without reading. Archives of Clinical Neuropsychology, 25, 689–712.CrossRefGoogle ScholarPubMed
Baiyewu, O.et al. (2005). The Stick Design test: a new measure of visuoconstructional ability. Journal of the International Neuropsychological Society, 11, 598–605.CrossRefGoogle Scholar
Bertolucci, P. H. F., Okamoto, I. H., Brucki, S. M. D., Siviero, M. O., Neto, J. T. and Ramos, L. R. (2001). Applicability of the CERAD neuropsychological battery to Brazilian elderly. Arquivos de Neuro-Psiquiatria, 59, 532–536.CrossRefGoogle ScholarPubMed
Cecato, J. F., Fiorese, B., Montiel, J. M., Bartholomeu, D. and Martinelli, J. E. (2012). Clock Drawing Test in elderly individuals with different education levels: correlation with Clinical Dementia Rating. American Journal of Alzheimer's Disease & Other Dementias, 27, 620–624.CrossRefGoogle ScholarPubMed
Chaytor, N. and Schmitter-Edgecombe, M. (2003). The ecological validity of the neuropsychological tests: a review of the literature on everyday cognitive skills. Neuropsychology Review, 13, 181–197.CrossRefGoogle ScholarPubMed
Dansilio, S. and Charamelo, A. (2005). Constructional functions and figure copying in illiterates or low-schooled Hispanics. Archives of Clinical Neuropsychology, 20, 1105–1112.CrossRefGoogle ScholarPubMed
de Paula, J. J. and Malloy-Diniz, L. F. (2013). Executive functions as predictors of functional performance in mild Alzheimer's dementia and mild cognitive impairment elderly. Estudos de Psicologia, 18, 117–124.CrossRefGoogle Scholar
de Paula, J. J.et al. (2010). Psychometric properties of a brief neuropsychological protocol for the use in geriatric populations. Revista de Psiquiatria Clínica, 27, 246–250.Google Scholar
de Paula, J. J.et al. (in press A). Development, validity, and reliability of the IFI-LIN: a multidimensional measure of activities of daily living for older people. Revista Brasileira de Psiquiatria.Google Scholar
de Paula, J. J., Miranda, D. M., Moraes, E. N. and Malloy-Diniz, L. F. (in press B). Mapping the clockworks: what does the Clock Drawing Test assess in normal and pathological aging? Arquivos de Neuro-Psiquiatria.Google Scholar
Di Santo, S. G., Prinelli, F., Adorni, F., Catagirone, C. and Musicco, M. (2013). A meta-analysis of the efficacy of Donepezil, Rivastigmine, Galantamine, and Memantine in relation to severity of Alzheimer's disease. Journal of the Alzheimer's Disease. Epub ahead of print.Google Scholar
Folstein, M. F., Fosltein, S. E. and McHugh, P. R. (1975). “Mini-Mental State”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Guérin, F., Ska, B. and Belleville, S. (1999). Cognitive processing of drawing abilities. Brain and Cognition, 40, 464–478.CrossRefGoogle ScholarPubMed
Guruje, O.et al. (1995). The CERAD neuropsychological test battery: norms from a Yoruba speaking Nigerian sample. West African Journal of Medicine, 14, 29–33.Google ScholarPubMed
Hong, U. J.et al. (2011). Effects of illiteracy and education on the visuoconstructional ability of non-demented elderly patients. Journal of the International Neuropsychological Society, 17, 934–939.CrossRefGoogle Scholar
IBM Corp. (2010). IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY. IBM Corp.Google Scholar
Jacqmin-Gadda, H., Fabrigoule, C., Commenges, D., Letenneur, L. and Dartigues, J. F. (2000). A cognitive screening battery for dementia in the elderly. Journal of Clinical Epidemiology, 53, 980–987.CrossRefGoogle ScholarPubMed
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies Of illness in the aged. Journal of the American Medical Association, 185, 914–919.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Lourenço, R. A., Ribeiro-Filho, S. T., Moreira, F. H., Paradela, E. M. P. and Miranda, A. S. (2008). The Clock Drawing Test: performance among elderly with low educational level. Revista Brasileira de Psiquiatria, 30, 309–315.CrossRefGoogle ScholarPubMed
Mattis, S. (1988). Dementia Rating Scale. Odessa, FL: Psychological Assessment Resources Inc.Google Scholar
McKhann, G. M.et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers & Dementia, 7, 263–269.CrossRefGoogle ScholarPubMed
Morris, J. C.et al. (1989). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology, 39, 1159–1165.Google Scholar
Porto, C. S., Fichman, H. C., Caramelli, P., Bahia, V. S. and Nitrini, R. (2003). Brazilian version of the Mattis Dementia Rating Scale. Arquivos de Neuro-Psiquiatria, 61, 339–345.CrossRefGoogle ScholarPubMed
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W. and Ferri, C. P. (2013). The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer's & Dementia, 9, 63–75.CrossRefGoogle ScholarPubMed
Prvulovic, D.et al. (2002). Functional imaging of visuospatial processing in Alzheimer's disease. Neuroimage, 17, 1403–1414.CrossRefGoogle ScholarPubMed
Rey, A. (1941). L’exam en psychologique dans les cases d’ encephalopathy traumatique. Archives de Psychologie, 28, 286–340.Google Scholar
Rosselli, M. and Ardila, A. (2003). The impact of culture and education on non-verbal neuropsychological measurements: a critical review. Brain and Cognition, 52, 326–333.CrossRefGoogle ScholarPubMed
Salmon, D. P. and Bondi, M. W. (2009). Neuropsychological assessment of dementia. Annual Reviews of Psychology, 60, 257–282.CrossRefGoogle ScholarPubMed
Shulman, K. I. (2000). Clock-drawing: is it the ideal cognitive screening test? International Journal of Geriatric Psychiatry, 15, 548–561.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Tippett, W. J. and Black, S. E. (2008). Regional cerebral blood flow correlates of visuospatial tasks in Alzheimer's disease. Journal of the International Neuropsychological Society, 14, 1034–1045.CrossRefGoogle ScholarPubMed
Unverzagt, F. W.et al. (1999). Clinical utility of CERAD neuropsychological battery in elderly Jamaicans. Journal of the International Neuropsychological Society, 5, 255–259.CrossRefGoogle ScholarPubMed
Vasconcelos, L. G., Brucki, S. M. D. and Bueno, O. F. A. (2007). Cognitive and functional dementia Assessment tools: review of Brazilian literature. Dementia & Neuropsychologia, 1, 18–23.CrossRefGoogle ScholarPubMed
Yamaguchi, H., Maki, Y. and Yamagami, T. (2010). Overview of non-pharmacological intervention for dementia and principles of brain-activating rehabilitation. Psychogeriatrics, 10, 206–213.CrossRefGoogle ScholarPubMed