Os testes neuropsicológicos mais utilizados para avaliar funções
                  executivas no envelhecimento

Faria, Camila de Assis; Alves, Heloisa Veiga Dias; Charchat-Fichman, Helenice

doi:10.1590/1980-57642015DN92000009

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Dementia & Neuropsychologia

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Original Articles • Dement. neuropsychol. 9 (2) • Apr-Jun 2015 • https://doi.org/10.1590/1980-57642015DN92000009 copiar

Os testes neuropsicológicos mais utilizados para avaliar funções executivas no envelhecimento

Autoria SCIMAGO INSTITUTIONS RANKINGS

Os testes neuropsicológicos que avaliam as funções executivas no envelhecimento são muitos e variam de acordo com os diferentes domínios.

OBJETIVO:

Apresentar uma revisão sistemática dos instrumentos mais utilizados para avaliar as funções executivas em idosos com diferentes níveis de escolaridade em pesquisas clínicas e experimentais.

MÉTODOS:

Foram pesquisados os artigos publicados nos últimos cinco anos, utilizando a base de dados PubMed com os termos: "neuropsychological tests", "executive functions" e "mild cognitive impairment", sem restrição de idioma.

RESULTADOS:

25 preencheram todos os critérios de inclusão. Os sete testes neuropsicológicos mais utilizados para avaliar funções executivas em idosos foram: [1] o Teste de Trilhas (TMT) Forma B; [2] Teste de Fluência Verbal (TFV) fonológica - F, A e S; [3] TFV categoria Animais; [4] Teste Desenho do Relógio (TDR); [5] Subteste Dígitos (WAIS-R ou WAIS-III); [6] Teste Stroop e [7] o Teste Wisconsin de Classificação de Cartas (WCST) e suas variações. Os domínios das funções executivas mais escolhidos pelos pesquisadores para serem avaliados foram: flexibilidade mental, fluência verbal, planejamento, memória operacional e controle inibitório.

CONCLUSÃO:

O presente estudo identificou os testes e os domínios de funções executivas mais utilizados nos últimos cinco anos, pelos principais grupos de pesquisa, para avaliar idosos. Os resultados encontrados podem direcionar pesquisas futuras e auxiliar a criação de protocolos de avaliação das funções executivas adequados aos diferentes níveis de educação e aos diferentes perfis sociodemográficos dos idosos do Brasil.

Revisão; comprometimento cognitivo leve; demência; idosos; funções executivas; testes neuropsicológicos

Names of EF tests	Predominant domain	Task description
Trail Making Test (TMT) Form B	Mental flexibility	Connect 13 numbers and 12 letters alternately and as quickly as possible.^9-10
Verbal Fluency Test (VFT) F, A and S	Verbal fluency	The test entails saying as many words a possible beginning with F, A and S in 1 minute. Participants cannot use proper nouns or use a stem word with different endings.^11-12
Verbal Fluency Test (VFT) Animals category	Verbal fluency	The entails saying as many animal names, as quickly as possible, in 1 minute, with no restrictions on first letter or any other characteristics.^{11, 13-14}
Clock Drawing Test (CDT)	Planning	Draw a clock with all the numbers and pointers marking a particular time. ^{13, 15-}¹⁹
Digits Forward and Backward subtests (WAIS-R or WAIS-III)	Working memory	In the Digits Forward subtest, the participant must repeat the numbers dictated by the examiner in the same order. In the Digits Backward subtest, the patient must repeat the same numbers in reverse order.^{13, 20}
Stroop Test	Inhibitory control	The test consists of three conditions: in the first condition, the subject must say, as quickly as possible, the names of the colors that are arranged on a card. In the second condition, the subject must say the names of the colors that the words “all”, “today”, etc. are printed in. In the third condition, the participant has to name the colors that the words “yellow”, “red”, etc. are printed in.^21-22
Wisconsin Card Sorting Test (WCST) and its variants	Mental flexibility	The test consists of cards that need to be classified according to color, shape or number categories. The categorization rules change every time 10 (out of a maximum of 128) response cards have been sorted correctly. WCST variants are versions with fewer cards.²³

Executive function tests	Frequency of test use	Percentage use, considering the 25 articles (%)	EF Domain	Study references (some studies used more than one test for the same domain)	Total studies evaluating the domain
Trail Making Test (TMT) Form B	9	36	mental flexibility	1, 29-42, 47	15
Wisconsin Card Sorting Test (WCST) and its variants	6	24
Rule Shift Cards Test (BADS)	2	8
Trail Making Test (TMT) Oral	1	4
Intra-Extra Dimensional Set Shifting (IED) of the CANTAB	1	4
VFT - F, A and S	7	28	verbal fluency	21-23, 32-33, 36, 38, 40, 42-46	13
VFT Animals category	6	24
VFT Fruits category	3	12
VFT semantics without specifying category	2	8
VFT “S”	1	4
VFT Vegetables category	1	4
VFT Supermarket category	1	4
VFT “A” of the EXIT-25	1	4
Clock Drawing Test (CDT)	6	24	Planning	1, 21-23, 31, 33, 40, 43, 45-49	13
Rey Complex Figure Copy	3	12
Action Program Test (BADS)	3	12
Key Search Test (BADS)	3	12
Zoo Map Test (BADS)	3	12
Tower of London	2	8
Setting Clock Test	1	4
Verbal Clock Test	1	4
Block Design subtest (WAIS-R)	1	4
Raven’s Colored Progressive Matrices	1	4
Digits Forward and Backward subtests (WAIS-R or WAIS-III)	6	24	working memory	21-22, 29-31, 33, 35-39, 42, 49	13
Codes subtest (WAIS-R or WAIS-III)	5	20
Arithmetic subtest (WAIS-R)	1	4
Number-Letter Sequencing subtest (WAIS-III)	1	4
Mind Control (WMS-R)	2	8
Clock Reading Test	1	4
Updating Test	1	4
SWM Strategy (CANTAB)	1	4
Cognitive Estimation Test	1	4
PaSMO	1	4
Stroop test	6	24	inhibitory control	1, 22, 29-30, 38-41, 43-45, 47, 49	13
Rule Shift Cards Test (BADS)	2	8
Inhibitory control subtest (FAB)	2	8
D-KEFS Interference Inhibition Test	1	4
Inhibitory control subtest (EXIT-25)	1	4
Hayling test	1	4
Codes subtest (WAIS-R or WAIS-III)	5	20	processing speed	30, 33, 35-37, 49	6
Simple reaction time (SRT) test (CANTAB)	1	4	processing speed	30, 33, 35-37, 49	6

Number of EF domains evaluated in study	Domain (number of studies)	Study references
1	planning (3) or mental flexibility (1)	1, 34, 47-48
2	verbal fluency (4), mental flexibility (2), planning (2) and inhibitory control (2)	23, 32, 41, 44, 46
3	working memory (7), mental flexibility (6), verbal fluency (4), planning (4), inhibitory control (4) and processing speed (2)	21, 29, 31, 35, 37, 39, 42-43, 45
4	working memory (5), mental flexibility (4), inhibitory control (4), verbal fluency (4), processing speed (3) and planning (3)	22, 30, 36, 38, 40, 49
5	mental flexibility, verbal fluency, planning, working memory, processing speed	33

Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Camila de Assis Faria. Pontifícia Universidade Católica do Rio de Janeiro - Rua Marquês de São Vicente, 225, Gávea - 22451-900 Rio de Janeiro RJ - Brasil. E-mail : camila_psic@yahoo.com.br