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Master's Dissertation
DOI
https://doi.org/10.11606/D.47.2015.tde-03062015-115402
Document
Author
Full name
Rodolfo Santos Flaborea
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2015
Supervisor
Committee
Costa, Marcelo Fernandes da (President)
Aprahamian, Ivan
Flaks, Mariana Kneese
Title in Portuguese
Avaliação neuropsicológica da tomada de decisão no comprometimento cognitivo leve
Keywords in Portuguese
Avaliação neuropsicológica
Comprometimento cognitivo leve
Neuropsicologia
Tomada de decisão
Abstract in Portuguese
Introdução: o aumento da população idosa traz uma demanda significativa sobre as ciências da saúde para lidar com os problemas característicos do envelhecimento. Neste contexto, as demências são as desordens neuropsiquiátricas de maior impacto atualmente. Poucas pesquisas acerca do CCL foram dedicadas a analisar a função neuropsicológica da tomada de decisão. Esta é definida como o processo de escolher uma ação específica, dentro de um rol de alternativas possíveis, que produza o resultado mais vantajoso para o sujeito. Logo, ela possui papel clínico fundamental, pois subsidia importante espectro da funcionalidade. Objetivo: avaliar se idosos com CCL amnéstico de múltiplos domínios ou de único domínio apresentam prejuízos na tomada de decisão sob risco, quando comparados a idosos saudáveis. Métodos: foram analisados os desempenhos de 20 sujeitos (9 CCL e 11 controles) no teste de tomada de decisão Cambridge Gambling Task (CGT). Utilizou-se modelo linear geral acompanhado de análise de covariância para idade, anos de escolaridade e escore do Mini Exame do Estado Mental. Resultados: Foi verificado efeito de grupo e da idade sobre a aversão ao atraso, proporção global de aposta e assunção de risco. Conclusão: pacientes com CCL demonstraram maior impulsividade nas escolhas das apostas, além de terem apostado menos ao longo de todo o CGT. O déficit no controle da impulsividade pode ser um indicador de maior risco para conversão para demência, hipótese esta que necessita ser mais investigada. Apostas menores podem constituir estratégia compensatória em reação à impulsividade ou, ainda, ser resultado da menor confiança do paciente com CCL em suas capacidades para lidar com o teste
Title in English
Neuropsychological assessment of decision-making in the mild cognitive impairment
Keywords in English
Decision-making
Mild cognitive impairment
Neuropsychological assessment
Neuropsychology
Abstract in English
Introduction: The increase in elderly population brings a significant demand upon the health sciences to deal with aging-specific issues. In this context, dementia is currently the group of neuropsychiatric disorders with the greatest impact. Research on cerebral reserve shows the importance of early treatment in these syndromes, highlighting the need for comprehension about Mild Cognitive Impairment (MCI), classically defined by literature as a prodromic stage for dementia. Few existing studies on MCI aimed at investigating the neuropsychological function of decision-making, which is defined as the process of choosing a specific action among several options in order to achieve the most advantageous outcome. Therefore, this function has a fundamental clinical role, since it grants the basis for the individual functionality. Objective: investigate possible deficits in the decision-making of a sample of elderly patients diagnosed with amnestic MCI of multiple or single domain by comparing their performance with that of healthy ones. Methods: the performances of a sample 20 subjects (9 MCI and 11 controls) in the Cambridge Gambling Task (CGT) were analysed. General linear model with covariance analysis for age, years of schooling and the Mini Mental State Examination scores was used for the statistical analyses. Results: it was found that group and age effect on delay aversion, overall proportion bet, and risk taking. Conclusion: MCI patients showed higher impulsivity on bet choices and made smaller bets throughout the CGT run. The impulsivity control deficit can be an indicator of the conversion risk from MCI to dementia, hypothesis that needs further investigation. Smaller bets may be a compensatory strategy for the increased impulsivity or the result of MCI patients less confidence in their own cognitive ability to deal with the test
 
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Publishing Date
2015-06-08
 
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