Includes bibliography. / This study provides a provisional normative range of performance for the South African semi- and unskilled black and coloured population groups on the Trail Making Test. One hundred and six black and coloured semi- and unskilled workers from the Groote Schuur Hospital in Cape Town, satisfying the criteria of 8 years or less of formal education, with no neurological impairment or psychopathology, and some degree of literacy, were randomly selected. Parts A and B of the Trail Making Test were then administered and scored, and the scores reported in tabular form, broken up in terms of race, age and education. A statistical analysis (multiple linear regression) was applied to the data and additional information on the effects of age, education and sex on test performance briefly discussed in terms of previous research findings. The results of this study add weight to Dugmore's (1987) assertion that existing norms currently in use for the Trail making Test are invalid for these population groups. Limitations of the study and suggestions for further research were also briefly discussed.

This study examined the utility of the Trail Making Test Quotient (Trails B/ Trails A) in assessing executive functioning relative to that of common tests of executive function such as the Wisconsin Card Sorting Test, Category Test, and the Stroop Test. The purpose of the current study was to investigate the relationship of the Trail Making Test Quotient (Trails B/ Trails A) with other common tests of executive functioning (i.e., Wisconsin Card Sorting Test, Stroop, Category Test) to determine whether these tests are measuring similar domains of functioning or whether Trail Making Test Quotient (Trails B/ Trails A) offers a more pure measure of executive functioning over and beyond that of Trail Making Test B alone or the difference score, Trail Making Test (Trails B- Trails A). A series of partial correlations were conducted involving the Trail Making Test scores (Quotient, Difference, and B [Raw]), and the scores of the executive functioning measures (Wisconsin Card Sorting Test, Category Test, and Stroop), controlling for age, education, and gender. Trails Quotient, Trails B Raw, and Trails Difference were found to significantly negatively correlate with WCST Total # of Categories. Only Trails B Raw and Trails Difference were found to significantly positively correlate with WCST Perseverative Responses and Category Error. None of the Trail Making Test measures used in this study were found to significantly correlate Stroop Interference. Correlation coefficients were compared to determine the strength of Trails Quotient's relationship with the aforementioned executive functioning measures relative to that of Trails Difference and Trails B Raw. Contrary to the hypotheses of the current study, the Trails Quotient demonstrated a significantly weaker correlation with WCST Total # of Categories, WCST Perseverative Responses, and Category Error than that of Trails Difference and Trails B Raw. Additionally, there were no significant differences in the correlation coefficients of Trails Quotient, Trails Difference, and Trails B Raw with Stroop Interference. However, upon further investigation using exploratory factor analyses, it was discovered that Trails Quotient may have represented a particular component of executive functioning more so than the Trails Difference and Trails B Raw. The results suggest that Trails Quotient offers a unique estimate of executive skill specific to cognitive organization, whereas Trails B Raw and Trails Difference represent multiple executive domains including regulatory and organizational abilities. Clinical practice will benefit from the current study's findings in that assessment of complex executive functioning will be more precise. Future research is needed to determine the utility of the Trails Quotient in identifying specific types and locations of brain injury. Assessment of specific impaired frontal skills common to degenerative dementias and traumatic brain injury may be possible with the use of Trails Quotient contingent upon further research. Future research into the domains of executive functioning and the Trail Making Test should focus on specific skills within regulatory and organizational components, and the development of normative data for Trails Quotient.

Mild Cognitive Impairment is a condition that affects an individual's thinking and decision making capabilities. Specifically, it is one where an individual's capabilities of memorizing, thinking and decision making are less efficient when compared to others. In order to diagnose this condition, a conventional method is to provide the subject with a small challenge they should be completed using pen and paper. This thesis focuses on how this method can be converted to a computer based test. A data visualization tool named Processing has been used to develop a system that runs a game-like test, which is completed by individuals using a mouse. The system then saves the individual's mouse movements in the form of a CSV file. This files are used for further analyzed using JMP Pro on how this data can be used for determining cognitive abilities via computing a metric called Fractal, and what conclusions can be drawn. In order to achieve comparable results, readings from two diverse age groups have been collected. The results using a total of 12 subjects are convincing in that the tool can be used to as a marker for detecting cognitive impairment.

No description available.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A população de idosos cresce rapidamente no Brasil. A prevalência de hipertensão arterial sistêmica (HAS) e distúrbios cognitivos é elevada nesta população. Testamos a hipótese de que a HAS reduz o desempenho cognitivos em idosos. Foram selecionamos idosos hipertensos e normotensos com idade &#8805; 60 < 80. O desempenho cognitivo foi avaliado pelo Cambridge Cognitive Examination Revised (CAMCOG-R), por subtestes do Wechsler Adult Intelligence Scale v.3 (WAIS III), além do Rey Auditory Verbal Learning Test (RAVLT), e o dos Trail Making Tests A/B (TMT-A/B). O desempenho cognitivo avaliado pelo escore global do CAMCOG-R e do QI estimado do WAIS III está reduzido nos idosos hipertensos mesmo quando controlado pela escolaridade, depressão, estado geral de saúde e qualidade de vida. O desempenho cognitivo em diversos domínios específicos controlados para a escolaridade, depressão, estado geral de saúde e qualidade de vida, e avaliados pelo CAMCOG-R, WAIS III, TMT-A e RAVLT também está reduzido nos idosos hipertensos. O presente estudo sugere que a HAS está associada ao declínio do desempenho cognitivo global em idosos. Notadamente, o desempenho das funções executivas está reduzido nos idosos hipertensos. Especula-se que a HAS seja um fator de risco para o declínio progressivo do desempenho cognitivo e, portanto, para o desenvolvimento de demência. / The elderly population is growing rapidly in Brazil. The prevalence of hypertension and cognitive disorders is high in this population. We tested the hypothesis that hypertension is associated with decreased cognitive performance in the elderly. We selected normotensive and hypertensive subjects aged &#8805; 60 <80 years old. Cognition was assessed through Cambridge Cognitive Examination Revised (CAMCOG-R), subtests of the Wechsler Adult Intelligence Scale v.3 (WAIS III), the Rey Auditory Verbal Learning Test (RAVLT), and the Trail Making Tests A/B (TMT-A/B). The cognitive performance assessed by the CAMCOG-R global score and the estimated WAIS III. QI is reduced in elderly hypertensives even when controlled for education, depression, health status and quality of life. The cognitive performance in diverse cognitive domains assessed through CAMCOG-R, WAIS III, TMT-A e RAVLT is also reduced in elderly hypertensives when contolled for education, depression, health status and quality of life. These results suggest that hypertension is associated with reduced global cognitive performance in eldely hypertensives. Notably, executive functions are reduced in eldely hypertensives. We speculate that hypertension might be a risk factor for the progressive decline in cognitive function and, therefore, for the development of dementia.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / A população de idosos cresce rapidamente no Brasil. A prevalência de hipertensão arterial sistêmica (HAS) e distúrbios cognitivos é elevada nesta população. Testamos a hipótese de que a HAS reduz o desempenho cognitivos em idosos. Foram selecionamos idosos hipertensos e normotensos com idade &#8805; 60 < 80. O desempenho cognitivo foi avaliado pelo Cambridge Cognitive Examination Revised (CAMCOG-R), por subtestes do Wechsler Adult Intelligence Scale v.3 (WAIS III), além do Rey Auditory Verbal Learning Test (RAVLT), e o dos Trail Making Tests A/B (TMT-A/B). O desempenho cognitivo avaliado pelo escore global do CAMCOG-R e do QI estimado do WAIS III está reduzido nos idosos hipertensos mesmo quando controlado pela escolaridade, depressão, estado geral de saúde e qualidade de vida. O desempenho cognitivo em diversos domínios específicos controlados para a escolaridade, depressão, estado geral de saúde e qualidade de vida, e avaliados pelo CAMCOG-R, WAIS III, TMT-A e RAVLT também está reduzido nos idosos hipertensos. O presente estudo sugere que a HAS está associada ao declínio do desempenho cognitivo global em idosos. Notadamente, o desempenho das funções executivas está reduzido nos idosos hipertensos. Especula-se que a HAS seja um fator de risco para o declínio progressivo do desempenho cognitivo e, portanto, para o desenvolvimento de demência. / The elderly population is growing rapidly in Brazil. The prevalence of hypertension and cognitive disorders is high in this population. We tested the hypothesis that hypertension is associated with decreased cognitive performance in the elderly. We selected normotensive and hypertensive subjects aged &#8805; 60 <80 years old. Cognition was assessed through Cambridge Cognitive Examination Revised (CAMCOG-R), subtests of the Wechsler Adult Intelligence Scale v.3 (WAIS III), the Rey Auditory Verbal Learning Test (RAVLT), and the Trail Making Tests A/B (TMT-A/B). The cognitive performance assessed by the CAMCOG-R global score and the estimated WAIS III. QI is reduced in elderly hypertensives even when controlled for education, depression, health status and quality of life. The cognitive performance in diverse cognitive domains assessed through CAMCOG-R, WAIS III, TMT-A e RAVLT is also reduced in elderly hypertensives when contolled for education, depression, health status and quality of life. These results suggest that hypertension is associated with reduced global cognitive performance in eldely hypertensives. Notably, executive functions are reduced in eldely hypertensives. We speculate that hypertension might be a risk factor for the progressive decline in cognitive function and, therefore, for the development of dementia.

Background: Physical activity has a great impact on cognition, it contributes to the brain working faster and more efficiently. Research has shown that physical activity can be a good tool for increasing concentration in young people. Objective: The purpose of the study is to investigate the impact of the physical activity that takes place during a lesson in Physical education on students' concentration with the help of a sports lesson. Methods: the study used a so-called trail making test, which is a tool for comparing the concentration between two different times. Twenty-five students belonging to two different classes were included in the study. The reference group had to complete the test twice after two sedentary lessons. The research group completed the first test after a sedentary lesson and the second test after physical activity in the form of a sports lesson. Results: During Test Session one, the intervention group needed an average of 129.84 seconds to complete both Part A and Part B of the test. The reference group needed an average of 106.2 seconds to complete both Part A and Part B of the test. During Test Session two, the intervention group needed an average of 83,93 seconds to complete both Part A and Part B of the test. The reference group needed an average of 61,63 seconds to complete both Part A and Part B of the test. Conclusion: The values that this study gave could therefore not demonstrate any connection between physical activity and the ability to concentrate in students at a secondary school.

Introdução: Prejuízos na atenção, concentração e execução de tarefas, entre outras funções cognitivas, parecem ser frequentes em doentes com câncer e em cuidados paliativos e podem comprometer o cotidiano desses pacientes. No entanto, há poucos estudos sobre o tema e desconhecem-se testes validados para essa população no Brasil. Objetivo: Validar o Teste de Trilhas B (TT-B) para uso em pacientes com câncer em cuidados paliativos. Método: Trata-se de estudo metodológico, de validação de instrumento, que envolveu pacientes (n=94) em tratamento paliativo no Ambulatório de Quimioterapia do Instituto do Câncer do Estado de São Paulo e seus acompanhantes (n=39). Os avaliados realizaram o TT-B e responderam dados sócio-demográficos, sobre a presença e intensidade de dor, de fadiga, sobre a qualidade do sono, ansiedade e depressão, em dois momentos, com intervalo máximo de sete dias. Os doentes também foram caracterizados quanto à doença e tratamento. As validades convergente e divergente foram testadas pela correlação entre o desempenho no TT-B, mensurado pelo tempo para a realização do teste e o número de erros cometidos, com a intensidade da dor, da fadiga, da ansiedade, da depressão e do repouso atribuído ao sono da noite anterior às avaliações. A validade discriminante foi testada pela comparação do TT-B entre doentes e sadios. A estabilidade do TT-B, em doentes e sadios, foi avaliada por meio de teste e reteste. Resultados: Os doentes tinham câncer colo-retal (47,8%), câncer de mama (15,9%), a totalidade apresentava metástase, foram homens (52,1%), com idade média de 53 anos. Para os doentes, o tempo médio de realização do TT-B foi de 147,5 segundos na primeira e 132 segundos na segunda avaliação e o número de erros médio foi de 1 na primeira e 0,8 na segunda avaliação. Para os acompanhantes o tempo de realização do TT-B foi de 127,3 e 110,7 segundos na primeira e segunda avaliação respectivamente e o número de erros foi 0,9 na primeira e 0,6 na segunda avaliação. O instrumento discriminou doentes de sadios em relação ao tempo utilizado para a realização do teste na primeira (p=0,014) e na segunda (p=0,035) avaliação, indicando melhor desempenho para os sadios, mas não em relação ao número de erros. O teste foi estável entre os sadios nas duas avaliações, tanto em relação ao tempo (p=0,071) quanto em relação ao número de erros (p=0,352) e entre os doentes o instrumento foi estável apenas em relação ao número de erros (p=0,913). O TT-B não demonstrou correlações significativas com dor, fadiga, depressão, ansiedade e descanso, o que causou estranheza. Conclusão: O TT-B está em processo de validação. Mostrou-se capaz de discriminar doentes de sadios e foi estável entre os saudáveis. Recomenda-se a continuidade de estudos com amostras maiores e a utilização do TT-B em paralelo a outro instrumento que avalie a função executiva. / Introduction: Impairments in attention, concentration and execution of tasks, among other cognitive functions, seem to be frequent in patients with cancer in palliative care and they can affect patients daily life. However, there are few studies about the theme and to our knowledge there are no validated tests for this population in Brazil. Objective: To validate Trial Making TestB (TMT-B) for assessment of patients with cancer in palliative care. Methods: Methodological study to validate an instrument that involved patients (n=94) in palliative treatment at the Clinic of Chemotherapy of the Instituto do Câncer do Estado de São Paulo and their healthy accompanying person (n=39). Patients were tested on TMT-B and answered demographic data, questions about the presence of pain and intensity, fatigue, quality of sleep, anxiety and depression, in two moments, with maximum interval of seven days. The patients were also characterized according to disease and treatment. The convergent and divergent validities were tested by the correlation between the performance on TMT-B, measured by the amount of time required to complete the task and the number of mistakes, and pain intensity, fatigue, anxiety, depression and the rest attributed to sleep in the previous night before assessments. The discriminate validity was tested by the comparison of TMT-B between patients and healthy accompany persons. The stability of TMT-B, in patients and healthy companions was evaluated through test and re-test. Results: The patients had colorectal cancer (47.8%), followed by breast cancer (15.9%), the totality presented metastasis, most patients were men (52.1%), mean age was 53 years. For patients, mean time required to complete TMT-B was 147.5 seconds in the first and 132 seconds in the second assessments and the mean number of mistakes was 1 in the first and 0.8 in the second assessments. For the healthy accompany person, the time required to complete TMT-B was respectively 127.3 and 110.7 seconds in the first and second assessments and the number of mistakes was 0.9 in the first and 0.6 in the second assessments. The instrument discriminated patients from healthy accompany persons regarding time required to complete the test in the first (p=0.014) and second (p=0.035) assessments, indicating better performance for the healthy ones, but not in relation to the number of mistakes. The test was stable among healthy people in the two assessments regarding time (p=0.071) and number of mistakes (p=0.352); for patients, the instrument was stable only in relation to the number of mistakes (p=0.913). TMT-B did not demonstrate significant correlations with pain, fatigue, depression, anxiety and rest. Conclusion: TMT-B is in validation process. It was able to discriminate between patients and healthy accompany persons and was stable for the healthy ones. Further studies are recommended with larger samples as well as the use of TMT-B in parallel to other instrument that evaluates the executive function.

In the last decades our knowledge concerning cardiovascular risk factors has grown rapidly through results from longitudinal studies. However, despite new treatment, in Western countries coronary heart disease remains the leading cause of death and stroke is still the leading cause of severe disability. The studies reported in these papers examine the relationships between stroke/transient ischaemic attack (TIA) and a number of different factors measured on two different occasions in men born in Uppsala 1920-1924 and are epidemiological in their character. The findings indicate that in addition to already established risk factors, indices of an unhealthy dietary fat intake and high serum lipoprotein(a) are independent predictors of stroke/TIA. Among different glucometabolic variables a low insulin sensitivity index derived from the euglycaemic insulin clamp and proinsulin carries a high predictive value for later stroke, independently of diabetes. Moreover, cognitive test performance measured with Trail Making Test B at age 70 is a strong and independent predictor of brain infarction, indicating that the risk is already increased in the subclinical phase of milder cognitive dysfunction. Performance at a pre-stroke Trail Making Test is also of predictive value for mortality after first-ever stroke/TIA, but none of the studied pre-stroke variables or cognitive tests was found to be related to dependency after an event. In summary these studies provide further knowledge about predictors of stroke and of mortality after first-ever stroke. They also indicate the possible importance of new markers of risk, such as the level of lipoprotein(a), profile of fatty acids in the diet, low insulin sensitivity derived from clamp investigations, level of proinsulin, and cognitive performance measured with Trail Making Tests.

Introdução: Prejuízos na atenção, concentração e execução de tarefas, entre outras funções cognitivas, parecem ser frequentes em doentes com câncer e em cuidados paliativos e podem comprometer o cotidiano desses pacientes. No entanto, há poucos estudos sobre o tema e desconhecem-se testes validados para essa população no Brasil. Objetivo: Validar o Teste de Trilhas B (TT-B) para uso em pacientes com câncer em cuidados paliativos. Método: Trata-se de estudo metodológico, de validação de instrumento, que envolveu pacientes (n=94) em tratamento paliativo no Ambulatório de Quimioterapia do Instituto do Câncer do Estado de São Paulo e seus acompanhantes (n=39). Os avaliados realizaram o TT-B e responderam dados sócio-demográficos, sobre a presença e intensidade de dor, de fadiga, sobre a qualidade do sono, ansiedade e depressão, em dois momentos, com intervalo máximo de sete dias. Os doentes também foram caracterizados quanto à doença e tratamento. As validades convergente e divergente foram testadas pela correlação entre o desempenho no TT-B, mensurado pelo tempo para a realização do teste e o número de erros cometidos, com a intensidade da dor, da fadiga, da ansiedade, da depressão e do repouso atribuído ao sono da noite anterior às avaliações. A validade discriminante foi testada pela comparação do TT-B entre doentes e sadios. A estabilidade do TT-B, em doentes e sadios, foi avaliada por meio de teste e reteste. Resultados: Os doentes tinham câncer colo-retal (47,8%), câncer de mama (15,9%), a totalidade apresentava metástase, foram homens (52,1%), com idade média de 53 anos. Para os doentes, o tempo médio de realização do TT-B foi de 147,5 segundos na primeira e 132 segundos na segunda avaliação e o número de erros médio foi de 1 na primeira e 0,8 na segunda avaliação. Para os acompanhantes o tempo de realização do TT-B foi de 127,3 e 110,7 segundos na primeira e segunda avaliação respectivamente e o número de erros foi 0,9 na primeira e 0,6 na segunda avaliação. O instrumento discriminou doentes de sadios em relação ao tempo utilizado para a realização do teste na primeira (p=0,014) e na segunda (p=0,035) avaliação, indicando melhor desempenho para os sadios, mas não em relação ao número de erros. O teste foi estável entre os sadios nas duas avaliações, tanto em relação ao tempo (p=0,071) quanto em relação ao número de erros (p=0,352) e entre os doentes o instrumento foi estável apenas em relação ao número de erros (p=0,913). O TT-B não demonstrou correlações significativas com dor, fadiga, depressão, ansiedade e descanso, o que causou estranheza. Conclusão: O TT-B está em processo de validação. Mostrou-se capaz de discriminar doentes de sadios e foi estável entre os saudáveis. Recomenda-se a continuidade de estudos com amostras maiores e a utilização do TT-B em paralelo a outro instrumento que avalie a função executiva. / Introduction: Impairments in attention, concentration and execution of tasks, among other cognitive functions, seem to be frequent in patients with cancer in palliative care and they can affect patients daily life. However, there are few studies about the theme and to our knowledge there are no validated tests for this population in Brazil. Objective: To validate Trial Making TestB (TMT-B) for assessment of patients with cancer in palliative care. Methods: Methodological study to validate an instrument that involved patients (n=94) in palliative treatment at the Clinic of Chemotherapy of the Instituto do Câncer do Estado de São Paulo and their healthy accompanying person (n=39). Patients were tested on TMT-B and answered demographic data, questions about the presence of pain and intensity, fatigue, quality of sleep, anxiety and depression, in two moments, with maximum interval of seven days. The patients were also characterized according to disease and treatment. The convergent and divergent validities were tested by the correlation between the performance on TMT-B, measured by the amount of time required to complete the task and the number of mistakes, and pain intensity, fatigue, anxiety, depression and the rest attributed to sleep in the previous night before assessments. The discriminate validity was tested by the comparison of TMT-B between patients and healthy accompany persons. The stability of TMT-B, in patients and healthy companions was evaluated through test and re-test. Results: The patients had colorectal cancer (47.8%), followed by breast cancer (15.9%), the totality presented metastasis, most patients were men (52.1%), mean age was 53 years. For patients, mean time required to complete TMT-B was 147.5 seconds in the first and 132 seconds in the second assessments and the mean number of mistakes was 1 in the first and 0.8 in the second assessments. For the healthy accompany person, the time required to complete TMT-B was respectively 127.3 and 110.7 seconds in the first and second assessments and the number of mistakes was 0.9 in the first and 0.6 in the second assessments. The instrument discriminated patients from healthy accompany persons regarding time required to complete the test in the first (p=0.014) and second (p=0.035) assessments, indicating better performance for the healthy ones, but not in relation to the number of mistakes. The test was stable among healthy people in the two assessments regarding time (p=0.071) and number of mistakes (p=0.352); for patients, the instrument was stable only in relation to the number of mistakes (p=0.913). TMT-B did not demonstrate significant correlations with pain, fatigue, depression, anxiety and rest. Conclusion: TMT-B is in validation process. It was able to discriminate between patients and healthy accompany persons and was stable for the healthy ones. Further studies are recommended with larger samples as well as the use of TMT-B in parallel to other instrument that evaluates the executive function.