The aim of this thesis was to develop a questionnaire for cognitive functioning, which could possibly be used as a screening instrument for early signs of dementia in the future. The introduction discusses the often made distinction between subjective and objective measures. A background to the four articles is provided, focussing on findings of weak relationships between self-report- and laboratory measures of memory/cognition. Studies I and II provided results and conclusions that guided instrument development and validation in Studies III and IV. All studies were based on data from participants in the Betula Prospective Cohort Study. Study I investigated predictors of scores on an established self-report instrument for memory failures (PRMQ). Candidate predictors were memory performance on laboratory tests, age, depressive symptoms, and personality traits. There was no relation to age, and test performance did not predict self-reported memory, but depressive symptoms and personality did. Given the finding of a lack of a relation to age, and a bulk of research articles claiming that memory complaints are common in the elderly or increase with age, Study II used a global rating of problems with memory, and reports of perceived causes. In contrast to Study I, problems ratings were related to age, such that increasing age meant higher severity of problems. Furthermore, perceived causes of memory problems differed across age. The elderly reported aging while the young reported stress and multitasking as primary causes. With these results as a background, the purpose of Study III was to develop a new instrument (the Cognitive Dysfunction Questionnaire - CDQ) with the explicit aim that scores should be related to laboratory test performance. A global construct of cognitive functioning with an emphasis on memory systems was adopted, and an item pool was generated. Based on exploratory principal components analysis and correlations with criterion measures (laboratory test performance), twenty items in six domains were selected. Preliminary psychometric evidence showed that the CDQ was reliable, and related to age and objective measures, but not to depressive symptoms. In Study IV, twenty additional items were constructed, and the CDQ was responded to by participants in independent samples. Confirmatory factor analysis was used to test the factor structure derived from Study III, and refinement was undertaken by collapse of two domains and exclusion of items. The final factor structure was cross-validated. Competing models and measurement invariance across age and sex was tested. Psychometric properties were investigated for the final 20-item version.

Submitted by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2016-08-19T13:56:32Z No. of bitstreams: 1 arquivototal.pdf: 1319883 bytes, checksum: b7f172ad52e0bad426f9e0d9747442ca (MD5) / Made available in DSpace on 2016-08-19T13:56:32Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1319883 bytes, checksum: b7f172ad52e0bad426f9e0d9747442ca (MD5) Previous issue date: 2016-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Studies show that subjective memory complaints (SMC) are very common in older adults and may be indicators of cognitive impairment associated with psychological factors (e.g., anxiety and depression) and cognitive impairment. The aim of this master thesis was to analyze the relationship between the prospective and retrospective memory complaints and performance on different measures of memory in people without dementia aged over 50 years. 81 volunteers of both sexes (68 women) with a mean age of 63 years (SD = 6.7) took part in the study. The procedure used in this study consists of two successive stages of evaluation. The first part includes screening tests of cognitive status and selection of participants, and questionnaires for assessing the prevalence of SMC. After this phase, we assessed semantic, episodic, working and prospective memory, the latter being tested through naturalistic tasks. Furthermore, a neuropsychological evaluation of various cognitive domains was performed, including attention, visual perception, language, processing speed, cognitive flexibility and inhibitory control. The prevalence of complaints in the sample was 53%. The results indicate that people with SMC have significantly higher prevalence of anxiety and depressive symptoms, lower overall score in prospective memory tasks and slowness in the execution of inhibitory control task. No significant differences were identified between the groups for performance in episodic, semantics and working memory tests. In the hierarchical regression analysis (stepwise method) we identified the symptoms of anxiety and performance in the long-term prospective memory task (based on time) as predictors of general and retrospectives memory complaints, but only anxiety as predictor of prospective complaints. We conclude, therefore, that different types of complaints are predicted by different variables. Retrospective complaints are related more significantly with symptoms of anxiety and objective performance. In the case of prospective complaints, they seem to reflect a distorted self-evaluation due to the symptoms of anxiety but without relationship with cognitive impairment. This work emphasizes the importance of including prospective memory tests in neuropsychological assessment protocols, as they showed greater sensitivity to detect deficits in healthy people. / Estudos apontam que as queixas subjetivas de memória (QSM) são muito comuns em idosos e podem ser indicadores de prejuízos cognitivos associados a fatores psicológicos (e.g., ansiedade e depressão) e comprometimento cognitivo. O objetivo dessa dissertação consistiu em analisar a relação entre as queixas prospectivas e retrospectivas de memória e o desempenho em diferentes medidas da memória em pessoas sem demência acima de 50 anos de idade. A amostra foi composta por 81 voluntários de ambos os sexos (68 mulheres) com média de idade de 63 anos (DP = 6,7). O procedimento utilizado nesse estudo constou de duas fases sucessivas de avaliação. A primeira parte incluiu testes de rastreio do estado cognitivo e seleção dos participantes, e questionários de avaliação da prevalência das QSM. Após esta fase, a memória foi avaliada em seu domínio operacional, semântico, episódico e prospectivo, sendo este último testado através de tarefas naturalísticas. Além disso, foi realizada uma avaliação neuropsicológica dos diferentes domínios cognitivos, incluindo a atenção, visuopercepção, linguagem, velocidade de processamento, flexibilidade cognitiva e o controle inibitório. A prevalência de queixas na amostra estudada foi de 53%. Os resultados indicam que as pessoas com QSM apresentam significativamente maior prevalência de sintomatologia ansioso-depressiva, menor escore geral em tarefas de memória prospectiva e lentificação na execução da tarefa de controle inibitório. Não foram identificadas diferenças significativas entre os grupos para o desempenho nas medidas de memória episódica, operacional e semântica. Nas análises de regressão hierárquica (por método stepwise) identificamos os sintomas de ansiedade e desempenho na tarefa de memória prospectiva de longo prazo (baseada no tempo) como preditores das queixas de memória gerais e retrospectivas, e apenas a ansiedade como variável preditora das queixas prospectivas. Concluímos, dessa forma, que diferentes tipos de queixas são preditas por diferentes variáveis. As queixas retrospectivas se relacionam mais significativamente com sintomas de ansiedade e desempenho objetivo. No caso das queixas prospectivas, estas parecem refletir uma autoavaliação distorcida decorrente dos sintomas de ansiedade e não de comprometimentos cognitivos. Através desse trabalho ressalta-se a importância de incluir testes de memória prospectiva em protocolos de avaliação neuropsicológica, pois estes demonstraram maior sensibilidade à detecção de déficits em pessoas saudáveis.

This diploma thesis deals with the topic of Subjective memory complaints (SMC) in elderly population in relation to early diagnostics of Alzheimer's Disease (AD). The term of SMC describes patients with subjective perception of cognitive impairment which is not objectivized during a complex neuropsychological assessment. The character of their subjective complaints has not been thoroughly examined, despite their increased risk to develop cognitive impairment, most likely due to AD (Reisberg, et al., 2008). The aim of this cross-sectional study was to verify the clinical significance of the concept of SMC and to characterize subjective complaints in SMC in comparison to patients with cognitive deficit at the stage of amnestic mild cognitive impairment (aMCI) and in comparison to cognitively healthy elderly (HE). SMC and aMCI patients did not differ in the amount of subjective complaints, but SMC patients reported significantly more complaints compared to HE. The difference in the amount of complaints reported by the patients themselves and by their informants was found neither in aMCI, nor in SMC patients. There were identified questions which may distinguish between SMC and aMCI patients, and questions which may distinguish between SMC patients and HE; that means questions able to distinguish...