Avaliação breve do défice executivo em pessoas idosas com Acidente Vascular Cerebral: Validação da Bateria de Avaliação Frontal

Helena Espirito-Santo; Inês Queiroz Garcia; Bárbara Monteiro; Naír Carolino; Fernanda Daniel

doi:10.7342/ismt.rpics.2016.2.2.39

Autores

Helena Espirito-Santo Centro de Investigação Interdisciplinar Psicossocial do Instituto Superior Miguel Torga (CCIPSO-ISMT); Centro de Investigação em Neuropsicologia e Intervenção Cognitiva e Comportamental (CINEICC), Universidade de Coimbra, Portugal https://orcid.org/0000-0003-2625-3754
Inês Queiroz Garcia Instituto Superior Miguel Torga, Coimbra, Portugal
Bárbara Monteiro Instituto Superior Miguel Torga, Coimbra, Portugal https://orcid.org/0000-0002-4706-1914
Naír Carolino Instituto Superior Miguel Torga, Coimbra, Portugal https://orcid.org/0000-0002-8131-1737
Fernanda Daniel Centro de Investigação Interdisciplinar Psicossocial do Instituto Superior Miguel Torga (CCIPSO-ISMT); Centro de Estudos e Investigação em Saúde da Universidade de Coimbra, Portugal https://orcid.org/0000-0002-2202-1123

DOI:

https://doi.org/10.7342/ismt.rpics.2016.2.2.39

Palavras-chave:

AVC, Disfunção Executiva, FAB, Idosos, Validação

Resumo

Contexto e Objetivos: O Acidente Vascular Cerebral (AVC) potencia o desenvolvimento de disfunção executiva, conduzindo a défice no desempenho das tarefas do quotidiano. A avaliação neuropsicológica das funções executivas é importante para desenvolver estratégias de reabilitação adequadas. Assim, são objetivos descrever os dados normativos, precisão de diagnóstico, propriedades psicométricas e análise fatorial da Bateria de Avaliação Frontal (FAB), instrumento breve e de rápida administração, numa amostra de idosos com AVC. Método: Inserida no projeto Trajetórias do Envelhecimento de Idosos em Resposta Social, esta investigação conta com uma amostra de 112 pessoas idosas com diagnóstico médico de AVC e 157 pessoas idosas de um subgrupo de controlo sem AVC. Os sujeitos apresentam idades compreendidas entre os 60 e os 100 anos (M = 78,20; DP = 7,57) sendo maioritariamente do sexo feminino (n = 194). A avaliação inclui entrevistas e testes neuropsicológicos agrupados em medidas de funcionamento executivo, medidas cognitivas de referência e medidas clínicas de controlo. Resultados: As variáveis idade e escolaridade interferiram nas pontuações obtidas na amostra clínica, não sendo verificado impacto da variável sexo. Para um ponto de corte de 7, a FAB teve uma sensibilidade de 83,4% e especificidade de 66,1 % (AUC = 0,64); revelou um alfa de Cronbach de 0,79 e correlações fortes com os testes executivos (teste de Stroop, Figura Complexa de Rey, fator Atencional-Executivo do Montreal Cognitive Assessment e Alternância nos testes de Fluência verbal). A análise fatorial confirmatória apontou uma estrutura com um fator. Conclusões: A FAB apresenta boa consistência interna, validade convergente e validade de constructo, aparentando ser uma escala útil para avaliar o défice executivo em pessoas idosas com AVC. Dadas algumas limitações do estudo, que poderão explicar a fraca precisão diagnóstica da FAB, são incentivadas investigações futuras pois a FAB revelou-se um instrumento com propriedades psicométricas promissoras.

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