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Estimating Premorbid Cognitive Abilities in Low-Educated Populations

Author

Listed:
  • Daniel Apolinario
  • Sonia Maria Dozzi Brucki
  • Renata Eloah de Lucena Ferretti
  • José Marcelo Farfel
  • Regina Miksian Magaldi
  • Alexandre Leopold Busse
  • Wilson Jacob-Filho

Abstract

Objective: To develop an informant-based instrument that would provide a valid estimate of premorbid cognitive abilities in low-educated populations. Methods: A questionnaire was drafted by focusing on the premorbid period with a 10-year time frame. The initial pool of items was submitted to classical test theory and a factorial analysis. The resulting instrument, named the Premorbid Cognitive Abilities Scale (PCAS), is composed of questions addressing educational attainment, major lifetime occupation, reading abilities, reading habits, writing abilities, calculation abilities, use of widely available technology, and the ability to search for specific information. The validation sample was composed of 132 older Brazilian adults from the following three demographically matched groups: normal cognitive aging (n = 72), mild cognitive impairment (n = 33), and mild dementia (n = 27). The scores of a reading test and a neuropsychological battery were adopted as construct criteria. Post-mortem inter-informant reliability was tested in a sub-study with two relatives from each deceased individual. Results: All items presented good discriminative power, with corrected item-total correlation varying from 0.35 to 0.74. The summed score of the instrument presented high correlation coefficients with global cognitive function (r = 0.73) and reading skills (r = 0.82). Cronbach's alpha was 0.90, showing optimal internal consistency without redundancy. The scores did not decrease across the progressive levels of cognitive impairment, suggesting that the goal of evaluating the premorbid state was achieved. The intraclass correlation coefficient was 0.96, indicating excellent inter-informant reliability. Conclusion: The instrument developed in this study has shown good properties and can be used as a valid estimate of premorbid cognitive abilities in low-educated populations. The applicability of the PCAS, both as an estimate of premorbid intelligence and cognitive reserve, is discussed.

Suggested Citation

  • Daniel Apolinario & Sonia Maria Dozzi Brucki & Renata Eloah de Lucena Ferretti & José Marcelo Farfel & Regina Miksian Magaldi & Alexandre Leopold Busse & Wilson Jacob-Filho, 2013. "Estimating Premorbid Cognitive Abilities in Low-Educated Populations," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-8, March.
    • Handle: RePEc:plo:pone00:0060084
    DOI: 10.1371/journal.pone.0060084
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    References listed on IDEAS

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    1. John Horn, 1965. "A rationale and test for the number of factors in factor analysis," Psychometrika, Springer;The Psychometric Society, vol. 30(2), pages 179-185, June.
    2. Márcia Lorena Chaves & Ana Luiza Camozzato & Cláudio Laks Eizirik & Jeffrey Kaye, 2009. "Predictors of Normal and Successful Aging Among Urban-Dwelling Elderly Brazilians," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 64(5), pages 597-602.
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    1. Tienan Feng & Xiwen Sun & Wenxin Niu & Hengjing Wu & Chenghua Jiang, 2014. "Evaluation of an Intervention to Improve Skills in Diagnostic Radiology of Rural Physicians over One Year in Four Rural Hospitals," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-7, April.

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