Iowa Gambling Task: avaliação da tomada de decisão em idosas saudáveis analfabetas e com baixa escolaridade

Master thesis Portuguese OPEN
Luciana Cassimiro (2016)
  • Publisher: Universidade de São Paulo
  • Subject: Aged | Aging | Analfabetismo | Cognição | Cognition | Decision-making | Envelhecimento | Idoso | Illiteracy | Mulheres | Psychological tests | Testes psicológicos | Tomada de decisões | Women | Neurologia

Introdução: A TD pode ser definida como um processo no qual o indivíduo tenta maximizar benefícios através da seleção de respostas que levam a resultados positivos. O efeito da baixa escolaridade na TD ainda é pouco compreendido. Objetivos: Descrever o desempenho de uma amostra de idosos saudáveis analfabetos e com baixa escolaridade no Iowa Gambling Task (IGT). Metodologia: Participaram do estudo 164 idosas com idade igual ou superior a 60 anos. Destas, 60 eram analfabetas e 104 apresentaram escolaridade entre um e quatro anos, divididas em 1-2 e 3-4 anos de escolaridade. As participantes foram submetidas aos instrumentos: Bateria Breve de Rastreio Cognitivo (BBRC), Mini Exame do Estado Mental (MEEM), Fluência Verbal (FV), Teste do Desenho do Relógio (TDR), Escala Depressão Geriátrica (EDG), Inventário de Ansiedade Geriátrica (IAG), Dígitos Ordem Direta e Ordem Inversa, Matrizes Progressivas Coloridas de Raven (MPCR), Wisconsin Card Sorting Test (WCST) e Iowa Gambling Task (IGT). Resultados: Os grupos divididos pela escolaridade foram equivalentes quanto à idade, número de doenças, uso de medicamentos, sintomas depressivos e ansiosos. Observou-se que no IGT as idosas alfabetizadas realizaram mais escolhas vantajosas do que as analfabetas. A análise do desempenho por blocos revelou diferenças significativas entre os grupos de escolaridade, exceto no primeiro bloco. A partir do bloco 2 observou-se uma diferenciação nas escolhas de cartas entre as faixas de escolaridade. As idosas analfabetas passaram a escolher as cartas das pilhas vantajosas com maior frequência somente a partir do bloco 3. Entretanto, no último bloco, quando os baralhos vantajosos e desvantajosos foram igualmente escolhidos pelas idosas analfabetas. O desempenho no IGT correlacionou-se significativamente com a escolaridade e todos os testes cognitivos, com exceção do teste de memorização de figuras da BBRC. Conclusão: Os resultados sugerem a influência da escolaridade na TD, com pior desempenho entre as analfabetas. O desempenho no IGT melhorou linearmente com maior nível de escolaridade. Descritores: Testes psicológicos; Cognição; Tomada de decisão; Idoso; Envelhecimento; Analfabetismo; Mulheres·. ABSTRACT Cassimiro L. Iowa Gambling Task: evaluation of decision-Making in healthy illiterate older adults and with low education [Dissertation]. São Paulo: \"Faculdade de Medicina, Universidade de São Paulo\"; 2016. Background: Decision making can be defined as a process in which the individual attempts to maximize benefits through the selection of responses that lead to positive results. The effect of minimum schooling on decision making is poorly understood. Objective: to investigate the pattern of decision making in a sample of healthy illiterate older adults and with low education in the Iowa Gambling Task (IGT). Methods: 164 non demented community-dwelling women participated in the study. 60 were illiterate, 52 had 1-2 years of schooling and 52 had 3-4 years of schooling. Participants completed the instruments: Brief Cognitive Screening Battery (BCSB), Mini Mental State Examination (MMSE), Verbal Fluency Test (animal category), Clock Drawing Test (CDT), Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory, Digit Span Forward and Backward, Raven\'s Coloured Progressive Matrices (CPM), Wisconsin Card Sorting Test (WCST), Iowa Gambling Task (IGT). Results: The groups, divided by levels of schooling, were equivalent as to age, number of diseases, medications taken daily, depression and anxiety symptoms. In the IGT the literate older adults made more advantageous choices than the illiterate. Analysis of performance per block revealed significant differences among the groups for all blocks except the first. From Block 2 onwards, a significant difference in the pattern of card choices among the educational levels was observed. The illiterate seniors started to choose cards from the more advantageous piles more frequently only after block 3. However, on the final block, both advantageous and disadvantageous cards were chosen with equal frequency by the illiterate seniors. IGT performance correlated significantly with education and all cognitive tests scores with the exception of the memorization of pictures on the BCSB. Conclusion: The results suggest that education influences IGT, with worse scores among the illiterate. IGT performance improved linearly with higher levels of education Background: Decision making can be defined as a process in which the individual attempts to maximize benefits through the selection of responses that lead to positive results. The effect of minimum schooling on decision making is poorly understood. Objective: to investigate the pattern of decision making in a sample of healthy illiterate older adults and with low education in the Iowa Gambling Task (IGT). Methods: 164 non demented community-dwelling women participated in the study. 60 were illiterate, 52 had 1-2 years of schooling and 52 had 3-4 years of schooling. Participants completed the instruments: Brief Cognitive Screening Battery (BCSB), Mini Mental State Examination (MMSE), Verbal Fluency Test (animal category), Clock Drawing Test (CDT), Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory, Digit Span Forward and Backward, Raven\'s Coloured Progressive Matrices (CPM), Wisconsin Card Sorting Test (WCST), Iowa Gambling Task (IGT). Results: The groups, divided by levels of schooling, were equivalent as to age, number of diseases, medications taken daily, depression and anxiety symptoms. In the IGT the literate older adults made more advantageous choices than the illiterate. Analysis of performance per block revealed significant differences among the groups for all blocks except the first. From Block 2 onwards, a significant difference in the pattern of card choices among the educational levels was observed. The illiterate seniors started to choose cards from the more advantageous piles more frequently only after block 3. However, on the final block, both advantageous and disadvantageous cards were chosen with equal frequency by the illiterate seniors. IGT performance correlated significantly with education and all cognitive tests scores with the exception of the memorization of pictures on the BCSB. Conclusion: The results suggest that education influences IGT, with worse scores among the illiterate. IGT performance improved linearly with higher levels of education
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