Abstract
We analyzed the performance of 162 normal subjects, subdivided into groups according to age and schooling, in the oral comprehension tasks of the Boston Diagnostic Aphasia Examination translated and adapted to Brazilian Portuguese to obtain a profile of performance for the Brazilian population, as well as cut-off scores for each task, and to determine the best combination of tasks that distinguish normal from aphasic subjects, as a guide for clinicians. The normal subjects were compared to 69 aphasics. Age alone influenced the performance in the designation of actions (subjects above 70 years showing the worst performance); schooling alone influenced the comprehension of forms, colors and numbers (subjects with less than four years of education showing a poorer performance). Both age and schooling influenced the performance in Body Part Identification (BPI) and Complex Ideational Material (CIM) with mean values of 70.5 +/- 3.3 (Word Discrimination, WD), 18.9 +/- 1.4 (BPI), 14.7 +/- 0.9 (Commands), and 10.3 +/- 1.7 (CIM) for the whole sample; the cut-off scores obtained were 65 (WD), 17.5 (BPI), 14 (Commands), and 9.5 (CIM) for the whole sample. Logistic regression showed that the combination of BPI + Commands + CIM was the most efficient in differentiating normal subjects from aphasics, with 72.5% sensitivity and 97.6% specificity. However, for low-education subjects, BPI and Commands were sufficient for this differentiation (75.7% sensitivity and 84.7% specificity). The main contribution of this study was to provide reference values that are far more representative of our population to be used by health professionals in Brazil, taking into account cultural differences.
Highlights
The evaluation of language comprehension is not a simple task since it involves the consideration of language processing abilities directly or indirectly interacting with other cognitive capacities [1]
We analyzed the performance of 162 normal subjects, subdivided into groups according to age and schooling, in the oral comprehension tasks of the Boston Diagnostic Aphasia Examination translated and adapted to Brazilian Portuguese to obtain a profile of performance for the Brazilian population, as well as cut-off scores for each task, and to determine the best combination of tasks that distinguish normal from aphasic subjects, as a guide for clinicians
We studied 162 individuals of both genders (54 males, 33.4%, and 108 females, 66.6%) classified into four groups according to age (A: 15 to 30, B: 31 to 50, C: 51 to 70, and D: above 70 years), and into three groups according to educational level (1: 1 to 4, 2: 5 to 8, and 3: 9 or more years)
Summary
The evaluation of language comprehension is not a simple task since it involves the consideration of language processing abilities directly or indirectly interacting with other cognitive capacities [1]. Cognitive effects related to socio-demographic variables, such as educational level, have been studied in countries with large contingents of socioculturally disadvantaged populations since these effects influence performance in cognitive and language tests [3,4,5,6]. These populations involve a broad spectrum which includes illiterate people with a high degree of sociocultural deprivation and other subgroups with varying degrees of social disadvantage. These difficulties are aggravated in situations that require metacognitive and metalinguistic operations such as those found in language tests that exclude contextual information, which comprises an important source of inferences used for comprehension [9]
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