Avaliação do discurso conversacional no envelhecimento saudável, CCL e demência leve e construção e estudo piloto do programa de capacitação em neuropsicologia do envelhecimento

Abstract

The presente thesis is composed of four empirical articles, with two important topics for neuropsychological evaluation. The first topic, includes the discourse assessment using the frequency of impaired communicative behaviors comparing young and older adults; The second topic, involves the development and preliminary results of the “Training Program in Neuropsychology of Aging for Health Team”. The firs article “Age-related differences in Conversational Discourse Abilities: a comparative study” compares the discourse performance of young and older adults. The results showed that young adult participants generally presented better performance in communicative skills. However, the elderly group was better in variables associated with speech engagement. It should be noted that the aspects associated with speech planning and self-monitoring did not show differences between groups. To the second article “Conversational Discourse among clinical subgroups in aging”, was used the discourse assessment comparing clinical subgroups. Significant differences were found in the aspects of: coherence, cohesion, comprehension and linguistic and emotional prosody. It is noted that some variables such as “Has an abnormal speech rate – decreased” revealed worse outcome to the azlheimer desease group. The third article, “Development of the Psycoeducation in Neuropsychology of Aging for Health Staff”, showed all the phases to development the material. The program was judged by four neuropsychologic experts and had a validity index of 0.785. The program was done in two phases with five steps. The final version was splited in 8 meetings, composing 4 subjects: 1. General knowledge about neurosciences; 2. Memory; 3. Executive Functions; 4. Communication and another meeting for revision. Finally, the fourth study “Effect and Effectiveness of Psycoeducation in Neuropsychology of Aging for Health Staff” was the applicability of the program. Seven community health agents participated and the result showed that “Memory” and “Communication” meetings were easily understood by participants. The “General knowledge about neurosciences” and “Executive function” meetings were more difficult to the agents. The qualitative analysis was extremely important for the participants to demonstrate how important participation in program was. This doctoral thesis contributes to the practice of evaluation and neuropsychological intervention in communication and training of health team. Finally, the need for continuity of all studies involved in this thesis is stressed, the importance of the theoretical axes described here for early and accurate diagnosis of patients with some associated cognitive pathology.