RESUMO
Information on the clinical utility of neuropsychological tests in non-North-American samples is limited. We examined the diagnostic efficacy of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery in Jamaican men and women age 65 and older. A total of 72 elders were diagnosed as normal and 12 were demented based on history, physical, and neurological examination, participants were tested with the CERAD battery. Normal controls scored significantly better than dementia patients on all tests in the CERAD battery. A discriminant function found that a combination of Word List Learning Sum Recall and Boston Naming Test correctly classified a total of 81 percent of the cases (83 percent of the dements and 81 percent of the normal controls). This study is the first to demonstrate thr clinical utility of the CERAD neuropsychological battery in the differential diagnosis of memory disorders of the aged in a non-North-American sample.(Au)
Assuntos
Idoso , Estudo Comparativo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Cognitivos/diagnóstico , Testes Neuropsicológicos , JamaicaRESUMO
The reports of the occurrence of HTLV-1 infection and/or HTLV-1 associated myelopathy (HAM)/tropical spastic paraparesis (TSP) in patients with certain organ-specific and nonorgan-specific autoimmune diseases prompted us to assess the relationship between TSP and humoral autoimmunity. Blood samples from 76 TSP patients, 60 asymptomatic HTLV-1 carriers and 100 HTLV-1 seronegative blood donors were examined for the presence of organ-specific and nonorgan-specific autoantibodies, reactive serological tests for syphilis, immunoglobulin and complement concentrations as well as immunecomplexes. High prevalences of autoantibodies (39/76, 51 percent), reactive serological tests for syphilis (23/76; 30 percent), hypergammaglobulinaemia (69/76, 90 percent) and the complement fixing immune complexes (44/76, 58 percent) were found in the TSP patients. These indicators of immunological disorder were found in statistically significantly lower prevalences in asymptomatic HTLV-1 carriers (12/60, 20 percent; p < 0.001; 6/60, 10 percent; p < 0.05; 32/60, 53 percent; p < 0.001 and 8/60, 13 percent; p < 0.001, respectively) and HTLV-1 seronegative blood donors (8/100, 8 percent; p < 0.001; 3/100, 3 percent; p < 0.001; 15/100, 15 percent p < 0.001 and 5/100, 5 percent; p < 0.001, respectively). The profiles of autoimmune phenomena observed in the patient and control groups revealed that they were associated with TSP rather than mere HTLV-1 infection and consequently pathogenic significance. The array of immunological features present in TSP was suggestive of autoimmune disease resulting from immune dysfunction. Studies which explore the possible existence of HTLV-1 induced autoantibodies with specificity for antigens of the spinal cord in TSP might be useful in elucidating its pathogenesis.(Au)