Descriptive performance in functional activities questionnaire and mini-mental state examination according to educational level and functional staging assessment (FAST) in a community-based sample of brazilian oldest old: The pietà study

Dementia staging guides drug choice, help clinicians to set prognosis, and add valuable information to decision making regarding health care interventions directed towards cognitively impaired individuals. Staging can be accomplished by functional scales or global cognitive measures such as MMSE. In low educated populations cognitive measures are unsuitable for this purpose, unless these scores are stratified according to educational level. We conducted a community-based study on brain aging in Caete, Southeast Brazil. A total of 639 participants aged 75+ gave written informed consent and completed the main evaluations from the study protocol (Caramelli, et al. Arq Neuropsiquiatr 2011), which included FAST for dementia, FAQ, among others. Cognitive performance in MMSE was judged according to 4 levels of educational attainment (illiterates; 1-3; 4-7; >7 years). In this study we report FAQ and MMSE results from the subset of cognitively impaired participants (FAST > 2) from the whole cohort, according to dementia staging and educational level. FAQ, FAST and MMSE were available from 294 participants with FAST scores above 2. FAQ scores, describe as means ± SD and interquartile range (IQR), according to FAST staging were: FAST 3= 1.9± 2.6 (0-3); FAST 4= 12,2 ± 7,1 (7-18); FAST 5= 17.6 ± 8,4 (9-25); FAST 6= 23.6 ± 8,5 (18-30); FAST 7= 29.1 ± 3.8 (30-30). MMSE performances [means ± SD (IQR)] according to FAST and education were as follows: Illiterates: FAST 3= 16.2 ± 2 (15-17); FAST 4= 15.6 ± 2.8 (13-16); FAST 5= 12.4 ± 5.6 (8-16); FAST 6= 9.1 ± 3.8 (8-11); FAST 7= NA. 1-3 years: FAST 3= 20.6 ± 3.6 (19-23); FAST 4= 16 ± 2.9 (14-18); FAST 5= 12.9 ± 2.1 (11-15); FAST 6= 10.5 ± 5.9 (6-14); FAST 7= 2.5 ± 3.8 (0-5). 4-7 years: FAST 3= 22 ± 2.6 (19-23); FAST 4= 18.9 ± 4.8 (14-18); FAST 5= 15.8 ± 5.6 (11-15); FAST 6= 8.8 ± 3.6 (6-14); FAST 7= NA. Theses results provide valuable information to help staging cognitive decline in low educated populations.