Objective: To present data from studies done in Brazil, which include a large number of illiterate individuals, to verify if subjective memory impairment is more common in illiterate, and to compare the performance of literate and illiterate individuals in simple neuropsychological tests.
Design: Subjective perception of memory decline and the performance in neuropsychological tests were investigated in two different elderly populations with high prevalence of illiteracy.
Materials and Methods: In a population study in the urban area of Catanduva, a town in Southeastern Brazil with 100, 913 inhabitants, data about subjective memory impairment were obtained from 1032 elderly individuals without dementia, 313 being illiterate. Similar information was obtained from 153 elderly inhabitants of the river banks of the Amazonian region, 98 being illiterate. From the population study of Catanduva, 51 control subjects (23 illiterate) were investigated through simple neuropsychological tests including the CERAD battery and the Brief Cognitive Screening Battery (Nitrini et al, 1999). Patients with mild or moderate Alzheimerxs dementia (N=21, 9 illiterate) were examined with these same neuropsychological tests and the accuracy of each test for the diagnosis of dementia in literate and illiterate individuals was compared using ROC curves.
Results: Subjective memory impairment was very frequent in both regions, and it was as common in illiterates as in literates. Delayed recall of simple drawings was less influenced by literacy level than other neuropsychological tests, and it showed the best accuracy in discriminating dementia from control in the illiterate group.
Conclusion: Literacy status may have no influence on the subjective perception of memory decline in aging individuals, and less verbally based neuropsychological tests may be more accurate for the diagnosis of dementia in illiterate individuals.
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