Development and validity of a new test of executive functions free of schooling bias (Tele).

Abstract

There are no cognitive assessment instruments free of educational bias to investigate executive functions in elderly people with low educational level. In view of this, we proposed to design a new schooling-free executive test (TELE) for these people. A non-experimental, cross-sectional and instrumental study was carried out in a sample composed of a total of 90 Chilean participants, of whom 74 were cognitively healthy elderly (control group) and 16 with a diagnosis of mild major neurocognitive disorder (MND). We used Addenbrook's Cognitive Assessment III (ACE III) and the Trail Making Tests (TMT) part A and B as cognitive comparison tests and the Activities of Daily Living Questionnaire (T-ADLQ) scale to assess functional impairment. Subsequently, an evaluator blinded to the results of these tests and to the participants' diagnosis, applied the TELE. Three comparison groups were established, cognitively healthy control with low schooling (2 to 8 years), middle schooling (9 to 12 years) and a clinical group with a diagnosis of NCCD. Using the ANOVA test with Tukey's post hoc, it was found that, unlike TMT and ACE III, TELE total and TELE time did not show significant differences between the control groups with different levels of schooling, but did show significant differences with the TNCM group. TELE time and total showed a moderate to high positive correlation with TMT and ACE III and a negative correlation with T-ADLQ. Of all the cognitive tests applied, only TELE was not affected by years of schooling, as reported by the ANCOVA analysis of covariance (TELE total: p=.570, TELE time: p=.273). Conclusion: TELE is a test for FE able to differentiate cognitively healthy older people from older people with mild major neurocognitive disorder, has convergent validity and is not affected by years of schooling.