Avaliação psicológica de indícios de demência vascular em adultos pós-acidente vascular encefálico

Abstract

Recent studies reveal the high frequency of young adults affected by Stroke and the relationship with Vascular Dementia (DV). This thesis seeks to identify early signs of cognitive decline characterized as Vascular Dementia in young adults after stroke through psychological assessment. The thesis is divided into three main studies. At first, a theoretical review was carried out on the cognition of individuals with CVA, with the aim of discussing stroke and its implications for the cognition of people affected by this condition. For this, a bibliographic survey was carried out in the main databases on this topic and the theoretical aspects related to Neuroscience, CVA and the cognitive dysfunctions resulting from this Accident were described. Regarding the concept of stroke, the description of its etiology, the identification of types and altered anatomical structures, as well as the risk factors, there is a vast number of studies. However, few publications related to cognitive dysfunction, specific brain areas and psychological instruments in strokes have been identified in research conducted in the field of Neuropsychology. Then, in Study II, a systematic review was carried out that aimed to establish a bibliographic survey and investigate scientific productions that demonstrate evidence of cognitive impairments in patients affected by both stroke and DV. With the selected literature, it was possible to identify, in the studies, limitations and difficulties in verifying or standardizing the cognitive impairments found in adults affected by stroke followed by DV. In study III, an empirical investigation was carried out with the title "Psychological assessment of signs of vascular dementia after stroke", with the objective of identifying the early signs of vascular dementia in young adult patients after stroke. The sociodemographic data of the patients, the presence of risk factors, the decline in cognitive functions and the correlation between cognitive functions were also analyzed specifically. 40 adults participated in this study with more than six months of diagnosis of stroke, aged between 20 and 59 years. Then, the results of the research carried out at the neurological rehabilitation center with individuals with stroke sequels were presented. Finally, the results found were discussed and suggestions for psychological research proposals were presented in this context. According to the data, the participants showed cognitive decline in the following cognitive functions: attention, executive functions and speed of mental processing. The correlation between functions can be observed between cognitive flexibility and attention, inhibitory control and attention, visuoconstructive praxis and visuospatial organization and processing speed and inhibitory control. The data supported the better structuring of the psychological assessment and cognitive rehabilitation service in the referred rehabilitation center and will better describe the risk situations for the development of DV. In general, the three studies of the thesis contribute to future investigations that contemplate the cognitive level, aiming at the elaboration of therapeutic approaches consistent with these clinical aspects of rehabilitation, thus seeking to prevent and stabilize degenerative diseases