Performance of a Brazilian Sample on the Portuguese Translation of the BNI Screen for Higher Cerebral Functions

Introduction: The Barrow Neurological Institute (BNI) Screen for Higher Cerebral Functions (BNIS) has been translated into several languages and found useful in evaluating multiple domains of cognitive and affective dysfunction, particularly in neuro-rehabilitation settings. Normative data from countries with high literacy rates have reported strikingly similar mean level of performance scores on this test, with age typically correlating higher with total score performance than education. In the present study, we obtain convenience sample normative data from a native Brazilian population on a Portuguese translation of the BNIS (i.e., BNIS-PT). Method: The BNIS was translated into Portuguese by two native speaking Portuguese neuropsychologists who were also fluent in English. It was then administered to 201 normally functioning native Brazilian individuals who varied considerably in age and formal educational training. Results: The mean BNIS total score was similar to what previous studies reported, but primarily in younger adults with at least 12years of formal education. In this Brazilian sample, the correlation of educational level and BNIS total score was r=.68, p<.001. The correlation of age and BNIS total score was r=-.36, p<.001. This is the opposite pattern to that observed in previous standardization studies. The strong correlation of education with performance in various subtests was observed in all age groups (ages ranging from 15 to 85years). Conclusion: This standardization study provides guidelines for calculating expected average performance levels on the BNIS-PT for Brazilian individuals with varying degrees of age and education. Educational level positively correlated with test performance on the BNIS-PT and was repeatedly observed to overshadow the effects of age, suggesting its important role in the development of higher cerebral functions in multiple domains in a Brazilian sample of normally functioning individuals.