Performance in Luria's fist-edge-palm test according to educational level

To investigate the performance of a large population with heterogeneous educational background in a test apparently uninfluenced by formal education.

We administered the Luria's fist-edge-palm test to 966 elderly individuals (299 illiterates) while screening for dementia in a Brazilian population. Individuals with scores in the Mini-Mental State Examination below the 25th percentile (adjusted for each of 4 educational levels) were considered suspect for dementia and excluded. The influence of educational level, age, and gender on the occurrence of failures and on the number of demonstrations for a successful reproduction was investigated.

The final population comprised 745 individuals (238 illiterates). Forty-eight individuals (25 illiterates) were unable to reproduce the sequence. Logistic regression showed that illiteracy was associated with failure, whereas gender and age were not. The proportion of individuals failing to reproduce the sequence was inversely related to the years of schooling. For those individuals who were able to reproduce the sequence, the number of demonstrations for successful reproduction was also inversely related to the years of schooling.

Illiteracy and low educational level are associated with impaired performance in the fist-edge-palm test, which may be the result of the use of different strategies according to educational level.