Abstract
Background. MoCA is widely used in Parkinson's disease (PD) to assess cognition. The Test Your Memory (TYM) test is a cognitive screening tool that is self-administered. Objectives. We sought to determine (a) the optimal value of TYM to discriminate between PD patients with and without cognitive deficits on MoCA testing, (b) equivalent MoCA and TYM scores, and (c) interrater reliability in TYM testing. Methods. We assessed the discriminant ability of TYM and the equivalence between TYM and MoCA scores and measured the interrater reliability between three raters. Results. Of the 135 subjects that completed both tests, 55% had cognitive impairment according to MoCA. A MoCA score of 25 was equivalent to a TYM score of 43-44. The area under the receiver operator characteristic (ROC) curve for TYM to differentiate between PD-normal and PD-cognitive impairment was 0.82 (95% CI 0.75 to 0.89). The optimal cutoff to distinguish PD-cognitive impairment from PD-normal was ≤45 (sensitivity 90.5%, specificity 59%) thereby correctly classifying 76.3% of patients with PD-cognitive impairment. Interrater agreement was high (0.97) and TYM was completed in under 7 minutes (interquartile range 5.33 to 8.52 minutes). Conclusions. The TYM test is a useful and less resource intensive screening test for cognitive deficits in PD.
Highlights
Cognitive impairment in Parkinson’s disease (PD) is common and associated with functional impairment and poor quality of life [1, 2]
The spectrum of dysfunction ranges from executive dysfunction to mild cognitive impairment (MCI) seen even in early PD (PD-MCI), through to Parkinson’s disease dementia (PDD)
Of the 5 who did not subsequently enroll in the drug trial, n = 1 declined, n = 2 had likely PDD, and patients assessed for eligibility ineligible to take part in ReSPonD trial sent information pack did not return pack returned pack declined to participate telephone screened excluded as ineligible or unable to attend for appointment attended for face-to-face assessment enrolled in Test Your Memory (TYM) study
Summary
Cognitive impairment in Parkinson’s disease (PD) is common and associated with functional impairment and poor quality of life [1, 2]. The spectrum of dysfunction ranges from executive dysfunction to mild cognitive impairment (MCI) seen even in early PD (PD-MCI), through to Parkinson’s disease dementia (PDD). Two studies have examined MoCA as a screening test for cognitive impairment in PD. MoCA is widely used in Parkinson’s disease (PD) to assess cognition. PD patients with and without cognitive deficits on MoCA testing, (b) equivalent MoCA and TYM scores, and (c) interrater reliability in TYM testing. We assessed the discriminant ability of TYM and the equivalence between TYM and MoCA scores and measured the interrater reliability between three raters. The area under the receiver operator characteristic (ROC) curve for TYM to differentiate between PD-normal and PD-cognitive impairment was 0.82
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