Abstract
BackgroundEarly distinguishing the cognitive impairment from healthy population is crucial to delay the progression of mild cognitive impairment (MCI) and Alzheimer disease (AD). Test Your Memory (TYM) has been proved to be a valid and reliable screening instrument for AD and MCI. This study aimed to develop a culturally appropriate and functional Standard Mandarin Chinese translation of the TYM, and to evaluate its reliability and validity in detecting AD and MCI in Chinese.Methods182 subjects with AD/MCI and 55 healthy controls were recruited to participate in this study, and everyone undergo the test of Standard Mandarin Chinese version of the TYM (TYM-CN), Mini-mental State Examination (MMSE), Montreal cognitive assessment (MoCA-BJ), and Clinical Dementia Rating (CDR) Scale. Concurrently, all the subjects with AD/MCI received the general physical and neurologic examinations, extensive laboratory tests, and brain computed tomography/magnetic resonance imaging (MRI). Of which, 90 subjects were asked to complete the re-test of TYM-CN at 3 weeks after the initial visit. Intra-class correlation coefficient (ICC) and Cronbach’s alpha was used to assess the test–retest reliability and the internal consistency. The validity, sensitivity and specificity were also analyzed. One-way analysis of variance, χ2 test, correlation analysis, and receiver operating characteristic curve (ROC) analysis were employed, as needed.ResultsThe total scores of TYM-CN was 43.89 ± 3.44, 40.88 ± 4.38, and 29.12 ± 7.44 (p < 0.01) for healthy controls group, MCI group, and AD group, respectively. The ICC for 11 items of TYM-CN ranged from 0.863 (copying) to 0.994 (anterograde), and that of the total scale was 0.993, suggesting an excellent reliability. Furthermore, the significant correlation was also found between TYM-CN and MMSE (r = 0.76), MoCA-BJ (r = 0.74), and CDR scores (r = 0.76), indicating a good validity. A TYM-CN scores ≤ 39.5 had 95% sensitivity and 95% specificity in differentiating AD from healthy controls, and that ≤ 43.5 had 75% sensitivity and 91% specificity in distinguishing MCI from healthy controls, respectively.ConclusionThe reliability and validity of the TYM-CN are statistically acceptable for the evaluation of cognitive impairment, which may contribute to neuropsychological tests for the diagnosis of AD and MCI from healthy controls in China.
Highlights
Distinguishing the cognitive impairment from healthy population is crucial to delay the progression of mild cognitive impairment (MCI) and Alzheimer disease (AD)
Translation and procedures To obtain a Chinese version of Test Your Memory (TYM), multiple translation procedures were performed according to Beaton’s guideline, which was used for cross-cultural adaptation of health-related questionnaires [25]
Any discrepancy of the fourth version from two translators was resolved in the fifth version by an expert committee of School of Social Development and Public Policy at Beijing Normal University and the Department of Outpatient, General Hospital of the People’s Liberation Army (301 Hospital)
Summary
Distinguishing the cognitive impairment from healthy population is crucial to delay the progression of mild cognitive impairment (MCI) and Alzheimer disease (AD). In China, which has the largest population of people with dementia, the prevalence of dementia appears to have increased steadily between 1990 and 2010 with the aging intensification [1, 3, 4]. A recent article published in 2014 showed that the prevalence of dementia among individuals aged over 65 years was 5.14% in China [5]. Another recent review study, conducted by Prince and his colleagues, indicated that the age-standardized prevalence for individuals over 60 years varied in a narrow range of 5–7% in the most world regions, with a higher prevalence of 8.5% in Latin America and a distinctively lower prevalence of 2–4% in the four sub-Saharan African regions [2]. Future projections should focus on the preventive interventions for lowering the incidence, the improvements in treatment and care for prolonging survival, and the disease-modifying interventions for preventing or slowing progression
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