Validating the Time and Change test to screen for dementia in elderly Koreans

Jung-Ae Rhee,Eun-Kyung Chung,Min-Ho Shin

doi:10.1186/1471-2458-4-52

Abstract

BackgroundWe assessed the applicability of the T&C test as an accurate and convenient means to screen for dementia in primary care and community settings.MethodsThe study group comprised 59 patients and 405 community participants, all of who were aged 65 years and over. The time component of the T&C test evaluated the ability of a subject to comprehend clock hands that indicated a time of 11:10, while the change component of the T&C test evaluated the ability of a subject to make 1,000 Won from a group of coins with smaller denominations (one 500, seven 100, and seven 50 Won coins).ResultsThe T&C test had a sensitivity and specificity of 73.0 and 90.9%, respectively, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and interobserver agreement rates were both 95% (κ = 0.91) (time interval, 24 hours). The association between the T&C test and K-MMSE test was modest, while significant (r = 0.422, p < 0.001). The T&C test scores were not influenced by educational status.ConclusionsWe conclude that the T&C test is useful as supplemental testing of important domains (e.g., calculation, conceptualization, visuospatial) to traditional measures such as the MMSE. However, because T&C test is simple, rapid, and easy to use, it can be applied conveniently to elderly subjects by non-specialist personnel who receive training.

Highlights

We assessed the applicability of the T&C test as an accurate and convenient means to screen for dementia in primary care and community settings
In a comparison of the T&C test and a diagnosis of dementia by physicians, 27 of 37 patients that had been diagnosed as demented were classified as positive for dementia according to the T&C test, and the sensitivity was 73.0%
The positive predictive value that indicated the probability of dementia, as determined by a positive classification according to the T&C test, was 93.1%, while the negative predictive value that indicated the probability of not being demented, as determined by a negative classification according to the T&C test, was 66.7%

Summary

Introduction

We assessed the applicability of the T&C test as an accurate and convenient means to screen for dementia in primary care and community settings. Most patients with dementia are not detected by family members or clinicians at an early stage, even though such patients have memory problems [2,3]. The Mini-Mental State Examination (MMSE) is a brief screening test that quantitatively assesses the cognitive status of elderly people [4,5]. It has shown good validity, the MMSE has been found to be influenced largely by racial differences and educational status [6,7,8,9,10]. The Time and Change (page number not for citation purposes)

Methods

Results

Discussion

Conclusion