TYM TEST – novel diagnostic tool to assess cognitive functions – study on inhabitants of social welfare house
Keywords:
TYM test, cognitive functions, cognitive impairment, elderlyAbstract
Cognitive impairment can affect the daily functioning of older people and worsen their quality of life.
The aim of this study was to assess cognitive functions using TYM-test, a new diagnostic tool and to compare obtained test results with the results in MMSE test. The survey was conducted among 65 residents of the Social Welfare Home (SWH) in Lublin. The average age of the study group was 76.2 years ± 12.2. We found the strong correlation between the results obtained in TYM-test and MMSE scale – in the final scoring (p <0.001, R = 0.71), and in the following domains: general orientation: p = 0.001, R = 0.49 and mathematical ability: p <0.001, R = 0.70. The study also shown the correlation between the tests used to assess visual-spatial abilities in both analyzed tests, for TYM sub-test of symbols linking (p = 0.001, R = 0.47), Clock Drawing Test (p = 0.001, R = 0.46) and the relevant subsection of MMSE.
Determination of cut-off point at 36 points in TYM-test was associated with the highest sensitivity and specificity for MMSE (p <0.001) and most strongly correlated with the diagnosis of cognitive impairment according to MMSE (p <0.001, R = 0.70). Determination of cut-off point at 30 points in the TYM-test showed a stronger correlation with both – the diagnosis of any cognitive impairment (p = 0.001, R = 0.47) and cognitive impairment associated with dementia (p = 0.001, R = 0.53). It seems that TYM-test is more sensitive indicator of cognitive impairment compared with MMSE scale. Determination of cut-off point at 36 and 30 points may be beneficial for sensitivity in identifying cognitive impairment and cognitive disorders with dementia.
References
1. Derkacz M., Sawicka A., Marczewski K. Łagodne zaburzenia funkcji poznawczych u chorych na cukrzycę – obserwacje ośrodka terenowego. Diab. Dośw. Klin., 2005; 5: 273-278.
2. Rapoport M.J., McCullagh S., Shammi P., Feinstein A. Cognitive impairment associated with major depression following mild and moderate traumatic brain injury. J. Neuropsychiatry Clin. Neurosci., 2005; 17: 61-65.
3. Paul R., Garrett K., Cohen R. Vascular dementia: a diagnostic conundrum for the clinical neuropsychologist. Appl. Neuropsychol., 2003; 10: 129-136.
4. Leyhe T., Laske C., Buchkremer G., Wormstall H., Wiendl H. Dementia as primary symptom in late onset multiple sclerosis Case series and review of the literature. Nervenarzt, 2005; 76: 748-755.
5. Valcour V.G., Shikuma C.M., Watters M.R., Sacktor N.C. Cognitive impairment in older HIV-1-seropositive individuals: prevalence and potential mechanisms. AIDS, 2004; 1(Suppl 1): 79-86.
6. Mochizuki H., Masaki T., Matsushita S., Ugawa Y., Kamakura K., Arai H. Cognitive impairment and diffuse white matter atrophy in alcoholics. Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology. Clin. Neurophysiol., 2005; 116: 223-228.
7. Munte T.F., Lill C., Otting G., Brabant G. Cognitive changes in short-term hypothyroidism assessed with event-related brain potentials. Psychoneuroendocrinology, 2004; 29: 1109-1118.
8. Cahn-Weiner D.A., Grace J., Ott BR., Fernandez H.H., Friedman J.H. Cognitive and behavioral features discriminate between Alzheimer's and Parkinson's disease. Neuropsychiatry Neuropsychol. Behav. Neurol., 2002; 15: 79-87.
9. Abyad A. Prevalence of Vitamin B12 Deficiency Among Demented Patients and Cognitive Recovery with Cobalamin Replacement. J. Nutr. Health Aging., 2002; 6: 254-260.
10. Derkacz M., Chmiel-Perzyńska I, Marczewski K. Zaburzenia funkcji poznawczych w cukrzycy. Med. Og., 2009; 15: 191-201.
11. Derkacz M., Marczewski K. Cukrzyca a zaburzenia funkcji kognitywnych.. Pol. Arch. Med. Wewn., 2005; 113: 273-277.
12. Chmiel-Perzyńska I., Derkacz M., Perzyńska-Starkiewicz A., Makara-Studzińska M., Szyprowska E, Perzyński A., Schabowski J. Wpływ hipoglikemii na funkcje poznawcze pacjentów z cukrzycą typu 1. Fam. Med. Prim. Care Rev., 2009; 11: 264-266.
13. Derkacz M., Mosiewicz J., Myśliński W. Zaburzenia funkcji kognitywnych u chorych na przewlekłą obturacyjną chorobę płuc. Wiad. Lek., 2007; 60: 143-147.
14. Folstein M.F., Folstein S.E., McHugh P.R. “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res., 1975; 12: 189-198.
15. Freedman M., Leach L., Kaplan E., et al. Clock Drawing: A Neuropsychological Analysis. NY: Oxford University Press; 1994.
16. Brown J., Pengas G., Dawson K., Brown LA., Clatworthy P. Self administered cognitive screening test (TYM) for detection of Alzheimer's disease: cross sectional study. BMJ, 2009; 9:b2030. doi: 10.1136/bmj.b2030.
17. Hancock P., Larner A.J. Test Your Memory test: diagnostic utility in a memory clinic population. Int. J. Geriatr. Psychiatry, 2010; DOI: 10.1002/gps.2639.
18. Shulman K.I., Pushkar Gold D., Cohen C.A., Zucchero C.A. Clock drawing and dementia in the community: a longitudinal study. Int. J. Geritr. Psychiatry, 1993; 8:487-496.
19. Borson S., Brush M., Gil E., Scanlan J., Vitaliano P., Chen J., et al. The Clock Drawing Test: utility for dementia detection in multiethnic elders. J. Gerontol. A. Biol. Sci. Med. Sci., 1999; 54: M534-540.
20. Sinclair A.J., Girling A.J., Bayer A.J. Cognitive dysfunction in older subjects with diabetes mellitus: impact on diabetes self-management and use of care services. Diabetes Res. Clin. Prac., 2000; 50: 203-212.
21. Samton J.B., Ferrando S.J., Sanelli P., Karimi S., Raiteri V., Barnhill J.W. The clock drawing test: Diagnostic, functional, and neuroimaging correlates in older medically ill adults. Journal of neuropsychiatry and clinical neurosciences, 2005; 17: 533-540.
22. Brodaty H., Moore C.M. The Clock Drawing Test for dementia of the Alzheimer's type: A comparison of three scoring methods in a memory disorders clinic. Int. J. Geriatr. Psychiatry, 1997; 12: 619-627.
23. Schramm U., Berger G., Muller R., Kratzsch T., Peters J., Frolich L. Psychometric properties of Clock Drawing Test and MMSE or Short Performance Test (SKT) in dementia screening in a memory clinic population. Int. J. Geriatr. Psychiatry, 2002; 17: 254-260.
24. Juby A., Tench S., Baker V. The value of clock drawing in identifying executive cognitive dysfunction in people with a normal Mini-Mental State Examination score. CMAJ, 2002; 15: 859-864.
25. Ferrucci L., Cecchi F., Guralnik J.M., Giampaoli S., Lo Noce C., Salani B., Bandinelli S., Baroni A. Does the Clock Drawing Test predict cognitive decline in older persons independent of the Mini-Mental State Examination? The FINE Study Group. Finland, Italy, The Netherlands Elderly. J. Am. Geriatr. Soc.,1996; 44: 1326-1331.
26. Folstein M.F., Folstein S.E., McHugh P.R.."Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res., 1975; 12: 189-198.
27. Perkin G.D. Neurologia w praktyce lekarza ogólnego. Gdańsk: Via Medica; 2003, s. 78.
28. Pużyński S., Wciórka J. Narzędzia oceny stanu psychicznego. W: Bilikiewicz A., Pużyński S., Rybakowski J.,Wciórka J. red., Psychiatria, 1st edition. Wrocław: Urban &Partner; 2002, s. 453-526.
29. Mohd A., Md A., Draman S. Physical and Mental Health Problems of the Elderly in Nursing Homes in Kuantan, Pahang. Int. Med. J., 2007; 6.
30. Zielińska A., Strugała M., Stachowska M. Ocena funkcjonowania czynnościowego, poznawczego oraz ryzyka rozwoju odleżyn, jako zasadniczych elementów w planowaniu zapotrzebowania na opiekę pielęgniarską u pacjentów w wieku podeszłym. Probl. Hig. Epidem., 2007; 88: 216-220.
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