Dementia and other cognitive problems are common. An estimated 24 million individuals in the world have dementia and the number affected will double every 20 years.1 Milder forms of cognitive dysfunction, including mild cognitive impairment, affect many more people.2 Alzheimer’s disease is the commonest form of dementia. Cognitive problems are a feature of many neurological and medical diseases including stroke, Parkinson’s disease, head injury, and epilepsy.
Assessment of a patient’s cognition is a crucial part of many medical consultations. Cognitive tests aid the diagnosis of dementia and are important in the medical and social management of patients and in the assessment of capacity. Once there are effective treatments for Alzheimer’s disease there will be an even greater need for a quick sensitive test that is suitable for use in primary care and by non-specialists. Dr.Jeremy Brown, British consultant neurologist,et al devised a cognitive test, the TYM ("test your memory"), in the detection of Alzheimer’s disease in his article named Self administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study and wich appeared in the recent BMJ 2009;338:b2030
The TYM test
The TYM is a series of 10 tasks on a double sided sheet of card with spaces for the patient to fill in (see appendix 1 on bmj.com). The patient’s ability to complete the test is an 11th task. The tasks are orientation (10 points), ability to copy a sentence (2 points), semantic knowledge (3 points), calculation (4 points), verbal fluency (4 points), similarities (4 points), naming (5 points), visuospatial abilities ( 2 tasks, total 7 points), and recall of a copied sentence (6 points). The ability to do the test is also scored (5 points), giving a possible total of 50 points. The scores for the subsets are printed on the card and the total score calculated by adding the subset scores. To ensure consistent scoring a single sheet of scoring instructions is availableControl participants completed the TYM with an average score of 47/50. Patients with Alzheimer’s disease scored an lower average of 33/50. The TYM score shows excellent correlation with the two standard tests. A score of 42/50 had a sensitivity of 93% and specificity of 86% in the diagnosis of Alzheimer’s disease. The TYM was more sensitive in detection of Alzheimer’s disease than the mini-mental examination, detecting 93% of patients compared with 52% for the mini-mental state examination. The negative and positive predictive values of the TYM with the cut off of 42 were 99% and 42% with a prevalence of Alzheimer’s disease of 10%. Thirty one patients with non-Alzheimer dementias scored an average of 39/50.
The authors concluded that the TYM can be completed quickly and accurately by normal controls. It is a powerful and valid screening test for the detection of Alzheimer’s disease.
Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
* Tune in tomorrow for Surveillance of Barrett's Columnar-Lined Esophagus.
Deepen your understanding of "medical malpractice"... www.MedMalBook.com
Tuesday, August 4, 2009
Subscribe to:
Post Comments (Atom)
Posts
Any research that provides additional insight into Alzheimer’s is critical to finding a cure. It’s also important for patients and families affected by Alzheimer’s to consider participating in clinical studies. One study is the ICARA Study, whose goal is to explore if an investigational drug, called Bapineuzumab, can help slow the progression of Alzheimer’s Disease. Patients and families affected by Alzheimer’s can visit www.icarastudy.com to see if they might be eligible to enroll.
ReplyDelete