Self administered cognitive screening test (TYM) for detection of Alzheimer's disease: cross sectional study

doi:10.1136/bmj.b2030

Published 9 June 2009, doi:10.1136/bmj.b2030
Cite this as: BMJ 2009;338:b2030

Research

Self administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study

Jeremy Brown, consultant neurologist, George Pengas, clinical research fellow, Kate Dawson, research nurse, Lucy A Brown, honorary research assistant, Philip Clatworthy, clinical research fellow

¹ Department of Neurology, Addenbrooke’s Hospital, Cambridge CB2 2QQ

Correspondence to: J Brown jmb75{at}medschl.cam.ac.uk

Objective To evaluate a cognitive test, the TYM ("test yourmemory"), in the detection of Alzheimer’s disease.

Design Cross sectional study.

Setting Outpatient departments in three hospitals, includinga memory clinic.

Participants 540 control participants aged 18-95 and 139 patientsattending a memory clinic with dementia/amnestic mild cognitiveimpairment.

Intervention Cognitive test designed to use minimal operatortime and to be suitable for non-specialist use.

Main outcome measures Performance of normal controls on theTYM. Performance of patients with Alzheimer’s diseaseon the TYM compared with age matched controls. Validation ofthe TYM with two standard tests (the mini-mental state examination(MMSE) and the Addenbrooke’s cognitive examination-revised(ACE-R)). Sensitivity and specificity of the TYM in the detectionof Alzheimer’s disease.

Results Control participants completed the TYM with an averagescore of 47/50. Patients with Alzheimer’s disease scoredan average of 33/50. The TYM score shows excellent correlationwith the two standard tests. A score of $≤$ 42/50 had a sensitivityof 93% and specificity of 86% in the diagnosis of Alzheimer’sdisease. The TYM was more sensitive in detection of Alzheimer’sdisease than the mini-mental examination, detecting 93% of patientscompared with 52% for the mini-mental state exxamination. Thenegative and positive predictive values of the TYM with thecut off of $≤$ 42 were 99% and 42% with a prevalence of Alzheimer’sdisease of 10%. Thirty one patients with non-Alzheimer dementiasscored an average of 39/50.

Conclusions The TYM can be completed quickly and accuratelyby normal controls. It is a powerful and valid screening testfor the detection of Alzheimer’s disease.

© Brown et al 2009
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Rapid Responses:

Read all Rapid Responses

TYM test accurate?: Michael R Barratt
bmj.com, 10 Jun 2009 [Full text]
Cultural bias: Aileen Wiglesworth
bmj.com, 11 Jun 2009 [Full text]
TYM test: too many false positives: Stephen L. Black
bmj.com, 11 Jun 2009 [Full text]
Age profile?: Rosaleen A. McCarthy
bmj.com, 11 Jun 2009 [Full text]
TYM promising, but really specific?: Antonio E Segovia
bmj.com, 11 Jun 2009 [Full text]
Re: TYM test: too many false positives: Harry Hall
bmj.com, 12 Jun 2009 [Full text]
Re: Cultural bias: Kevin R Smith
bmj.com, 14 Jun 2009 [Full text]
Pedantic Scoring: Kevin R H Smith
bmj.com, 14 Jun 2009 [Full text]
89 year old patient - diagnostic differential&treatment: John D Herman
bmj.com, 15 Jun 2009 [Full text]
Re: TYM test: too many false positives: Joan McClusky
bmj.com, 15 Jun 2009 [Full text]
A few concerns: Sarah Cuthbertson
bmj.com, 16 Jun 2009 [Full text]
Further testing of 'Test Your Memory Test' is needed: Louise Robinson, et al.
bmj.com, 19 Jun 2009 [Full text]
Is the TYM really a memory test? And some other comments.: Josef Kessler Ph.D., et al.
bmj.com, 24 Jun 2009 [Full text]
A methodological fallacy?: Akshya Vasudev
bmj.com, 2 Jul 2009 [Full text]
If the patient is illiterate?: Nazan Karaoglu
bmj.com, 3 Jul 2009 [Full text]
Authors' reply: Jeremy Brown, et al.
bmj.com, 9 Jul 2009 [Full text]
First of a kind: Andrew S. Hua
bmj.com, 12 Jul 2009 [Full text]
I would very much to see the actual TYM test: Robert K Johnson
bmj.com, 5 Sep 2009 [Full text]
Obtaining copies of test: Edward W BEAL
bmj.com, 10 Oct 2009 [Full text]