Intended for healthcare professionals

Research

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

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b2030 (Published 10 June 2009) Cite this as: BMJ 2009;338:b2030

Further testing of 'Test Your Memory Test' is needed

Dear Sir, the recent publicity generated by the article on the test
'test your memory (TYM)'(1)highlights intense general interest in early
and accurate recognition of dementia, usually Alzheimer's disease.
Although the TYM is 'self administered' it was given out by clinic staff
to clinic attendees in a setting to which people had been referred with
comparisons provided for defined clinical subgroups; the people filling in
the questionnaires had already been through at least one filter and seen
their gp. They were also seen immediately afterwards by a clinician who
could address any concerns. The danger of calling a test 'self
administered' in the title is that it provides a very different and
potentially misleading message - that of downloading the test from the
internet and doing it in the home setting with no forum for interpretation
or provision of support; the diagnosis of dementia is a process which
requires multidisciplinary assessement and often over a period of time(2).

Many older people are now asking their doctors whether they should get and
do the test. In addition, the TYM was administered to a relatively young
population (median ages under 70) with potentially high educational
levels; memory clinic referrals have not been demonstrated to be
representative of the general older population. It is uncertain exactly
how much advantage it provides over MMSE as the full MMSE ROCurve was not
provided. These factors mean that it would be unwise to assume it would
perform as well in the very different settings such as general practice
waiting rooms or at home. If this is the intention of this test it must be
applied in many different and appropriate settings, with longitudinal
follow up to ensure validity, as well as appropriate support to those
completing it. All this has to be done before any suggestion that this
might be a useful test in any more extended settings for early detection
of Alzheimer's disease or dementia.

1. Brown, J., et al. Self-administered cognitive screening test (TYM)
for detection of Alzheimer’s disease : cross sectional study. BMJ
2009;338:b030

2. Nicholl, C. Diagnosis of dementia. BMJ 2009; 338:b1176
http://www.bmj.com/cgi/content/extract/338/jun08_3/b1176?papetoc

Competing interests:
None declared

Competing interests: No competing interests

19 June 2009
Louise Robinson
Chair; Primary Care Clinical Studies Group, Dementia and Neurodegenerative Diseases Research Network
Carol Brayne, Steve Iliffe on behalf of the Primary Care Clinical Studies Group, Dementia and Neurodegenerative Diseases Research Network
Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AA