Browse > Article

Availability of the Time and Change Test in Screening for Dementia in the Elderly  

Chung, Eun-Kyung (Department of Preventive Medicine of Medical School and Research Institute of Medical Science)
Shin, Min-Ho (Department of Preventive Medicine, Seonam University College of Medicine)
Rhee, Jung-Ae (Department of Preventive Medicine of Medical School and Research Institute of Medical Science)
Publication Information
Journal of Preventive Medicine and Public Health / v.36, no.2, 2003 , pp. 101-107 More about this Journal
Abstract
Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.
Keywords
Dementia; Mass screening; Aged;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Folstein MF, Bassett SS, Anthony JC, Romaniski AJ, Nestadt GR. Dementia: Case ascertainment in a community survey. J Gerontol 1991; 46: MI32-138
2 Bowers J, Jorm AF, Henderson S, Harris P. General practitioners' detection of depres-sion and dementia in elderly patients. Med J Aust 1990; 153: 192-196
3 Woo JT, Lee JH, Yoo KY, Kim CY, Kim Yi Lee GO. Prevalence estimation of dementia in a rural area of Korea. J Korean Neuropsychiatr Assoc 1997; 36: 92-102 (Korean)
4 Lee DY, Yoon IC, Lee KU, Jhoo JH, Kim KW, Lee JH, Woo JI. Reliability and validity of the Korean version of short Blessed Test. J Korean Neuropsychiatr Assoc 1999; 38(6): 1297-1307(Korean)
5 Fillenbaum GG, Hughes DC, Heyman A, Geroge LK, Blazer DG. Relationship of health and demographic characteristics to Mini-Mental State Examination score among community residents. Psychol Med 1988; 18: 719-726   DOI   ScienceOn
6 O' Connor DW. Pollitt PA. Hyde JB. Fellows JL. Miller ND. Brook CP. Reiss BB. Roth M. The prevalence of dementia as measured by the Cambridge Mental Disorders of the Elderly Examination. Acta Psychiatr Scand 1989; 79: 190-198   DOI   ScienceOn
7 Sox HC. Preventive health services in adults. N Eng J Med 1994; 330: 1589-1595   DOI   ScienceOn
8 Rubenstein LV, Calkins DR, Greenfield S. Health status assessment for elderly patients. Report of the Society of General Internal Medicine Task Force on Health Assessment. J Am Geriatr Soc 1988; 37: 562-569
9 Jorm AF, Scott R, Henderson AS. Educational level differences on the Mini-Mental State: the role of test bias. Psychol Med 1988; 18: 727-731   DOI
10 통계청. 장래인구추계, 2001
11 Ross GW, Abbott RD, Petrovitch H, Masaki KH, Murdaugh C, Trockman C, Curb JD, White LR. Frequency and char-acteristics of silent dementia among elderly Japanese-American men. JAMA 1997; 277: 800-805   DOI   ScienceOn
12 Kang YK, Na DL, Hahn SH. A validity study on the Korean Mini-Mental State Examination(K-MMSE) in dementia patients. J Korean Neurol Assoc 1997; 15(2): 300-307 (Korean)
13 McCartney JR, Palmateer LM. Assessment of cognitive deficit in geriatric patients:A study of physician behavior. J Am Geriatr Soc 1985; 33: 467-471   DOI   PUBMED
14 MaAllister TW. Cognitive functioning in the affective disorders. Comprehensive Psychiatry 1981; 22: 572-586   DOI   PUBMED   ScienceOn
15 Anthony JC, Le Resche L, Niaz U, Von Korff MR, Folstein MF. Limits of the Mini-Mental State' as a screening test for dementia and delirium among hospital patients. Psychol Med 1982; 12: 397-408   DOI   ScienceOn
16 Jung WY, Na JG, Cho KW, Lim GH, Im IM, Kim SH, Lee YJ, Rhee JA, Kim BW. A study on the prevalence of dementia and its related factors in the rural elderly. J Korean Neurol Assoc 1994; 12(4): 628-646 (Korean)
17 Kawamoto R. Simple screening test for dementia in elderly persons-the time and charge test. Japanese J PublicHealth 2000; 47(6): 486-491(Japanese)
18 Galasko D, Klauber MR, Hofstetter CR. The Mini-Mental State Examination in the early diagnosis of Alzheimer's disease. Arch Neuro 1990; 47: 49-52   DOI   ScienceOn
19 White H, Davis P. Cognitive screening tests:An aid in the care of elderly outpatients. J Gen Intern Med 1990; 5: 438-445   DOI
20 Lee JH, Lee KU, Lee DT, Kim KW, Jhoo JH, Lee KH, Han SH, Woo JI. Develop ment of the Korean version of the Con-sortium to Establish a Registry for Alzheimer's Disease(CERAD) Assessment Packet(CERAD-K):Clinical and Neuro-psychological Assessment Batteries. J Genrontol (In press), 2000
21 Inouye SK, Robinson JT, Froehlich TE, Richardson ED. The time and change test: a simple screening test for dementia. J Gerontol 1998; 53A(4): M281-286
22 Escobar JI,Burnam A, Karno M, Forsythe A, Landsverk J, Golding M. Use of the Mini-Mental State Examination(MMSE) in a community population of mixed eth-nicity. Cultural and linguistic artifacts. J Nerv Ment Dis 1986; 174: 607-614   DOI   PUBMED
23 McLean S. Assessing dementia. Diffi-culties, definitions and differential diag-nosis. Aust NZ J Psychiatry 1987; 21: 142-174   DOI
24 Iliffe S, Mitchley S, Gould M, Haines A. Evaluation of the use of brief screening instruments for dementia, depression and problem drinking among elderly people in general practices. Br J Gen Pract 1994; 44: 503-507
25 Froehlich TE, Robinson JT, Inouye SK. Screening for dementia in the outpatient setting: the time and change test. Geriatr Soc 1998; 46(12): 1506-1511   DOI
26 Folstein MF, Folstein SE, McHugh PR. Mini-Mental State Examination: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-198   DOI   ScienceOn
27 Kim DH, Na DL, Yeon BG, Kang YW, Min KB, Lee SH, Lee SS, Lee MR, Pyo OJ,Park CH, Kim SM, Bae SS. Prevalence of dementia in the elderly of urban com-munity in Korea. Korean J Prev Med 1999; 32(3): 306-316 (Korean)
28 Henderson AS, Huppert FA. The problem of mild dementia. Psychol Med 1984; 14: 5-115   DOI
29 Lachs MA, Feistein AR, Cooney LM. A simple procedure for general screening for functional disability in elderly patients. Ann Intern Med 1990; 112: 699-706   DOI   ScienceOn
30 Kim KW, Ahn SY, Lee DY. Comparison of MMSE-KC, and SBT-K as screening tests for dementia. Yong-In Psychiatry Bull 2001; 8(1): 44-51(Korean)
31 Park JH. Epidemiology of dementia in elderly people in Jookjang-Myun, Pohang, kyungpook province:1990-1999. J Korean Geriatric Psychiatry 2000; 4(1): 50-57 (Korean)
32 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder. 4th Ed. Washington DC. 1994