A new self-administered test could be the way forward in early diagnosis of Alzheimer's disease. The 10-task test was much more sensitive in picking out those with Alzheimer's than the standard test, according to a new report.

Summary

Early diagnosis of Alzheimer's disease is important and the mini-mental state examination (MMSE) is the standard way of detecting the condition. But a new study from Cambridge, UK, suggests that there might be a better way, with a simpler test. The study compares the self-administered cognitive screening test (TYM, or 'test your memory') with the MMSE and finds it performs better.

Introduction

The main symptom of Alzheimer's disease is decline in memory, although other cognitive deficits are also important. Although there is no cure for Alzheimer's disease, as yet, there are treatments and interventions that may delay the progress of the condition. That is why earlier and more accurate diagnosis is so important.

What was done

Researchers at Addenbrooke's Hospital, Cambridge, UK, devised and evaluated a new test called TYM (Test Your Memory). It is a series of ten tasks including the ability to copy a sentence, knowledge of words and their meaning, calculation, verbal fluency and recall ability. The ability to carry out the test is also noted. Each of the tasks has a score and the total for the TYM test is 50 points. The researchers had a group of 540 healthy individuals aged 18 to 95 years carry out the test. They also tested 139 patients with either Alzheimer's disease or mild cognitive impairment. The test was compared to the MMSE and another standard test called the Addenbrooke's cognitive examination.

What was found

The healthy controls completed the test in an average time of five minutes. Their average score was 47 out of 50. Those with Alzheimer's had a lower average score of 33. Those with mild cognitive impairment scored an average of 45. Average performance was constant between ages 18 and 70, with a small decline after this age. Scores did not vary between men and women or with geographical location, suggesting the socioeconomic factors might have only minor impact on the results. The TYM could detect 93% of those with Alzheimer's disease while the MMSE detects only 52% of those with the condition.

What this study means

The TYM is faster to administer than MMSE and does not need highly qualified people to do so. It is also more accurate and tests a wider range of cognitive abilities. The Addenbrooke's test is also more sensitive than MMSE, but takes longer to administer. Therefore, the TYM looks very promising, but it now needs to be validated in a wider range of clinical settings.

Source

• Brown J, Pengas G et al Self administered cognitive screening test (TYM) for detection of Alzheimer's disease: cross sectional study BMJ online June 9 2009 BMJ 2009;338:b2030