| خلاصه مقاله | The population worldwide is aging rapidly, particularly in developed countries, and will pose challenges for health care systems. One of the problems is dealing with the enormous resources required to provide care for patients with cognitive decline, impacting patients and families (1). Early recognition is one of the most critical steps for appropriate treatment and meticulous research. The most beneficial approach for timely detection might be using valid screening tools (2, 3).
In addition to the standard clinical methods of history taking and examination, many cognitive screening instruments (CSI) or assessment tools have become available to diagnose patients with cognitive complaints (4, 5).
In response to having a practical method for scoring cognitive abilities, the Mini-Mental State Examination (MMSE) was developed in 1975(6) and is still used as the most popular screening tool in clinical practice to assess people with dementia worldwide, including Turkey. Although the MMSE provides valuable information to detect patients displaying early signs of cognitive decline, false-negative results might be challenging in patients with high premorbid intelligence or those highly educated. Another well-known tool for the same purpose is the Clock Drawing Test (CDT) (7).
Cognitively impaired patients, especially those with Alzheimer’s disease (AD), can be successfully screened using cognitive screening tools, especially when combined. A reasonable specificity was observed when using a combination of the MMSE and CDT to screen patients with AD (8). Again, some disadvantages are observed, like lower sensitivity to the early changes in highly educated individuals (9, 10) and low sensitivity to detect mild forms of AD (11).
Test Your Memory (TYM) was introduced as an alternative tool, especially to meet the criteria of minimal operator time to administrate, test a reasonable range of cognitive functions, and be sensitive to mild AD (12).
Hancock and Larner conclude that TYM is a helpful screening test in the cognitive function clinic setting, with patients who fall below the designated cutoff requiring further investigation to ascertain a cause for their cognitive impairment. Self-administered tests such as TYM may be of particular value when clinician time is limited (13, 14).
In another study by Koekkoek et al., the TYM showed a good correlation with a neuropsychological assessment, performed better in discriminating between variations of cognition, and showed more agreement with a neuropsychological evaluation than the MMSE (15).
Brown et al. showed that the TYM test can be used in a general neurology clinic and can help distinguish patients with Alzheimer's disease (AD) from those with no neurological cause for their memory complaints (16).
The Turkish version of TYM (TYM-TR) was introduced by Maviş et al. (17). Our investigation on 100 demented patients showed that patients’ cognitive deficits might be more evident when measured by the TYM-TR compared to the MMSE (18).
According to our findings, patients with neurocognitive disorders (with different severity) scored lower in TYM-TR than in MMSE. Since we compared the standardized scores, this difference means that when patients receive a lower score on the TYM than MMSE, they get diagnosed with milder impairments and are less likely to be missed. Tasks for evaluating registration, recall, and drawing the letter M were more sensitive than matching items in the MMSE (18). In addition, the TYM-TR has some advantages compared to the MMSE by evaluating cognitive domains like verbal fluency, abstraction, and semantic memory, and needs intact executive functioning to perform visuospatial tasks (drawing the letter M and a clock face). These items increase the chance of detecting less common forms of dementia, such as dementia with Lewy bodies, Parkinson’s disease dementia, and Frontotemporal Dementia (18). |