Validating the Time and Change test to screen for dementia in elderly Koreans.
BACKGROUND
We assessed the applicability of the T&C test as an accurate and convenient means to screen for dementia in primary care and community settings.


METHODS
The study group comprised 59 patients and 405 community participants, all of who were aged 65 years and over. The time component of the T&C test evaluated the ability of a subject to comprehend clock hands that indicated a time of 11:10, while the change component of the T&C test evaluated the ability of a subject to make 1,000 Won from a group of coins with smaller denominations (one 500, seven 100, and seven 50 Won coins).


RESULTS
The T&C test had a sensitivity and specificity of 73.0 and 90.9%, respectively, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and interobserver agreement rates were both 95% (kappa = 0.91) (time interval, 24 hours). The association between the T&C test and K-MMSE test was modest, while significant (r = 0.422, p < 0.001). The T&C test scores were not influenced by educational status.


CONCLUSIONS
We conclude that the T&C test is useful as supplemental testing of important domains (e.g., calculation, conceptualization, visuospatial) to traditional measures such as the MMSE. However, because T&C test is simple, rapid, and easy to use, it can be applied conveniently to elderly subjects by non-specialist personnel who receive training.
Rhee
Jung-Ae
JA
Department of Preventive Medicine, Chonnam National University Medical School, Hak-1-dong, Dong-gu, Gwangju 501-190, South Korea. jarhee@healthis.org <jarhee@healthis.org>
Chung
Eun-Kyung
EK
Shin
Min-Ho
MH
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D003153:Community Health Services; D032882:Comprehension / Q000502:physiology; D003704:Dementia / Q000175:diagnosis* / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007723:Korea; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008609:Mental Status Schedule; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011594:Psychometrics / Q000295:instrumentation; D013998:Time Perception / Q000502:physiology*; D014796:Visual Perception / Q000502:physiology*