Test of gestures (TEGEST) for a brief examination of episodic memory in mild cognitive impairment


Authors: A. Bartoš 1,2
Authors‘ workplace: Neurologická klinika 3. LF UK a FN Královské Vinohrady, Praha 1;  Národní ústav duševního zdraví, Klecany 2
Published in: Cesk Slov Neurol N 2018; 81(1): 37-44
Category: Original Paper
doi: 10.14735/amcsnn201837

Overview

Aim:
A quick and simple examination can detect early impairment of episodic memory. The aim of the study was to develop an original Czech test which would simulate episodic memory and could be administered without any aids anytime and anywhere.

Participants and methods:
Participants demonstrated six gestures symbolic for all human senses (twice for sight) as instructed by the administrator in a new test of gestures (TEGEST). Then, they were asked to carry them out in the same sequence again immediately and after a 20-min distraction. The TEGEST and Montreal cognitive assessment (MoCA) were administered to 25 individuals with mild cognitive impairment and 25 socio-demographically paired subjects with normal cognitive functions divided according to zhe results of neuropsychological tests.

Results:
Individuals with mild cognitive impairment (MoCA 23 ± 4 points) recalled a significantly smaller number of gestures than normal elderly people (MoCA 27 ± 3 points): 4 ± 1 vs. 5 ± 1 gestures (p = 0.008). However, the two groups did not differ in the low number of correct sequences of gestures (two). The number or sequence of gestures were not related to age, education, or gender. The number of recalled gestures correlated with the MoCA score (r = 0.7; p = 0.001). The optimal cut-off score was ≤ 4 correctly recalled gestures (sensitivity 84%; specificity 48%; area under the receiver operating characteristic curve = 0.70).

Conclusion:
The novel six-gesture test (TEGEST) is a one- or two-minute and easy-to-use instrument which may signal mild cognitive impairment by four or fewer recalled gestures.

Key words:
memory – mild cognitive impairment – Alzheimer‘s disease – dementia – neuropsychological tests – screening – test – gestures – TEGEST

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


Chinese summary - 摘要

对轻度认知障碍患者情景记忆的简单检查-手势测试(TEGEST)

目标:

一个快速简单的检查可以检测到情景记忆的早期损害。 这项研究的目的是改良一个原始的捷克测试,它可以模拟情景记忆,并且可以在任何时间和任何地方无需任何辅助器具进行测试。

参与者和方法:

参与者按照管理人员在新的手势测试(TEGEST)中的指示,展示象征着人类所有感官(包括两次视觉)的六种手势。然后,他们被要求立即再次以相同的顺序执行,并在20分钟后休息。 TEGEST和蒙特利尔认知评估(MoCA)对25名轻度认知障碍患者和25名社会人口统计学配对的受试者进行测试,根据这些受试者的神经心理学测试结果进行分类。

结果:

轻度认知功能障碍患者(MoCA 23±4分)回忆的手势数量明显少于正常老年人(MoCA 27±3分):4±1 vs. 5±1个手势(p = 0.008)。 然而,这两组在手势的正确序列数量较少时没有差异(两个)。 手势的次数或顺序与年龄,教育或性别无关。 召回手势的次数与MoCA评分相关(r = 0.7; p = 0.001)。 最佳截断分数≤4正确召回手势(敏感性84%;特异性48%;受试者工作特征曲线下面积= 0.70)。

结论:

新型的六手势测试(TEGEST)是一种耗时极少且易于操作的检查,它通过四次或更少的召回手势来表现轻微的认知障碍。

关键词:

记忆 - 轻度认知障碍 - 阿尔茨海默病 - 痴呆 - 神经心理测试 - 筛查 - 测试 - 手势 - TEGEST


Sources

1. Bartoš A, Raisová M. Testy a dotazníky pro vyšetřování kognitivních funkcí, nálady a soběstačnosti. Praha: Mladá Fronta; 2015.

2. Rektorová I. Screeningové škály pro hodnocení demence. Neurol praxi 2011; 12 (Suppl G): 37–45.

3. Ressner P, Hort J, Rektorová I et al. Recommendations for the diagnosis and management of Alzheimer‘s disease and other disorders associated with dementia. Cesk Slov Neurol N 2008; 71/104 (4): 494–501.

4. Albert MS, DeKosky ST, Dickson D et al. The diagnosis of mild cognitive impairment due to Alzheimer‘s disease: recommendations from the National Institute on Aging-Alzheimer‘s Association workgroups on diagnostic guidelines for Alzheimer‘s disease. Alzheimers Dement 2011; 7 (3): 270–279. doi: 10.1016/j.jalz.2011.03.008.

5. Mortamais M, Ash JA, Harrison J et al. Detecting cognitive changes in preclinical Alzheimer‘s disease: A review of its feasibility. Alzheimers Dement 2017; 13 (4): 468–492. doi: 10.1016/j.jalz.2016.06.2365.

6. Ritchie K, Ropacki M, Albala B et al. Recommended cognitive outcomes in preclinical Alzheimer‘s disease: Consensus statement from the European Prevention of Alzheimer‘s Dementia project. Alzheimers Dement 2017; 13 (2): 186–195. doi: 10.1016/j.jalz.2016.07.154.

7. Cerami C, Dubois B, Boccardi M et al. Clinical validity of delayed recall tests as a gateway biomarker for Alzheimer‘s disease in the context of a structured 5-phase development framework. Neurobiol Aging 2017; 52: 153–166. doi: 10.1016/j.neurobiolaging.2016.03.034.

8. Pause BM, Zlomuzica A, Kinugawa K et al. Perspectives on episodic-like and episodic memory. Front Behav Neurosci 2013; 7: 33. doi: 10.3389/fnbeh.2013.00033.

9. Costa A, Bak T, Caffarra P et al. The need for harmonisation and innovation of neuropsychological assessment in neurodegenerative dementias in Europe: consensus document of the Joint Program for Neurodegenerative Diseases Working Group. Alzheimers Res Ther 2017; 9 (1): 27. doi: 10.1186/s13195-017-0254-x.

10. Mistridis P, Krumm S, Monsch AU et al. The 12 years preceding mild cognitive impairment due to Alzheimer‘s disease: the temporal emergence of cognitive decline. J Alzheimers Dis 2015; 48 (4): 1095–1107. doi: 10.3233/jad-150137.

11. Saxton J, Lopez OL, Ratcliff G et al. Preclinical Alzheimer disease: neuropsychological test performance 1.5 to 8 years prior to onset. Neurology 2004; 63 (12): 2341–2347.

12. Schmid NS, Taylor KI, Foldi NS et al. Neuropsychological signs of Alzheimer‘s disease 8 years prior to diagnosis. J Alzheimers Dis 2013; 34 (2): 537–546. doi: 10.3233/jad-121234.

13. Silva D, Guerreiro M, Santana I et al. Prediction of long-term (5 years) conversion to dementia using neuropsychological tests in a memory clinic setting. J Alzheimers Dis 2013; 34 (3): 681–689. doi: 10.3233/jad-122098.

14. Hirni DI, Kivisaari SL, Krumm S et al. Neuropsychological markers of medial perirhinal and entorhinal cortex functioning are impaired twelve years preceding diagnosis of Alzheimer‘s dementia. J Alzheimers Dis 2016; 52 (2): 573–580. doi: 10.3233/jad-150158.

15. Bartoš A. Netestuj, ale POBAV – písemné záměrné Pojmenování OBrázku A jejich Vybavení jako krátká kognitivní zkouška. Cesk Slov Neurol N 2016; 79/112 (6): 671–679.

16. Folstein MF, Folstein SE, McHugh PR. „Mini-Mental State“. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12 (3): 189–198.

17. Bartoš A, Raisová M. The Mini-Mental State Examination: Czech norms and cutoffs for mild dementia and mild cognitive impairment due to Alzheimer‘s disease. Dement Geriatr Cogn Disord 2016; 42 (1–2): 50–57. doi: 10.1159/000446426.

18. Nasreddine ZS, Phillips NA, Bedirian V et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53 (4): 695–699. doi: 10.1111/j.1532-5415.2005.53221.x.

19. Bartoš A, Orlíková H, Raisová M et al. Česká tréninková verze Montrealského kognitivního testu (MoCA-CZ1) k časné detekci Alzheimerovy nemoci. Cesk Slov Neurol N 2014; 77 (5): 587–594.

20. Mioshi E, Dawson K, Mitchell J et al. The Adden-brooke‘s Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. Int J Geriatr Psychiatry 2006; 21 (11): 1078–1085. doi: 10.1002/ gps.1610.

21. Hummelová-Fanfrdlová Z, Rektorová I, Kateřina S et al. Česká adaptace addenbrookského kognitivního testu. Cesk Psychol 2009; 53 (4): 376–388.

22. Bartoš A, Raisová M, Kopeček M. Novelizace české verze Addenbrookského kognitivního testu (ACE-CZ). Cesk Slov Neurol N 2011; 74/107 (6): 681–684.

23. Beránková D, Krulová P, Mračková M et al. Addenbrookský kognitivní test – orientační normy pro českou populaci. Cesk Slov Neurol N 2015; 78/111 (3): 300–305.

24. Preiss M, Bartoš A, Čermáková R et al. Neuropsychologická baterie Psychiatrického centra Praha: Klinické vyšetření základních kognitivních funkcí. 3. přepracované vyd. Praha: Psychiatrické centrum 2012.

25. Bartoš A, Janoušek M, Petroušová R et al. Tři časy Testu kreslení hodin hodnocené BaJa skórováním u časné Alzheimerovy nemoci. Cesk Slov Neurol N 2016; 79/112 (4): 406–412.

26. Petersen RC, Doody R, Kurz A et al. Current concepts in mild cognitive impairment. Arch Neurol 2001; 58 (12): 1985–1992.

27. Dušek L, Pavlík T, Jarkovský J et al. Hodnocení diagnostických testů – křivky ROC. Cesk Slov Neurol N 2011; 74/107 (4): 493–499.

28. Kopecek M, Stepankova H, Lukavsky J, Ripova D, Nikolai T, Bezdicek O. Montreal cognitive assessment (MoCA): Normative data for old and very old Czech adults. Appl Neuropsychol Adult 2017; 24 (1): 23–29.

29. Roalf DR, Moberg PJ, Xie SX, Wolk DA, Moelter ST, Arnold SE. Comparative accuracies of two common screening instruments for classification of Alzheimer‘s disease, mild cognitive impairment, and healthy aging. Alzheimers Dement 2013; 9 (5): 529–537.

30. Trzepacz PT, Hochstetler H, Wang S et al. Relationship between the Montreal Cognitive Assessment and Mini-mental State Examination for assessment of mild cognitive impairment in older adults. BMC Geriatrics 2015; 15: 107. doi: 10.1186/s12877-015-0103-3.

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Paediatric neurology Neurosurgery Neurology

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