Premium
Triple test, a diagnostic observation, can detect cognitive impairment in older adults
Author(s) -
Isik Ahmet T.,
Soysal Pinar,
Kaya Derya,
Usarel Cansu
Publication year - 2018
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/psyg.12289
Subject(s) - medicine , cognitive impairment , neuropsychology , mini–mental state examination , dementia , test (biology) , activities of daily living , disease , trail making test , cognition , audiology , psychology , psychiatry , paleontology , biology
Background A simple, quick, and efficient screening tool for detecting mild cognitive impairment ( MCI ) and A lzheimer’s disease ( AD ) is essential, especially in the primary care setting. In this study, we examined the neuropsychological profiles of elderly patients and aimed to assess the diagnostic value of the triple test, comprised of the attended alone sign ( AAS ), head‐turning sign, and applause sign ( AS ), for detecting MCI and AD . Method Comprehensive geriatric assessment was performed in 354 elderly outpatients, and the presence or absence of AS , AAS and HTS was investigated. Results Of the 354 patients, 93 patients were considered to be cognitively impaired ( MCI : 30; AD : 63); the remaining 261 were cognitively healthy. Relative to those without AS , patients with AS had significantly lower scores on the M ini– M ental S tate E xamination, the clock‐drawing test, Instrumental Activities of Daily Living Scale, and Basic Activities of Daily Living Scale ( P < 0.001, for each). Similar significant differences were found between patients who were positive and negative for the HTS ( P < 0.001) and between those who attended the clinic alone and those who were accompanied ( P < 0.001). The sensitivity of the triple test for identifying cognitively impairment (CI), MCI , and AD was 0.61, 0.30, and 0.72, respectively; the specificity was 0.85, 0.68, and 0.83, respectively; and the positive and negative predictive values were 0.69, 0.09, and 0.59, respectively, and 0.79, 0.90, and 0.89, respectively. Conclusions The present study suggests that the triple test is a simple, quick, and efficient screening tool for detecting cognitive impairment, and the results may reflect deterioration in patients’ activities of daily living. Additionally, it could be advantageous in clinical practice because educational level does not affect the test outcome. Therefore, it may be an appropriate test to screen for cognitive impairment in the elderly, both as a bedside diagnostic test and in daily clinical practice, especially in the primary care setting.