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Abstract(s)
In a longitudinal study that lasted 2 years, we assessed 150 subjects (91 control
group / 59 dementia group) and compared their results in an experimental nonverbal test
(TUGA), for cognitive impairment and dementia, with the results obtained by the same
groups in two major screening tests, the Montreal Cognitive Assessment (MOCA) and
the Addenbrooke Cognitive Examination Revised (ACE-R). To validate our test and to
confirm the frontal assessment characteristics and the non-verbal abstract reasoning
nature of TUGA, we also correlated the scores obtained, with the results in two other
tests, the Frontal Assessment Battery (FAB) and the Raven Progressive Matrices
Standard (RPM-std). Finally, to have a characterization of the level of autonomy of our
dementia group and follow any changes on this dimension throughout the study, we have
also applied the Barthel Activities of Daily Living Index (BI). The result showed that:
(1) TUGA total scores have a strong correlation with MOCA (r=,796, p ≤ ,001) and ACER (r=,761, p ≤ ,001) total scores and a moderate correlation with FAB(r=,551, p ≤ ,001).
(2) For an optimal cutoff score of 7.5, TUGA had a specificity of 80% and a
sensitivity of 78%, with statistically significant differences with MOCA and ACE-R.
(3) The evidences show that in both moments of evaluation, TUGA (78,0% -
96,6%), is not only more sensitive detecting cognitive impairment related dementia, but
detects it earlier than ACE-R (6,8% - 66,1%) and MOCA (3,4% - 22,4%).
(4) TUGA is as sensitive to dementia patients with frontal lobe deficits and/or with
psychomotor slowing.
(5) The individual Deck observation of TUGA results, gives useful qualitative and
quantitative information about the possible etiology of the scores.
(6) TUGA total scores have a moderate correlation with RPM-std (r=,526, p ≤ ,001)
and as expected, a very strong correlation with TUGA Deck D RPM-std (r=,914, p ≤
,001), opening a wide range of clinical possibilities and application areas. These results
become even more relevant if we consider the simplicity of TUGA tasks.
Description
Keywords
TUGA portuguese cognitive screening test Cognitive impairment assessment Dementia assessment Montreal cognitive assessment Addenbrooke's cognitive examination revised Raven progressive matrices Frontal assessment battery