The use of the Hungarian Test Your Memory (TYM-HUN), MMSE, and ADAS-Cog tests for patients with mild cognitive impairment (MCI) in a Hungarian population: a cross-sectional study

Garbóczy, Szabolcs; Magócs, Éva; Szőllősi, Gergő József; Harsányi, Szilvia; Égerházi, Anikó; Kolozsvári, László Róbert · 2020 · Crossref

DOI: 10.1186/s12888-020-02982-6

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Summary

This cross-sectional study evaluates the diagnostic utility of the Hungarian version of the Test Your Memory (TYM-HUN) for identifying mild cognitive impairment (MCI) in a Hungarian population. The research was motivated by the need for early detection of cognitive decline, which often precedes Alzheimer’s disease, using tools that are inexpensive, non-invasive, and suitable for primary care settings. While the Mini-Mental State Examination (MMSE) is widely used, it lacks sensitivity for early MCI detection, and the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), though reliable, is time-consuming. The study aimed to determine if the self-administered TYM-HUN could effectively distinguish MCI patients from healthy controls and to establish an optimal cut-off score. The study recruited 50 participants aged 55–84 years from the Psychiatric Clinic and Hospital of the University of Debrecen: 25 patients diagnosed with MCI according to DSM-5 criteria and 25 healthy controls. Exclusion criteria included evidence of neurovascular disease, other neurological or systemic conditions, and depressive symptoms identified via the Beck Depression Inventory. Participants completed the TYM-HUN, MMSE, and ADAS-Cog tests. Statistical analyses included Spearman’s rank correlation to assess relationships between test scores and receiver operating characteristic (ROC) curve analysis to determine sensitivity, specificity, and optimal cut-off points. Results indicated that TYM-HUN scores significantly correlated with both MMSE scores (ρ = 0.626; p < 0.001) and ADAS-Cog scores (ρ = −0.723; p < 0.001). The study established an optimal TYM-HUN cut-off point of 44/45 points for distinguishing MCI from normal aging. At this threshold, the test demonstrated a sensitivity of 80% and a specificity of 96%, with a positive predictive value of 95.24% and a negative predictive value of 82.76%. The area under the ROC curve was 0.932. MCI patients scored significantly lower on the TYM-HUN (mean 39.52) compared to healthy controls (mean 47.40). No significant differences in TYM-HUN performance were observed based on gender or education level within the MCI group. The authors conclude that the TYM-HUN is a reliable, fast, and self-administered screening tool for early detection of MCI in Hungarian populations. Its high specificity and sensitivity, combined with a short administration time of 5–10 minutes, make it suitable for use in general practice and outpatient settings, unlike the more cumbersome ADAS-Cog. The study highlights the TYM-HUN as a viable alternative to the MMSE for early cognitive impairment screening, potentially facilitating earlier intervention and reducing the societal burden of dementia. The findings support the broader applicability of the TYM test across different cultural contexts for identifying prodromal stages of Alzheimer’s disease.

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• mci dementia driving