Abstract
The purpose of this prospective study was to measure patients’ ability to open a purse, take out money, and count it, in order to identify persons in need of increased health care. The study population consisted of 183 patients (mean age 78.9; range: 66-95) in two settings: 78 consecutively admitted geriatric hospital patients who could return home, and 105 community-dwelling patients aged 70 years or older. None was completely dependent on others, nor severely demented. Time for task performance was measured. Further assessment included the Mini-mental State Examination (MMSE), Barthel index of ADL, instrumental activities of daily living (IADL), socioeconomic status, grip strength, Williams board test, and medication profile. The Timed Test of Money Counting (TTMC) was reliable (interrater and intrarater), and showed construct and concurrent validity with other measures of physical function. There was a strong correlation (p<0.001) between the time required to count money, and to open and close the panel doors of the Williams board. The other functional measures were also significantly correlated with the TTMC. After 18 months, 26 of the patients had died, and 5 were lost to follow-up. The remainder were divided into those who had stable needs (group I), and those with increasing careneeds or nursing home placement (group II). Time required for money counting was significantly different (p<0.001) between groups (30.9±17.5 seconds for group I, and 122.6±94.4 seconds for group II). Using cut-off times of less than 45 seconds to identify persons with stable needs, and of more than 70 seconds to identify persons with increasing needs, the sensitivity and specificity were 83% and 75%, respectively, with 85% positive and 75% negative predictive accuracy. The TTMC seems helpful in identifying elderly persons in need of increased care. The test is performed quickly, requires no special equipment, and can be easily included in the routine geriatric examination. (Aging Clin. Exp. Res. 7: 179-183, 1995)
Similar content being viewed by others
References
Applegate W.B., Blass J.P., Williams T.F.: Instruments for the functional assessment of older people. N. Engl. J. Med. 322: 1207–1214, 1990.
A report of joint workshops of the Research Unit of the Royal College of Physicians and the British Geriatrics Society. Standardized assessment scales for elderly people. The Royal College of Physicians of London and the British Geriatrics Society, London, 1992.
Hedrick S.C., Barrand N., Deyo R., Haber P., James K., Met-ter J., Mor V., Scanlon W., Weissert W., Williams M.: Working group recommendations: measuring outcomes of care in geriatric evaluation and management units. J. Am. Geriatr. Soc. 39: 48S–52S, 1991.
Solomon D.: National Institutes of Health consensus development conference statement: geriatric assessment methods for clinical decision-making. J. Am. Geriatr. Soc. 36: 342–347, 1988.
Katz S., Ford A.B., Moskowitz R.W., Jackson B.A., Jaffee M.W.: Studies of illness in the aged — The index of ADL: a standardized measure of biological and psychological function. JAMA 185: 914–919, 1963.
Lawton M.P., Brody E.M.: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9: 179–186, 1969.
Mahoney F.I., Barthel D.W.: Functional evaluation: The Barthel index. Md. State Med. J. 14: 61–65, 1965.
Rubenstein L.Z., Schairer C., Wieland D., Kane R.A.: Systematic biases in functional status assessment of elderly adults: effects of different data sources. J. Gerontol. 39: 689, 1984.
Folstein M.F., Folstein S.E., McHugh P.R.: Mini-mental State: a practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12: 189–198, 1975.
Williams M.E., Hadler N.M., Earp J.A.: Manual ability as a marker of dependency in geriatric women. J. Chronic Dis. 35: 115–122, 1982.
Nikolaus T., Specht-Leible N., Bach M., Oster P., Schlierf G.: Soziale Aspekte bei Diagnostik und Therapie hochbetagter Patienten. Erste Erfahrungen mit einem neuentwickelten Fragebogen im Rahmen des geriatrischen Assessment. Z. Gerontol. 27: 240–245, 1994.
Ostwald S.K., Snowdon D.A., Rysavy S.D., Keenan N.L., Kane R.L.: Manual dexterity as a correlate of dependency in the elderly. J. Am. Geriatr. Soc. 37: 963–969, 1989.
Scholer S.G., Potter J.F., Burke W.J.: Does the Williams manual test predict service use among subjects undergoing geriatric assessment? J. Am. Geriatr. Soc. 38: 767–772, 1990.
Williams M.E.: Identifying the older person likely to require long-term services. J. Am. Geriatr. Soc. 35: 761–766, 1987.
Williams M.E., Hornberger J.C.: A quantitative method of identifying older persons at risk for increasing long term care services. J. Chronic Dis. 37: 705–711, 1984.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nikolaus, T., Bach, M., Oster, P. et al. The Timed Test of Money Counting: A simple method of recognizing geriatric patients at risk for increased health care. Aging Clin Exp Res 7, 179–183 (1995). https://doi.org/10.1007/BF03324310
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03324310