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The 5 Objects Test: a novel, minimal-language, memory screening test

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Abstract

Very brief screening tests are useful in primary care, but may show reduced sensitivity in detecting Alzheimer’s disease or other dementias in the early stages and may show an education or age bias. We examined the reliability, validity, sensitivity, specificity and relationship with demographic variables of a novel, very brief memory screening test that makes limited language demands. Participants were 452 neurological patients with different diagnoses and a community-dwelling sample of 119 middle-aged and older controls. The 5 Objects Test requires the recall of the locations of five everyday objects, immediately after placement and after a brief period of time. The test was unaffected by age and education and showed good reliability and discriminant validity. In receiver operating characteristic (ROC) analyses, specificity was high across a range of sensitivities in all four main comparisons (AD cases versus controls; all dementia cases versus controls; memory-impaired versus non memory-impaired patients; MCI cases versus controls), and sensitivity was lowest in differentiating MCI cases from controls. The test showed similar areas under the ROC curve to the much longer modified Mini Mental State Examination. The 5 Objects Test is a reliable and valid very brief screening test that is suitable for primary care. Because of its limited linguistic demands, the test is appropriate for persons with limited language use or from different linguistic backgrounds.

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References

  1. Aarsland D, Kurz MW (2010) The epidemiology of dementia associated with Parkinson disease. J Neurol Sci 289:18–22

    Article  PubMed  Google Scholar 

  2. Abd-Al-Atty MF, Abou-Hashem RM, Abd El Gawad WM et al (2012) Test Your Memory test, Arabic version: is it practical in a different culture? J Am Geriatr Soc 60:596–597

    Article  PubMed  Google Scholar 

  3. Acevedo A, Lowenstein DA, Agrón J et al (2007) Influence of sociodemographic variables on neuropsychological test performance in Spanish-speaking older adults. J Clin Exp Neuropsychol 29:530–544

    Article  PubMed  Google Scholar 

  4. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders (DSM-IV). APA, Washington DC

    Google Scholar 

  5. Bornebroek M, Breteler MMB (2004) Epidemiology of non-AD dementias. Clin Neurosci Res 3:349–361

    Article  Google Scholar 

  6. Brodaty H, Low LF, Gibson L et al (2006) What is the best screening instrument for general practitioners to use? Am J Geriatr Psychiatry 14:391–400

    Article  PubMed  Google Scholar 

  7. Brown J, Pengas G, Dawson K et al (2009) Self-administered cognitive screening test (TYM) for detection of Alzheimer’s disease: cross sectional study. BMJ 338:b2030

    Article  PubMed Central  PubMed  Google Scholar 

  8. Bruandet A, Richard F, Bombois S, Maurage CA et al (2009) Alzheimer disease with cerebrovascular disease and vascular dementia: clinical features and course compared with Alzheimer disease. J Neurol Neurosurg Psychiatry 80:133–139

    Article  CAS  PubMed  Google Scholar 

  9. Callahan CM, Hendrie HC, Tierney WM (1995) Documentation and evaluation of cognitive impairment in elderly primary care patients. Ann Intern Med 122:422–429

    Article  CAS  PubMed  Google Scholar 

  10. Cordell CB, Borson S, Boustani M, Chodosh J et al (2013) Alzheimer’s Association recommendations for operationalizing the detection of cognitive impairment during the Medicare Annual Wellness Visit in a primary care setting. Alzheimers Dement 9:141–150

    Article  PubMed  Google Scholar 

  11. Cullum C, Thompson L, Smernoff E (1993) Three-word recall as a measure of memory. J Clin Exp Neuropsychol 15:321–329

    Article  CAS  PubMed  Google Scholar 

  12. Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB: a Frontal Assessment Battery at bedside. Neurology 55:1621–1622

    Article  CAS  PubMed  Google Scholar 

  13. Dubois B, Touchon J, Portet F, Ousset PJ et al (2002) “The 5 words”: a simple and sensitive test for the diagnosis of Alzheimer’s disease. Presse Med 31:1696–1699

    CAS  PubMed  Google Scholar 

  14. Economou A (2006) Intraindividual variability in memory test performance in middle aged and elderly persons from the community. J Clin Exp Neuropsychol 12(Suppl. 1):188

    Google Scholar 

  15. Evans DA, Grodstein F, Lowenstein D et al (2011) Reducing case ascertainment costs in the U.S. population studies of Alzheimer’s disease, dementia, and cognitive impairment-Part 2. Alzheimers Dement 7:110–123

    Article  PubMed Central  PubMed  Google Scholar 

  16. Guilmette T, Tshoh J, Malcolm C (1995) Orientation and three-word recall in predicting memory: age effects and false-negative errors. Neuropsychiatry Neuropsychol Behav Neurol 8:20–25

    Google Scholar 

  17. Hoops S, Naxem S, Siderowf AD, Duda JE et al (2009) Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease. Neurology 73:1738–1745

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Loewenstein DA, Acevedo A, Agron J et al (2009) The utility of a brief memory screen in the diagnosis of mild memory impairment in the elderly: preliminary study. Am J Geriatr Psychiatry 17:437–440

    Article  PubMed Central  PubMed  Google Scholar 

  19. McKhann G, Drachman D, Folstein M et al (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services task force on Alzheimer’s disease. Neurology 34:939–944

    Article  CAS  PubMed  Google Scholar 

  20. McKeith I, Mintzer J, Aarsland D, Burn D et al (2004) Dementia with Lewy bodies. Lancet Neurol 3:19–28

    Article  PubMed  Google Scholar 

  21. Mitchell A (2009) A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res 43:411–431

    Article  PubMed  Google Scholar 

  22. Morris JC (1993) The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 43:2412–2414

    Article  CAS  PubMed  Google Scholar 

  23. Nasreddine ZS, Phillips NA, Bédirian V et al (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53:695–699

    Article  PubMed  Google Scholar 

  24. Papageorgiou SC, Kontaxis T, Bonakis A, Kalfakis N, Vassilopoulos D (2009) Frequency and causes of early-onset dementia in a tertiary referral center in Athens. Alzheimer Dis Assoc Disord 23:347–351

    Article  PubMed  Google Scholar 

  25. Piguet O, Hornberger M, Shelley BP, Kipps CM, Hodges JR (2009) Sensitivity of current criteria for the diagnosis of behavioral variant frontotemporal dementia. Neurology 72:732–737

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Prestia A, Rossi R, Geroldi C et al (2006) Validation study of the three objects-three places test: a screening test for Alzheimer’s disease. Exp Aging Res 32:395–410

    Article  PubMed  Google Scholar 

  27. Rascovsky K, Hodges JR, Knopman D, Mendez MF et al (2011) Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 134:2456–2477

    Article  PubMed Central  PubMed  Google Scholar 

  28. Ravaglia G, Forti P, Maioli F et al (2005) Screening for mild cognitive impairment in elderly ambulatory patients with cognitive complaints. Aging Clin Exp Res 17:374–379

    Article  PubMed  Google Scholar 

  29. Royall DR, Cordes JA, Polk M (1998) CLOX: an executive clock drawing task. J Neurol Neurosurg Psychiatry 64:588–594

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. Stern Y, Sano M, Paulson J et al (1987) Modified Mini-Mental State Examination: validity and reliability. Neurology 37(Suppl. 1):179

    Google Scholar 

  31. Tombaugh TN, McIntyre NJ (1992) The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 40:922–935

    Article  CAS  PubMed  Google Scholar 

  32. Tröster AI (2011) A précis of recent advances in the neuropsychology of mild cognitive impairment(s) in Parkinson’s Disease and a proposal of preliminary research criteria. J Int Neuropsychol Soc 17:1–14

    Article  Google Scholar 

  33. Valcour VG, Masaki KH, Curb JD et al (2000) The detection of dementia in the primary care setting. Arch Intern Med 160:2964–2968

    Article  CAS  PubMed  Google Scholar 

  34. White T, Bauer R, Bowers D, Crosson B, Kessler H (1995) Recall of three words after five minutes: its relationship to performance on neuropsychological memory tests. Appl Neuropsychol 2:130–133

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

A preliminary version of this study was presented at the 21st Meeting of the European Neurological Society.

Conflicts of interest

The authors declare no financial or other conflict of interest.

Ethical standard

Treatment of human subjects, as well as all research procedures, was conducted using appropriate ethical guidelines.

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Authors and Affiliations

  1. Cognitive Neurology-Extrapyramidal Disorders Unit, 1st University Department of Neurology, Eginition Hospital, Medical School, University of Athens, Athens, Greece

    Sokratis G. Papageorgiou & Christopher Routsis

  2. Department of Psychology, School of Philosophy, University of Athens, Panepistimiopolis, Ilissia, 157 84, Athens, Greece

    Alexandra Economou

  3. Behavioral Neurology Unit, 2nd University Department of Neurology, ATTIKON University General Hospital at Haidari, University of Athens, Athens, Greece

    Sokratis G. Papageorgiou & Christopher Routsis

Authors
  1. Sokratis G. Papageorgiou
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  2. Alexandra Economou
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  3. Christopher Routsis
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Correspondence to Alexandra Economou.

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Papageorgiou, S.G., Economou, A. & Routsis, C. The 5 Objects Test: a novel, minimal-language, memory screening test. J Neurol 261, 422–431 (2014). https://doi.org/10.1007/s00415-013-7219-1

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  • DOI: https://doi.org/10.1007/s00415-013-7219-1

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