Test of gestures (TEGEST) for a brief examination of episodic memory in mild cognitive impairment

Czech version

Authors: A. Bartoš ^1,2
Authors‘ workplace: Neurologická klinika 3. LF UK a FN Královské Vinohrady, Praha ¹; Národní ústav duševního zdraví, Klecany ²
Published in: Cesk Slov Neurol N 2018; 81(1): 37-44
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn201837

Overview

Aim:
A quick and simple examination can detect early impairment of episodic memory. The aim of the study was to develop an original Czech test which would simulate episodic memory and could be administered without any aids anytime and anywhere.

Participants and methods:
Participants demonstrated six gestures symbolic for all human senses (twice for sight) as instructed by the administrator in a new test of gestures (TEGEST). Then, they were asked to carry them out in the same sequence again immediately and after a 20-min distraction. The TEGEST and Montreal cognitive assessment (MoCA) were administered to 25 individuals with mild cognitive impairment and 25 socio-demographically paired subjects with normal cognitive functions divided according to zhe results of neuropsychological tests.

Results:
Individuals with mild cognitive impairment (MoCA 23 ± 4 points) recalled a significantly smaller number of gestures than normal elderly people (MoCA 27 ± 3 points): 4 ± 1 vs. 5 ± 1 gestures (p = 0.008). However, the two groups did not differ in the low number of correct sequences of gestures (two). The number or sequence of gestures were not related to age, education, or gender. The number of recalled gestures correlated with the MoCA score (r = 0.7; p = 0.001). The optimal cut-off score was ≤ 4 correctly recalled gestures (sensitivity 84%; specificity 48%; area under the receiver operating characteristic curve = 0.70).

Conclusion:
The novel six-gesture test (TEGEST) is a one- or two-minute and easy-to-use instrument which may signal mild cognitive impairment by four or fewer recalled gestures.

Key words:
memory – mild cognitive impairment – Alzheimer‘s disease – dementia – neuropsychological tests – screening – test – gestures – TEGEST

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

对轻度认知障碍患者情景记忆的简单检查-手势测试（TEGEST）

目标：

一个快速简单的检查可以检测到情景记忆的早期损害。这项研究的目的是改良一个原始的捷克测试，它可以模拟情景记忆，并且可以在任何时间和任何地方无需任何辅助器具进行测试。

参与者和方法：

参与者按照管理人员在新的手势测试（TEGEST）中的指示，展示象征着人类所有感官（包括两次视觉）的六种手势。然后，他们被要求立即再次以相同的顺序执行，并在20分钟后休息。 TEGEST和蒙特利尔认知评估（MoCA）对25名轻度认知障碍患者和25名社会人口统计学配对的受试者进行测试，根据这些受试者的神经心理学测试结果进行分类。

结果：

轻度认知功能障碍患者（MoCA 23±4分）回忆的手势数量明显少于正常老年人（MoCA 27±3分）：4±1 vs. 5±1个手势（p = 0.008）。然而，这两组在手势的正确序列数量较少时没有差异（两个）。手势的次数或顺序与年龄，教育或性别无关。召回手势的次数与MoCA评分相关（r = 0.7; p = 0.001）。最佳截断分数≤4正确召回手势（敏感性84％;特异性48％;受试者工作特征曲线下面积= 0.70）。

结论：

新型的六手势测试（TEGEST）是一种耗时极少且易于操作的检查，它通过四次或更少的召回手势来表现轻微的认知障碍。

关键词：

记忆 - 轻度认知障碍 - 阿尔茨海默病 - 痴呆 - 神经心理测试 - 筛查 - 测试 - 手势 - TEGEST

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