The TE4D-Cog: a new test for detecting early dementia in English-speaking populations

Int J Geriatr Psychiatry. 2005 Dec;20(12):1172-9. doi: 10.1002/gps.1412.

Abstract

Background: The screening test usually used to detect dementia (Mini Mental State Examination, MMSE) is limited by a ceiling effect and high false positive rates, as are other similar instruments. There is therefore a need for a more sensitive and specific screening tool to aid early detection and diagnosis of dementia.

Objective: The hypothesis of the study was that the TE4D-Cog would be more sensitive and specific than the MMSE in detecting mild cognitive impairment in patients with AD.

Method: The TE4D (Test for the Early Detection of Dementia from Depression) was adapted from its original German version for English-speaking populations. This new scale (the TE4D-Cog) was then administered together with the MMSE and the cognitive subscale of the Alzheimer's disease Assessment Scale (ADAS-Cog) to 178 people with a diagnosis of Alzheimer's disease and 25 cognitively intact comparators. The sensitivity and specificity in detecting dementia of the TE4D-Cog and the MMSE were compared in those with mild dementia and those without dementia.

Results: The TE4D-cog had high sensitivity with an acceptable specificity and low false positive rate. It also had good concurrent validity, high inter-rater reliability, good internal consistency and strong predictive validity.

Conclusions: The TE4D-Cog is easy to administer, short and acceptable. Results are independent of age, gender and level of education. The TE4D-Cog may therefore be a useful alternative to the MMSE as a dementia screening instrument.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / psychology
  • Cognition Disorders / diagnosis
  • Cognition Disorders / etiology
  • Female
  • Geriatric Assessment / methods
  • Humans
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Neuropsychological Tests*
  • Psychiatric Status Rating Scales
  • Psychometrics
  • Reproducibility of Results
  • Sensitivity and Specificity