The "Time and Change" Test: An Appropriate Method to Detect Cognitive Decline in the Elderly

Abstract

The Time and Change (T&C) test is an easy and time-saving test validated for the detection of dementia. Our aim was to determine how geriatric features like depression, disability, and comorbidity are able to influence the result of the T&C and, consequently, to decide whether it could be a reliable screening test for cognitive impairment in the elderly. A total of 220 participants (mean age = 75.8+/-9.6 years, 63.7% females) underwent the T&C, Mini-Mental State Examination, and the Clock Drawing Test; Activities of Daily Living, Instrumental Activities of Daily Living, comorbidity, and depression were also evaluated. Time and Change-positive participants were older, had poorer cognitive tests, and had higher levels of disability and comorbidity than participants testing negative. Multivariate analysis showed that cognitive impairment and comorbidity were the only features that influenced the T&C, regardless of age, education, disability, and depression. We conclude that the T&C should be implemented in primary care because it quickly identifies elderly patients with cognitive impairment who need a more accurate evaluation.

Validating the Time and Change test to screen for dementia in elderly Koreans

“…The Time and Change (T&C) test was developed by Inouye et al [11] to assess (i) how well a patient understands time and (ii) the ability of the patient to calculate using money. Several studies have found that the T&C test allows direct assessment of two important activities of daily living and supplements the testing of calculation, conceptualization, and visuospatial cognitive domains irrespective of race and education [11-13]. …”

Being Well, Being Musical: Music Composition as a Resource and Occupation for Older People

“…Challenges that face the ageing population include poor motivation in self care (Mussi et al 2002), dissociative states that include depression and in some cases suicidal ideation (Rubin andHewstone 1998, De Leo et al 2001), loneliness (Bruce et al 2007), emotional distress (Scott et al 2001) and impaired quality of life (Hassell et al 2006). Such challenges indicate the more negative outcomes arising from the enormous social transformation that an ageing population may experience upon entering a later stage of life.…”

Overactive bladder medicines and cognitive testing

“…After all, the same study identified darifenacin as being five times more constipating than oxybutynin, and 10 times more so than placebo, a side effect that few patients are likely to brush aside. While the Name‐Face Association Test possesses good test–retest reliability and ecological validity, it does not appear to possess the same validity as other tests, such as the Time and Change test, in detecting dementia and cognitive impairment in elderly people (10,11). Cognitive testing should include a comprehensive analysis of the aforementioned tasks in order to best identify the effects of OAB agents on all aspects of cognition, rather than simply the most salient features.…”