Didier Maillet1,2, Fanny Matharan3,4, Hervé Le Clésiau5, Olivier Bailon6, Karine Pérès3,4, Hélène Amieva3,4, Catherine Belin1,7. 1. Unité fonctionnelle Mémoire et Maladies Neurodégénératives, Service de Neurologie, CHU Avicenne (AP-HP), Bobigny F-93009, France. 2. Laboratoire PSITEC EA 4072, UFR de Psychologie Université de Lille Pont de Bois BP 60149 Villeneuve d'Ascq Cedex F-59 653, France. 3. INSERM, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, Bordeaux F-33000, France. 4. Université de Bordeaux, Bordeaux F-33000, France. 5. Centre d'Examens de Santé de la Caisse primaire d'Assurance Maladie de la Seine-Saint-Denis, Bobigny F-93009, France. 6. Service de neurologie, CHU Avicenne (AP-HP), Bobigny F-93009, France. 7. Laboratoire de psychopathologie et de neuropsychologie clinique EA 4057, Institut de psychologie, Université Paris Descartes, Boulogne-Billancourt F-92774, France.
Abstract
OBJECTIVE: To validate the TNI-93 test in illiterate and low-educated subjects by setting cutoff scores to discriminate non-demented and demented subjects in a clinical setting (CESILL) and verifying the adequacy of these cutoff scores in a population-based study (AMI cohort). METHOD: We used two study samples. First, a clinical setting (CESILL) comprising normal elderly participants and demented patients, mostly multicultural, low educated, or illiterate, was used to compute the cutoff scores of TNI-93 for the detection of dementia. Second, the AMI cohort, a population-based cohort of retired farmers living in a rural setting, was used as a replication study, to assess the detection properties of the cutoff scores in a different population composed mostly of low-educated older people. RESULTS: When combining the two scores, that is, free recall <6 or total recall <9, TNI-93 can detect dementia with a high sensitivity (87%) and specificity (96%), in the CESILL setting. These cutoff scores were roughly similar in the AMI cohort with high sensitivity (80% sensitivity) and specificity (81% specificity). In both study samples, the level of education had no effect on performance. CONCLUSIONS: The TNI-93 appears to be a good test to detect dementia. The absence of a significant effect of education level on the performances makes the TNI-93 a tool of choice in the screening of dementia in illiterate/low-educated subjects.
OBJECTIVE: To validate the TNI-93 test in illiterate and low-educated subjects by setting cutoff scores to discriminate non-demented and demented subjects in a clinical setting (CESILL) and verifying the adequacy of these cutoff scores in a population-based study (AMI cohort). METHOD: We used two study samples. First, a clinical setting (CESILL) comprising normal elderly participants and demented patients, mostly multicultural, low educated, or illiterate, was used to compute the cutoff scores of TNI-93 for the detection of dementia. Second, the AMI cohort, a population-based cohort of retired farmers living in a rural setting, was used as a replication study, to assess the detection properties of the cutoff scores in a different population composed mostly of low-educated older people. RESULTS: When combining the two scores, that is, free recall <6 or total recall <9, TNI-93 can detect dementia with a high sensitivity (87%) and specificity (96%), in the CESILL setting. These cutoff scores were roughly similar in the AMI cohort with high sensitivity (80% sensitivity) and specificity (81% specificity). In both study samples, the level of education had no effect on performance. CONCLUSIONS: The TNI-93 appears to be a good test to detect dementia. The absence of a significant effect of education level on the performances makes the TNI-93 a tool of choice in the screening of dementia in illiterate/low-educated subjects.