Cognitive screening tools for primary care settings: examining the ‘Test Your Memory’ and ‘General Practitioner assessment of Cognition’ tools in a rural aging population in Greece

Figures & data

Table 1. Community sample demographics by cognitive impairment risk group.

	Entire sample (n = 319)	MMSE ≤23 (n = 81)	MMSE ≥24 (n = 238)
Gender, n (%)^b
Women	206 (64.6)	61 (75.6)	145 (61.0)
Men	113 (35.4)	20 (24.4)	93 (39.0)
Age (mean ± SD in years)^a	71.0 ± 6.9	74.2 ± 7.0	70.1 ± 6.5
Age groups, n (%)^a
60–69	153 (48.3)	24 (29.5)	129 (54.4)
70–79	123 (38.6)	36 (44.9)	87 (36.5)
80–89	43 (13.2)	21 (25.6)	22 (9.1)
Education (mean ± SD in years)^a	6.4 ± 3.1	4.8 ± 2.5	6.8 ± 3.1
Education groups, n (%)^c
0–6	261 (81.8)	75 (92.2)	186 (78.3)
7–12	48 (15.1)	6 (7.7)	42 (17.5)
≥13	10 (3.1)	–	10 (4.2)
Past occupation, n (%)^d
Farmer	122 (38.1)	24 (29.8)	98 (40.6)
Labourer	27 (8.6)	3 (4.3)	24 (9.4)
Housekeeper	84 (26.3)	33 (40.4)	51 (23.1)
Clerical	44 (13.7)	5 (6.4)	39 (15.0)
Technician	15(4.7)	4 (4.3)	11 (4.7)
Educator	2 (0.7)	–	2 (0.9)
Business owner	25 (7.9)	12 (14.9)	13 (6.4)
Family status, n (%)
Single	6 (1.8)	3 (3.4)	3 (1.3)
Married	231 (72.3)	50 (61.8)	181 (75.8)
Widowed/divorced	82 (25.9)	28 (34.8)	54 (22.9)

^a P <0.0001,

^b P = 0.01,

^c P = 0.015,

^d P = 0.02.

Table 2. Community sample clinical characteristics and performance on MMSE, TYM, and GPCog by cognitive impairment risk group.

	Entire sample (n = 319)	MMSE ≤23 (n = 81)	MMSE ≥24 (n = 238)
Depression (%)	46 (14.5)	17 (21.0)	29 (12.8)
Dementia (%)^a	12 (3.9)	11 (13.4)	2 (1.3)
PD (%)	3 (1.0)	2 (2.4)	1 (0.7)
CVA (%)	6 (1.8)	3 (3.7)	3 (1.3)
Functionality^a
Fully independent (%)	167 (52.5)	51 (62.2)	196 (82.2)
Partly dependent (%)	152 (47.5)	30 (37.8)	42 (17.8)
MMSE
Mean ± SD	26.0 ± 3.2	21.3 ± 2.0	27.5 ± 1.8
Range	14–30	14–23	24–30
TYM
Mean ± SD	38.5 ± 7.9	30.5 ± 8.3	41.1 ± 5.7
Range	2–50	2–45	19–50
GPCog
Mean ± SD	6.8 ± 2.2	4.8 ± 2.4	7.4 ± 1.7
Range	1–9	1–9	2–9

^a P < 0.0001.

PD: Parkinson’s disease; CVA: cerebrovascular accident.

Table 3. Associations between demographic characteristics, TYM, MMSE and GPCog total scores. Zero-order Pearson correlations are shown above the diagonal and partial correlations controlling for age and education below the diagonal.

	MMSE	TYM	GPCog
Age	–0.41^a	–0.45^a	–0.45^a
Education	0.39^a	0.49^a	0.38^a
MMSE	1	0.75^a	0.69^a
TYM	0.66^a	1	0.70^a
GPCog	0.59^a	0.58^a	1

^a P = 0.0001.

Figure 1. Receiver Operating Characteristic Curves of TYM (upper panel) and GPCog scores (lower panel) for detecting risk of cognitive impairment based on MMSE performance.

Table 4. Sensitivity and specificity for identifying at risk individuals using TYM and GPCog scores against MMSE-defined cognitive impairment risk. Optimal cut-off values associated with maximum J index (Sensitivity + Specificity –1).

	TYM	GPCog
Cut-off	35/36 or 38/39^a	7/8
Sensitivity	0.80	0.89
Specificity	0.77	0.61
Positive predictive value	0.47	0.38
Negative predictive value	0.93	0.95

^a 35/36 for persons with ≤5 years of education and 38/39 for persons with ≥6 years of education.

Figure 2. Bland–Altman plots illustrating the distribution of standardized score differences for each pair of tests (MMSE minus TYM in the left-hand panel and MMSE minus GPCog in the right-hand panel) as a function of corresponding average scores.