What is the TYM test?
British medical researchers have created a new cognitive test that detects Alzheimer’s disease quickly and accurately. The self administered test, known as TYM or “test your memory”, was developed at Addenbrooke’s Hospital.
Although the mental illness known widely as “dementia” is quite common, with a prevalence of around 13 for every 1000 people aged 65-69 and 122 in 1000 in those over 80, only about half of people affected by this debilitating disease are ever diagnosed. This new test, that evaluates a patient’s cognitive ability, appears to be faster and more accurate than current tests in detecting early dementia, according to the British researchers that developed it. The best news about TYM may be that you can give the test to yourself. No need for a doctor’s visit or a copay.
The TYM test “shows great promise as a screening test for Alzheimer’s or in monitoring response to treatment,” according to lead researcher Dr. Jeremy Brown, who is a consultant neurologist at Addenbrooke’s Hospital in Cambridge. However, he said, “so far it has only been tested in one clinical scenario, and it needs assessment in others.”
People can take the test, which exists as a kind of questionnaire, on their own. However, the results of the test still need to be interpreted by medical professionals and if a medical solution can be found for possible dementia, that too will require a doctor’s care.
Though many in the media are saying so, the researchers do no believe that TYM is a diagnostic test for Alzheimer’s disease. The closest that the Addenbrooke’s Hospital researchers will come to saying this — “It could be useful in identifying people who need further evaluation.” A good TYM score means that it is very unlikely for a specific patient to develop Alzheimer’s. On the flip side, a poor TYM score could have several causes and even more outcomes, such as anxiety or dyslexia. However, a low TYM score does increase the chances that a patient could develop Alzheimer’s disease.
The report is published in the June 9 edition of the British Medical Journal.
How did the TYM test come about? Brown and his fellow researchers gave the TYM exam to nearly 600 people, aged 18 to 95 years old. These subject had no history of neurological disease or brain injury. Brown et al also gave the exam to 139 people who had been diagnosed with Alzheimer’s or other cognitive impairment or memory troubles. They then compared the results of the TYM exam with two more commonly used cognitive tests: the “mini mental state examination” and the ‘Addenbrooke’s cognitive examination”, which the participants also were given.
For the TYM, people are usually asked to complete a set of 10 tasks that test their ability to do various mundane things, like give a word’s meaning, copy a sentence, and to do simple math calculations. The test also included some simple “recall” abilities as well testing the patient’s verbal skills. Each task can earn the subject a maximum of 50 points.
An example TYM question might be “Name four animals beginning with the letter “S”.
People who had no history of mental problems took an average of five minutes to complete the test. Their average score on these various tests was a healthy 47 — remember that 50 is the maximum average. However, people with Alzheimer’s or other mental impairment took much longer to finish the test (an average of 11 minutes) and earned an average score of just 33. People with mild memory problems or past head injuries had an average score of 45, the researchers found.
The TYM far outperformed older tests given by the researches, successfully identifying 93 percent of patients with Alzheimer’s. In contrast, the “mini mental state examination” identified a much smaller 52 percent of Alzheimer’s patients, suggesting that the TYM test is more sensitive in detecting mild cases of Alzheimer’s disease. Not to mention that the TYM takes far less time to complete than the mini mental state examination, once thought to be the best tool for identifying the presence of Alzheimer’s disease.
Speaking on behalf of the TYM exam, William Thies, who is vice president of medical and scientific affairs at the Alzheimer’s Association, said “I think the TYM exam needs to be tried in many more places with many more people before it can be widely used.”
Thies is worried about the test’s credibility, and about the buzz the researchers have garnered in a very short time. And Thies has a good point — any medical diagnostic test needs to be tested across broad portions of various population. To be widely accepted, the TYM test needs to take into account the cultural and language differences of different populations. Thies was also skeptical about the small sample size origianlly tested with TYM — just around 660 test subjects. This is hardly a large enough pool to determine if a diagnostic is a success.
If the TYM test meets all of these criterion, it could be a useful tool in identifying people who do not need further evaluation for Alzheimer’s, and allow doctors working with dementia patients to focus on those with legitimate need. In other words, TYM looks like a remarkable tool for triage.
Without a proper diagnosis, patients and care providers cannot access the medical services they need, meaning earlier diagnosis is key to living with dementia. However, early diagnosis is not easy, and as of now, no definitive test exists.
The TYM test was designed to lessen the test operator’s time spent working, and to be suitable for non Dementia specialists to use effectively. The TYM can be completed quickly and accurately under normal circumstances. It is being celebrated as a powerful and valid screening test for the detection of Alzheimer’s disease.
If TYM — test your memory — is to be adopted more widely, though, it has a few hurdles to overcome. Should TYM be altered to take into account a wide range of populations, we could begin to see TYM used in hospitals and doctor’s offices across the world.
For more information about the TYM test, visit: