the money test

P04-035
THE MONEY TEST
C Carnero*, MS Barquero**, MA Payno**, A Frank***, M Baquero, F Lacruz, JM Manubens, B Indakoetxea, ML Martínez, C Antúnez, V Bueno,
on behalf the “Money Test Group”. *H. Torrecárdenas, Almería; **H. Clínico San Carlos, Madrid; *** H. La Paz, Madrid; Spain.
Background
Methods
Results
Conclusions
The majority of screening tests to detect cognitive
impairment are strongly influenced by educational
level, and most of them are not useful for illiterate
subjects.
The MT was administered to 309 subjects older than
60 years-old without cognitive impairment
or
dementia, recruited from the general neurology
clinics. For each subject different parameters were
controlled: age, gender, handling of coins (never,
occasionally, frequent), years of education (none,
less than 10, more than 10), educational level
(illiterate, can read and write but not fluently, can
read and write fluently) and the neurological problem
to attend the clinic (potential capability to induce or
not cognitive impairment). Multiple linear regression
was performed to examine the relationship between
the total score of the MT and qualitative variables of
interest. A factorial analysis of the MT was
performed by the principal component method with
Varimax rotation.
305 subjects (98.7%) concluded the MT in 4.7+ 1.7
minutes (fig. 2) with scores of 24±3 (fig 3) with a
median =25 and score of 20 and 18 for percentiles
10 and 5, respectively. The distribution of subjects
according to years of education, educational level
and handling of coins is presented in graphics. The
total score was not influenced by gender, years of
education or neurological problem, but was
influenced by age (>70 y.o. β= -1.37 p<0.001),
handling of coins (never= ref.; occasionally: β= 2.15
p<0.001; frequent: β= 3.68 p<0.001), and
educational level (illiterate =ref.; no fluent read and
write: β= 2.38 p<0.001; fluent: β= 3.32 p<0.001).
(Table 1). The 4 factors with autovalue >0.9
attained the 64% of the variance of the MT score
and were independently correlated with the memory
and fluency items (the first), calculations (second)
and recognition (third), the last factor had a
negative correlation with intrusions number in
fluency tasks (Table 2).
The MT is easy to perform, fast, ecological and
well accepted by the subjects. It was
concluded for most subjects, including illiterate
subjects. The total score is not influenced by
years of education but it is influenced by
educational level. The factorial design
suggests that the MT explores different
cognitive domains, specially memory and
calculation, in an independent way. Moreover,
it can evaluate indirectly the functional
capability of the subject and his/her social
adaptation. It is useful to be applied to any
culture or country.
These circunstances imply that the utility of these
screening tests is very low in populations with a high
prevalence of low educational level subjects, in which
there will be more convenient to apply tools not
influenced by education and feasible to perform by
illiterate subjects.
Objective
Design and evaluation of a screening test to detect
cognitive impairment in low educational level
populations, to be applied to illiterate subjects.
Design
Fig. 3: Scores
Fig. 2: Time (minutes)
The Money Test (MT) is based on the knowledge
and practical use of 12 local coins, exploring items of
recognition, recall, handling, calculation and memory
of the used coins. (Figure 1; AppendixI)
100
60
50
80
Table 1: Factorial Analysis
40
60
30
n = 305
40
20
APPENDIX
20
The Money Test
I am going to explore your memory, please listen carefully to everything that follows.
Do you remember how many different legal coins are there in Spain at this moment? Pay
you special attention to the fact that the question is about coins and not about bills.
1
5
10
25
50
100
200
500
2000
Other (especificar):
Total corrects:
Intrusions:
Put all the coins in front of the subject, grouped by value and remember the subject to
pay attention because there will be questions about these tasks later.
(2 of 100 pts, 4 of 25 pts, 6 of 5 pts.)
Recognition of coins (pointing to one of each value).
5 pts
25 pts
100 pts
Correct
Incorrect
Correct
Incorrect
Correct
Incorrect
Mixed all the coins.
How many coins are there in here? (12)
Answer:
Correct
Incorrect
Can you change this coin for others with less value?
(pointing one coin of 100 pts)
Correct
Incorrect
How much money is in here? (330 pts)
Answer:
Correct
Incorrect
Please, divide these coins in two groups, each one with the same value. (165 pts)
Correct
Incorrect
Please, divide these coins in three groups, each one with the same value. (110 pts)
Correct
Incorrect
Retire the coins.
Do you remember how many different legal bills are there in Spain at this moment? Listen
that the question is now about bills and not about coins.
1000
2000
5000
10000
Others (to specify):
Total corrects:
Intrusions:
How many coins did I show you before?
Answer:
Correct
Incorrect
How much money was there in total?
Answer::
Correct
Incorrect
Do you remember which coins have you seen? (One correct point in ”Number of coins” and “coin
value”. Maximum 6 points)
Nunber of Coins
Coins Valiums
__ 6
5 __
__ 4
25 __
__ 2
100 __
TOTAL
10
0
2
3
4
Correct Coins
0.55
0.33
0.38
0.14
Intrusion Coins
0.14
0.25
0.08
-0.75
Correct Bills
0.51
0.34
0.34
0.32
Intrusion Bills
0.19
0.02
0.06
-0.83
Recognition 5
0.37
0.09
0.63
0.20
Recognition 25
0.12
0.19
0.77
0.1
Recognition 100
0.07
0.16
0.82
0.05
Counting
0.05
0.81
0.08
0.08
Change
0.22
0.65
0.31
0.05
Adding
0.48
0.48
0.27
0.14
Dividing x 2
0.44
0.62
0.15
0.09
Dividing x 3
0.62
0.44
0.10
0.16
Recall number
0.78
0.10
0.04
0.09
Quantity recall
0.81
0.06
0.16
0.15
Coins recall
0.62
0.39
0.41
0.18
0
1,0
2,0
3,0
4,0
5,0
6,0
7,0
8,0
9,0
TIEMPO
10,0
11,0
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
TOTAL
Years of Education
Educational Level
Educational Level
13,53%
Fig.1
Factors
1
None
Less than 10
More than 10
41,91%
44,55%
24,34%
68,75%
Handling of coin
Handling of Coins
4,33%10,33%
85,33%
Illiterate
6,91%
Never
Occasionally
Frequent
Non fluent read
and write
Fluent
Money Test Group
H.Universitario La Paz – Madrid H. Ntra.Sra. Aranzazu - San
H. Torrecárdenas – Almería
Sebastián
Anna Frank García
Cristóbal Carnero Pardo*
Begoña Indakoetxea
Antonio Tallón Barranco
Elena Márquez Báez
Juanbeltz
Ángel García González
Teresa García López
Pedro Guardado Santervás H.Universitario La Fe – Valencia H. Virgen de las Nieves Granada
Jesús Olivares Romero
Miguel Baquero Toledo
Rosa Vilches Carrillo
Pedro Serrano Castro
Anabel Campos
H. Virgen del Camino - Pamplona
Teresa Montoro Ríos
H.Gómez Ulla – Madrid
José M. Manubens Bertrán
H. General Yagüe – Burgos
Julio Ferrero Arias
H. Clínico San Carlos - Madrid
Miguel Góñi Imízcoz
Clínica San Rafael - Cádiz
Sara Merino
María S. Barquero Jiménez
Pedro A. Sánchez Ayaso
H.Virgen de la Arrixaca – Murcia
María A. Payno Vargas
Carmen Antúnez Almagro H.Virgen de la Macarena - Sevilla H. General Universitario - Murcia
Carlos Martínez Parra
Rafael Carles Díez
Mª Luisa Martínez Navarro
José Manuel Gata Gata
H. de Navarra – Pamplona
H. Río Carrión - Palencia
H.Vega Baja - Orihuela
Francisco Lacruz Bescos
Valentín Bueno Rodríguez
Isabel Aramendia Etxeberria
Ángel Pérez Sempere
H. Marina Alta - Denia
H.Cruz Roja Española – Córdoba Santiago Mola Caballero de Rodas
Jaume Morera Guitart
Antonio Arjona Padillo
Fundación Hospital Alcorcón
H. 12 de Octubre - Madrid
José Luis Dobato Ayuso
Jaime Díaz Guzmán
*Actualmente en el Hospital Virgen de las Nieves (Granada, Spain)
e-mail: [email protected]
Acknowledgment:
Partially supported by SAS (Exp. 230/00)