On 11 Jun 2009 at 13:49, Rick Froman wrote:

> I understand the principle here, and this may have already been addressed,
> but is the number of 65-69 year olds per thousand with dementia the
> appropriate comparison group? Unless we are going to deploy this test
> willy-nilly on all 65-69 year olds (for example, when they show up to
> renew their driver's license or each time they go to the doctor along with
> their weight and bp), it seems that someone taking a screening test for
> Alzheimer's is probably already in a select population of individuals who
> are showing some symptoms or evidence of a disorder.

Given its ease of administration, and the fact that people can give it to 
themselves in five minutes, I think there's a good chance that anyone who 
ever forgets a name will want to take this test to reassure themselves 
that they don't have Alzheimer's (and then find out the opposite). 

In addition, screening means that _everyone_ gets tested, whether they 
show symptoms or not. The 65-69 range seems to me the target population, 
as this is exactly the age when people are essentially symptomless but 
are starting to worry about it (trust me). 
 
> I think the test itself is also pretty humorous. With its questions like,
> "Who is the Prime Minister?" "In what year did the 1st World War start?",

Yes, it's unfortunate that they chose items which are clearly specific to 
a British population, which suggests a rather haphazard approach to test 
construction. These are easily adjusted to make the test more suitable 
internationally, but then there will be a need to re-do the validation. 
Not an impressive move on their part, and another indication that this is 
a bad test.

> I think its secret purpose might be to declare the average USA citizen
> demented 

Well. isn't he? After all, he put up with Bush for 8 years. 'Though he 
does seems to be in remission at the moment.

If interested, you may now admire my rapid response to BMJ at
http://www.bmj.com/cgi/eletters?lookup=by_date&days=1
(Scan down a page or so to "TYM test: too many false positives".)

You knew this was what I was up to, didn't you?

Stpehen

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Stephen L. Black, Ph.D.          
Professor of Psychology, Emeritus   
Bishop's University      e-mail:  [email protected]
2600 College St.
Sherbrooke QC  J1M 1Z7
Canada

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