Teste do Tempo & Troco: Estudo de validação
Bibliographic record
Abstract
Objectivo: O nosso estudo teve como objectivo validar o Teste Time and Change (T&C) na população portuguesa. O T&C é um instrumento útil e eficaz para detectar demência na população idosa, avaliando duas actividades básicas do quotidiano. Método: A amostra geral do nosso estudo é constituída por 401 idosos, dos quais 96 (23,9%) são do sexo masculino e 305 (76,1%) do sexo feminino, com idades que variam entre 65 e 100 anos, e que se encontram sob resposta social (lares ou centros de dia) no Concelho de Coimbra. Para além do T&C, estes idosos foram avaliados com o Mini-Mental State Examination (MMSE), para avaliar o defeito cognitivo; Montreal Cognitive Assessment (MoCA), para avaliar o declínio cognitivo, com o Geriatric Anxiety Inventory (GAI), para os sintomas ansiosos e com o Geriatric Depression Scale (GDS) para os sintomas depressivos. Resultados: O T&C com o MoCA apresenta uma sensibilidade de 82,7%, uma especificidade de 65,7%, um PPP de 71,1% e um PPN de 78,7%. Na validade de critério concorrente com o MMSE, o T&C exibe uma sensibilidade de 79,6%, uma especificidade de 60,1%, um PPP de 65,0% e um PPN igual a 76,0%. Utilizando como padrão de referência o MoCA, o T&C é mais sensível a diagnosticar demência em indivíduos com escolaridade. Por outro lado, usando como padrão de referência o MMSE, o T&C é mais sensível em idosos sem escolaridade. Quanto mais velhos são os indivíduos, maior é a capacidade do T&C de diagnosticar demência, independente do padrão de referência usado. Na estabilidade temporal teste-reteste de duas horas e de seis meses o T&C apresentou concordâncias moderadas. Quanto à validade convergente, o T&C exibe uma correlação moderada com o MoCA e baixa com o MMSE. Cinquenta virgula seis por cento dos idosos pontuou positivamente no teste; este valor indica que a maioria dos idosos possui demência. Não houve associações estatisticamente significativas entre o resultado global do T&C e as variáveis sociodemográficas, onde os idosos mais velhos têm desempenhos inferiores (36,3%). Por fim, verificámos que não existem associações estatisticamente significativas entre a sintomatologia depressiva e a sintomatologia ansiosa e o declínio cognitivo. Conclusão: Este estudo mostra que a versão portuguesa do teste T&C é fidedigno e válido para a população idosa portuguesa, sob resposta social e baixa escolaridade. Os elevados valores no T&C apontam para a urgência de estratégias de intervenção. / Purpose: Our study aimed to validate the Time and Change Test (T&C) in the Portuguese population. The T&C is an useful and effective instrument for detecting dementia in the elderly population, assessing two basic activities of daily life. Method: The overall sample of our study consists of 401 seniors, of whom 96 (23.9%) were male and 305 (76.1%) female, with ages ranging between 65 and 100 years, and who are in social response (nursing homes or day centers) in the Municipality of Coimbra. In addition to the T&C, these elderly were assessed with the Mini-Mental State Examination (MMSE) to detect the cognitive defect; the Montreal Cognitive Assessment (MoCA) to assess cognitive decline; the Geriatric Anxiety Inventory (GAI) for anxiety symptoms, and the Geriatric Depression Scale (GDS) for depressive symptoms. Results: The T&C with the MoCA has a sensitivity of 82.7%, a specificity of 65.7%, a PPP of 71.1% and 78.7% of a NPP. In the concurrent criterion validity with the MMSE, the T&C exhibits a sensitivity of 79.6%, a specificity of 60.1%, a PPP of 65.0% and a NPP equal to 76.0%. Using as benchmark the MoCA, the T&C is more sensitive to diagnose dementia in individuals with some type of schooling. On the other hand, using as a reference standard the MMSE, the T&C is more sensitive in the elderly with no schooling. The older individuals, the higher the T&C's ability to diagnose dementia, independent of the reference standard used. In T&C test-retest stability over time of two hours and of six months showed moderate agreement. As to convergent validity, the T&C exhibits a moderate correlation with the MoCA and low with the MMSE. Fifty point six percent of seniors scored positively in the test, this value indicates that most older people have dementia. There were no statistically significant associations between the overall result of the T&C and the sociodemographic variables, where the oldest old have lower performance (36.3%). Finally, we found that there are no statistically significant associations between depressive symptoms and anxiety symptoms and cognitive decline. Conclusion: This study shows that the Portuguese version of the T&C test is reliable and valid for elderly Portuguese, under low education and social response. The high values in the T&C points to the urgency of intervention strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.071 | 0.192 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".