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: ccarnerop@supercable.es Acknowledgment: Partially supported by SAS (Exp. 230/00)