Validating an Australian version of the Time and Change Test: A screening test for cognitive impairment

Objectives: The 'Time and Change Test' - a brief cognitive screening test has been validated in several countries to assess cognitive impairment. We attempted to validate an Australian version of the test among hospital inpatients. Methods: One hundred and thirty patients consented to participate in the study. They underwent an assessment for a Diagnostic and Statistical Manual of Mental Disorders (DSM IV) diagnosis for dementia or delirium, the Mini-Mental State Examination and the Time and Change Test. Results: The Time and Change Test had a sensitivity of 44% (95% CI; 23%, 66%) and a specificity of 90% (**80%, 96%) for a DSM IV diagnosis of dementia or delirium. Conclusions: This version of the Time and Change was less sensitive than other versions. The sensitivity of the test came from the change component, and reduced complexity of this task may account for this finding. We recommend study of a more complex change-making test as a screening tool for cognitive impairment.