Normative data for the Tygerberg Cognitive Battery and Mini-Mental Status Examination in a South African population

Roos, Annerine; Calata, Dorothy; Jonkers, Liesl; Maritz, Stephan J.; Kidd, Martin; Daniels, Willie M.U.; Hugo, Frans J.

doi:10.1016/j.comppsych.2009.03.007

« Previous Next »Comprehensive Psychiatry
Volume 51, Issue 2 , Pages 207-216, March 2010

Normative data for the Tygerberg Cognitive Battery and Mini-Mental Status Examination in a South African population

Annerine Roos
- Department of Psychiatry, University of Stellenbosch, Tygerberg 7505, South Africa
- Corresponding author. Tel.: +27 21 938 9756; fax: +27 21 933 5790.
Dorothy Calata
- Department of Psychiatry, University of Stellenbosch, Tygerberg 7505, South Africa
Liesl Jonkers
- Department of Occupational Therapy, University of Stellenbosch, Tygerberg 7505, South Africa
Stephan J. Maritz
- Medical Research Council of SA, Biostatistics Unit, Tygerberg 7505, South Africa
Martin Kidd
- Department of Statistics and Actuarial Sciences, University of Stellenbosch, Matieland 7602, South Africa
Willie M.U. Daniels
- Discipline of Physiology, University of KwaZulu-Natal, Durban 4000, South Africa
Frans J. Hugo
- Armadale Health Services, Department of Health, Armadale, WA 6112, Australia

published online 20 April 2009.

Abstract

Background

Normative data for the Tygerberg Cognitive Battery (TCB) and Mini-Mental Status Examination (MMSE) (in South Africa) have not been formally examined before. The TCB was developed for the bedside pen-and-paper screening of cognitive impairment in each of the 6 main cognitive domains, including attention and concentration, speech, memory, praxis, gnosis, and executive functioning. The test is also used to diagnose different neuropsychiatric conditions. The MMSE is an established screen of cognitive status, which is often used as a comparative standard for novel screening tests such as the TCB. The TCB was initially developed in English and Afrikaans, and a Xhosa version was also initiated with this study so that the 3 most common languages of the region could be accommodated.

Aims

The first aim of the study was to estimate normative test performance on the TCB and MMSE among controls, and the second aim was to develop a Xhosa version of the TCB.

Methods

Assessments of the TCB and MMSE were carried out in a population of healthy individuals (n = 157). In addition, healthy Xhosa-speaking participants (n = 14) were screened using a Xhosa version of the TCB.

Results

Reliability scores for all forms of the TCB were satisfactory. Age and education correlated significantly with TCB scores (r = −0.26, P < .01; r = 0.64, P < .01, respectively), whereas only education significantly correlated with MMSE scores (r = 0.32, P < .05). Normative values were calculated accordingly, that is, controlled for the effects of age and education. The TCB scores also correlated significantly with MMSE scores (r = 0.49, P < .05), demonstrating the potential of the TCB to serve as an alternate cognitive assessment tool, along with the MMSE, to focus neuropsychiatric investigations. Scores on the Xhosa version differed significantly on speech, praxis, and gnosis between the Afrikaans and English participant scores.

Conclusion

These normative data can be used to increase precision and to provide an impartial evaluation when applying TCB to evaluate the cognitive ability of neuropsychiatrically impaired adult patients. However, age and education effects should be considered when computing the results of cognitive assessment.