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Updated: Jun 22, 2026

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
Self administered cognitive screening test (TYM) for detection of Alzheimer's disease: cross sectional study
Jeremy Brown1, George Pengas, Kate Dawson
1Department of Neurology, Addenbrooke's Hospital, Cambridge CB2 2QQ. jmb75@medschl.cam.ac.uk
Objective:
To evaluate a cognitive test, the TYM ("test your memory"), in the detection of Alzheimer's disease.
Design:
Cross sectional study.
Setting:
Outpatient departments in three hospitals, including a memory clinic.
Participants:
540 control participants aged 18-95 and 139 patients attending a memory clinic with dementia/amnestic mild cognitive impairment.
Intervention:
Cognitive test designed to use minimal operator time and to be suitable for non-specialist use.
Main Outcome Measures:
Performance of normal controls on the TYM. Performance of patients with Alzheimer's disease on the TYM compared with age matched controls. Validation of the TYM with two standard tests (the mini-mental state examination (MMSE) and the Addenbrooke's cognitive examination-revised (ACE-R)). Sensitivity and specificity of the TYM in the detection of Alzheimer's disease.
Results:
Control participants completed the TYM with an average score of 47/50. Patients with Alzheimer's disease scored an average of 33/50. The TYM score shows excellent correlation with the two standard tests. A score of
Conclusions:
The TYM can be completed quickly and accurately by normal controls. It is a powerful and valid screening test for the detection of Alzheimer's disease.
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