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Three-Objects-Three-Places Episodic Memory Test to Screen Mild Cognitive Impairment and Mild Dementia: Validation in
Federica Ribaldi1,2, Sophie Krug1, Daniele Altomare3
1Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
Background:
The Three-Objects-Three-Places (3O3P) test is a 5-min screen for episodic memory impairment due to Alzheimer's disease, known for its briefness and easy administration, culture- and language-free nature, and the absence of specific equipment. However, no studies have validated its potential in memory clinic cohorts. The aim of this study was to test its convergent, discriminant, and known-group validities and to define thresholds for its clinical use.
Methods:
We included 2062 cognitively unimpaired (CU), mild cognitive impairment (MCI) and dementia patients from the Geneva Memory Center cohort who underwent the 3O3P test in the context of clinical practice. Convergent and discriminant validities were assessed using an exploratory factor analysis. The known-group validity was assessed in CU vs. MCI and dementia using the area under the curve (AUC). 3O3P test scores vs. amyloid and tau positivity, neurodegeneration, and cognition (ATNC) were assessed using the Kruskal-Wallis test. The 3O3P test cut-offs were calculated using sensitivity, specificity, PPV, NPV, and accuracy.
Results:
Mean age was 72 years (SD = 11), 60% were female, mean education was 13 years (SD = 4), and mean MMSE was 25 (SD = 5). The 3O3P and Delayed Total Recall tests loaded strongly on the "memory" factor and weakly on "non-memory" factors. The 3O3P test can discriminate CU vs. MCI (AUC = 0.71) and dementia (AUC = 0.92). Higher 3O3P scores were associated with lower prevalence of ATNC (p < 0.001). A 3O3P value of 7 can detect MCI and dementia patients.
Conclusions:
The 3O3P test has demonstrated good convergent, discriminant, and known-group validity in a large memory clinic population.
Insights
The Three-Objects-Three-Places (3O3P) test effectively screens for Alzheimer's-related memory loss in memory clinics. A score of 7 or lower indicates mild cognitive impairment or dementia.
Area of Science:
- Neuroscience
- Cognitive Psychology
- Geriatrics
Background:
- The Three-Objects-Three-Places (3O3P) test is a brief, culture-free episodic memory screen.
- Its validation in memory clinic populations is lacking.
- This study aimed to validate the 3O3P test in a clinical setting.
Purpose of the Study:
- To assess the convergent, discriminant, and known-group validity of the 3O3P test.
- To establish clinical thresholds for the 3O3P test.
- To evaluate its utility in identifying memory impairment in a memory clinic cohort.
Main Methods:
- 2062 participants (cognitively unimpaired, MCI, dementia) from a memory clinic cohort were analyzed.
- Exploratory factor analysis assessed convergent and discriminant validity.
- Known-group validity was determined using Area Under the Curve (AUC) comparing cognitively unimpaired to MCI and dementia groups.
- Association with amyloid, tau, neurodegeneration, and cognition (ATNC) was examined.
Main Results:
- The 3O3P test demonstrated strong loading on the 'memory' factor.
- The test effectively discriminated between cognitively unimpaired and MCI (AUC=0.71) and dementia (AUC=0.92) groups.
- Higher 3O3P scores correlated with lower ATNC markers (p<0.001).
- A threshold of 7 on the 3O3P test identified MCI and dementia patients.
Conclusions:
- The 3O3P test exhibits robust convergent, discriminant, and known-group validity.
- It is a valuable tool for assessing episodic memory in memory clinic populations.
- The established threshold of 7 aids in clinical diagnosis of memory impairment.
