Test of gestures (TEGEST) for a brief examination of episodic memory in mild cognitive impairment

Aim: A quick and simple examination can detect early impairment of episodic memory. The aim of the study was to develop an original Czech test which would simulate episodic memory and could be administered without any aids anytime and anywhere. Participants and methods: Participants demonstrated six gestures symbolic for all human senses (twice for sight) as instructed by the administrator in a new test of gestures (TEGEST). Then, they were asked to carry them out in the same sequence again immediately and after a 20-min distraction. The TEGEST and Montreal cognitive assessment (MoCA) were administered to 25 individuals with mild cognitive impairment and 25 socio-demographically paired subjects with normal cognitive functions divided according to zhe results of neuropsychological tests. Results: Individuals with mild cognitive impairment (MoCA 23 +/- 4 points) recalled a significantly smaller number of gestures than normal elderly people (MoCA 27 +/- 3 points): 4 +/- 1 vs. 5 +/- 1 gestures (p = 0.008). However, the two groups did not differ in the low number of correct sequences of gestures (two). The number or sequence of gestures were not related to age, education, or gender. The number of recalled gestures correlated with the MoCA score (r = 0.7; p = 0.001). The optimal cut-off score was = 4 correctly recalled gestures (sensitivity 84%; specificity 48%; area under the receiver operating characteristic curve = 0.70). Conclusion: The novel six-gesture test (TEGEST) is a one-or two-minute and easy-to-use instrument which may signal mild cognitive impairment by four or fewer recalled gestures.