{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T18:29:22Z","timestamp":1782498562119,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T00:00:00Z","timestamp":1517875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychogeriatrics"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>A simple, quick, and efficient screening tool for detecting mild cognitive impairment (<jats:styled-content style=\"fixed-case\">MCI<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>lzheimer\u2019s disease (<jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>) is essential, especially in the primary care setting. In this study, we examined the neuropsychological profiles of elderly patients and aimed to assess the diagnostic value of the triple test, comprised of the attended alone sign (<jats:styled-content style=\"fixed-case\">AAS<\/jats:styled-content>), head\u2010turning sign, and applause sign (<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>), for detecting <jats:styled-content style=\"fixed-case\">MCI<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Comprehensive geriatric assessment was performed in 354 elderly outpatients, and the presence or absence of <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>, AAS and HTS was investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 354 patients, 93 patients were considered to be cognitively impaired (<jats:styled-content style=\"fixed-case\">MCI<\/jats:styled-content>: 30; <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>: 63); the remaining 261 were cognitively healthy. Relative to those without <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content>, patients with <jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> had significantly lower scores on the <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ini\u2013<jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ental <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tate <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>xamination, the clock\u2010drawing test, Instrumental Activities of Daily Living Scale, and Basic Activities of Daily Living Scale (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001, for each). Similar significant differences were found between patients who were positive and negative for the HTS (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and between those who attended the clinic alone and those who were accompanied (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The sensitivity of the triple test for identifying cognitively impairment (CI), <jats:styled-content style=\"fixed-case\">MCI<\/jats:styled-content>, and <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> was 0.61, 0.30, and 0.72, respectively; the specificity was 0.85, 0.68, and 0.83, respectively; and the positive and negative predictive values were 0.69, 0.09, and 0.59, respectively, and 0.79, 0.90, and 0.89, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study suggests that the triple test is a simple, quick, and efficient screening tool for detecting cognitive impairment, and the results may reflect deterioration in patients\u2019 activities of daily living. Additionally, it could be advantageous in clinical practice because educational level does not affect the test outcome. Therefore, it may be an appropriate test to screen for cognitive impairment in the elderly, both as a bedside diagnostic test and in daily clinical practice, especially in the primary care setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/psyg.12289","type":"journal-article","created":{"date-parts":[[2018,2,7]],"date-time":"2018-02-07T03:57:32Z","timestamp":1517975852000},"page":"98-105","source":"Crossref","is-referenced-by-count":29,"title":["Triple test, a diagnostic observation, can detect cognitive impairment in older adults"],"prefix":"10.1111","volume":"18","author":[{"given":"Ahmet T.","family":"Isik","sequence":"first","affiliation":[{"name":"Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine Dokuz Eylul University  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6042-1718","authenticated-orcid":false,"given":"Pinar","family":"Soysal","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Geriatric Center Kayseri Education and Research Hospital  Kayseri Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derya","family":"Kaya","sequence":"additional","affiliation":[{"name":"Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine Dokuz Eylul University  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cansu","family":"Usarel","sequence":"additional","affiliation":[{"name":"Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine Dokuz Eylul University  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000165977.38272.15"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000332605"},{"key":"e_1_2_6_4_1","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1136\/jnnp.2005.068023","article-title":"\u2018Who came with you?\u2019 A diagnostic observation in patients with memory problems?","volume":"76","author":"Larner AJ","year":"2005","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"e_1_2_6_5_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/978-1-4471-6371-8_3","volume-title":"Dementia in Clinical Practice: A Neurological Perspective","author":"Larner AJ","year":"2014"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1136\/jnnp.2010.224394","article-title":"Applause sign: is it really specific for parkinsonian disorders? 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