Department of Internal Medicine and Medical Specialties (DIMI), Section of Gerontology and Geriatrics, Genova 16132, Italy.
Aging Ment Health. 2010 Mar;14(2):155-8. doi: 10.1080/13607860903228804.
The Tower of London (ToL) is a problem-solving task, which is a valuable tool for the neuropsychological examination of a patient with a possible cognitive decline. The aim of the present study was to evaluate the ToL in comparison to the Mini Mental State Examination (MMSE) in a group of older people with or without dementia.
Seventy outpatients of both sexes, 30 with low-moderate dementia and 40 with apparently normal cognition were evaluated with the MMSE and the ToL task in the same day. The ToL score was calculated according to the Krikorian method and also the execution time was measured. The differences between groups were assessed with the unpaired t-test, and the relationship between two parameters was assessed with the analysis of the coefficient of linear regression. The results were adjusted for age and education.
The evaluation of cognitive impairment by MMSE showed a significant difference in the two groups (p < 0.001). The mean scores (p < 0.001) and execution times (p < 0.05) of the ToL, resulted significantly lower in the patients affected by dementia. However, seven participants with dementia had a normal score in the ToL test, indicating that the executive neuropsychological tasks could be preserved notwithstanding the cognitive decline and nine participants with normal MMSE obtained a low ToL score, suggestive of the higher sensibility of the ToL for the executive task that reveals an unknown cognitive deficit.
The correlation between MMSE and ToL is good, but ToL test provides complementary information to the MMSE and vice versa.
伦敦塔测验（ToL）是一种解决问题的任务，对于疑似认知能力下降的患者的神经心理学检查是一种有价值的工具。本研究的目的是在有或没有痴呆的老年人群体中，将 ToL 与简易精神状态检查（MMSE）进行比较评估。
70 名男女门诊患者，30 名患有中低程度痴呆，40 名认知功能正常，他们在同一天接受 MMSE 和 ToL 任务的评估。根据 Krikorian 方法计算 ToL 得分，同时测量执行时间。使用独立样本 t 检验评估组间差异，使用线性回归系数分析评估两个参数之间的关系。结果按年龄和教育程度进行调整。
MMSE 评估认知障碍在两组之间存在显著差异（p < 0.001）。痴呆患者的 ToL 平均得分（p < 0.001）和执行时间（p < 0.05）明显较低。然而，7 名患有痴呆症的患者在 ToL 测试中获得了正常分数，表明执行神经心理任务可能在认知能力下降的情况下得以保留，而 9 名 MMSE 正常的患者获得了较低的 ToL 分数，提示 ToL 对揭示未知认知缺陷的执行任务具有更高的敏感性。
MMSE 和 ToL 之间的相关性良好，但 ToL 测试提供了与 MMSE 互为补充的信息，反之亦然。
