By 2025, the number of elderly people in the world will double and by 2050 will reach around two billion individuals, with the majority of them in developing countries. Alzheimer's disease (AD) is the fourth disease that most compromises the quality of life in elderly. This work aims to suggest new methodologies for evaluating elderly people with mild cognitive impairment and Alzheimer‟s disease, introducing a Brazilian version of the TSM-"Test Your Memory" and showing the performance fo this people in tests from CANTAB. It is an analytical, retrospective, longitudinal case-control study, performed at the Laboratory of Neurodegeneration and Infection, University Hospital João de Barros Barreto, from January 2009 to January 2011. Ninety five individuals 65 years old or older were divided in three groups: Alzheimer's disease (AD, n = 21), mild cognitive impairment (DCL, n = 31) and control (n = 43). Patients with previous stroke, primary depression, head injury, other dementias and other neuropsychiatric disorders, and serious visuo-auditory deficits were excluded. The participants were submitted to an initial assessment, screening with GDS-5 and DSM-IV, the International Physical Activity Questionnaire (IPAQ), CERAD neuropsychological test battery and the TSM - Test Your Memory (Brazilian version).Statistical analysis was performed using one-way ANOVA, defining the p-value<0.05 to detect significant differences. Female individuals of mixed ethnicity, aged 70 to 79 years predominated in all groups. The average MMSE score between the three groups was significantly different (control: 26.6± 2.2; DCL: 25.1 ± 2.6, DA: 17.3 ± 4.9, p <0.05), however, the TSM proved to be a more sensitive test to distinguish DCL patients from AD (control: 42.4± 5; DCL: 35.5 ± 7.7, DA: 25.7 ± 8, p <0.01 ). The three groups had different mean scores. In the CERAD word list, clock test, TNBr and phonological verbal fluency. The performance in TSM was significantly lower in DCL and AD groups than in the control group. And DA group was worse in this test than the DCL group too. The tests and measurements of CANTAB that best separate the three groups from the performance obtained were RVP A‟, PAL-trials to success and PAL-total errors in 6 patterns phase. Good correlations were found between the TSM and other tests, especially with the MMSE (Pearson‟s coefficient r = 0.79, p <0.0001) and clock test (r = 0.76, p <0.0001), as well as good correlations between the measures of PAL and TSM and MMSE. Physical activity level, in the control group was higher than in all other groups. When the level of physical activity and performance on cognitive tests were correlated, there were no significant differences in the different groups, except by a better performance in word recall test from CERAD, and word list in DCL group (DCL "active":4.7 ± 1.8; DCL"not active": 3 ± 1.5,p <0.01). Taken as a Whole, these results suggest that the application of automated automated neuropsychological tests associated with routine clinical tests and TYM, improve the clinical assessment´s sensitivity and reliability, especially in the early stages of dementia where the precoceous and accurate diagnosis are essential to guide therapeutic actions, drugs or behavioral modifications.
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