Telephone-based screening for dementia

January 01, 0001

Telephone-based screening for dementia

These US authors sought to determine the accuracy of a telephone interview in classifying (1) demented from nondemented participants, (2) cognitively impaired participants from cognitively normal participants, and (3) participants with mild cognitive impairment (MCI) from those with normal cognition or (4) MCI from dementia among an ethnically and educationally diverse community-based sample. The sample consisted of 377 (30.5% non-Hispanic white, 34.7% non-Hispanic black, and 33.7% Caribbean Hispanic) older adults. The validation standard was diagnosis of dementia and MCI based on in-person evaluation.

They found: "The sample included 256 people (67.9%) with normal cognition, 68 (18.0%) with MCI, and 53 (14.1%) with dementia. Validity of the TICS was comparable among non-Hispanic whites, non-Hispanic blacks, and Hispanics. Among non-Hispanic whites, the DQ had better discrimination of those with dementia from those without dementia and from those with MCI than among other racial/ethnic groups. Telephone measures discriminated best when used to differentiate demented from nondemented participants (88% sensitivity and 87% specificity for the TICS; 66% sensitivity and 89% specificity for DQ) and when used to differentiate cognitively normal participants from those with cognitive impairment (ie, MCI and dementia combined; 73% sensitivity and 77% specificity for the TICS; 49% sensitivity and 82% specificity for DQ). When demographics and prior memory test performance were used to calculate pretest probability, consideration of the telephone measures significantly improved diagnostic validity."

The authors concluded: "The TICS has high diagnostic validity for identification of dementia among ethnically diverse older adults, especially when supported by the DQ and prior visit data. However, telephone interview data were unable to reliably distinguish mild cognitive impairment from normal cognition."

Telephone-based screening for dementia could have public health application.

For the full abstract, click here.

Arch Neurol 68(5):607-614, May 2011 © 2011 to the American Medical Association
Telephone-Based Identification of Mild Cognitive Impairment and Dementia in a Multicultural Cohort. Jennifer J. Manly, Nicole Schupf, Yaakov Stern, Adam M. Brickman, Ming- X. Tang, Richard Mayeux.

Category: N. Neurological. Keywords: dementia, cognitive impairment, telephone-based interview, diagnostic test study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 12 August 2011

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