Detection of dementia in the elderly using telephone screening of cognitive status

Detection of dementia in large, geographically dispersed populations is difficult. Conventional in-person neuropsychological assessment techniques, no matter how brief, are too costly to be practical for this purpose. Telephone interviewing is an obvious alternative for cognitive screening, but its practical utility is relatively unexplored. We therefore investigated the performance characteristics of a telephone screen for dementia in elderly residents of congregate housing facilities. We interviewed 209 subjects using the Telephone Interview for Cognitive Status (TICS) and a modified version (TICS-m) that includes items sensitive to early dementia (delayed recall) and eliminates other items difficult to verify in survey work. After the subjects received a brief in-person neuropsychological assessment, TICS and TICS-m scores were compared as predictors of the resulting clinical assignment (normal, mildly impaired, or demented). Although the TICS-m yielded slightly better results, both versions of the instrument were sensitive and specific indicators of dementia in this community sample. In a separate exercise, both instruments also correctly identified 17 clinic patients with carefully diagnosed Probable AD. Telephone interviewing of cognitive function may therefore provide an economical approach to mental status screening in research studies where in-person assessment is impractical.