Screening for Dementia by Telephone Using the Memory Impairment Screen

Authors


  • Supported by National Institute on Aging Grant AG03949. Presented in part at the American Neurological Association meeting, San Diego, California, 1997. The Albert Einstein College of Medicine owns the copyright and makes this test available as a service to the research community but licenses the test for commercial use.

Address correspondence to Richard B. Lipton, MD, Einstein Aging Study, Albert Einstein College of Medicine, 1165 Morris Park Avenue, Bronx, New York 10461. E-mail: rlipton@aecom.yu.edu

Abstract

Objectives: To develop and assess telephone-based screening tests for dementia, especially Alzheimer's disease (AD).

Design: A cross-sectional validation study nested within a longitudinal study of aging and dementia.

Setting: The Einstein Aging Study of the Albert Einstein College of Medicine, Bronx, New York.

Participants: Three hundred elderly community volunteers living in Bronx County, 27 of whom were diagnosed with dementia based on in-person clinical evaluation. Of the 27 individuals with dementia, 18 had AD.

Measurements: A telephone battery was administered that included the Memory Impairment Screen by telephone (MIS-T, a test of semantic memory), the Category Fluency Test (CF-T), and the Telephone Instrument for Cognitive Status (TICS). An in-person evaluation then followed that included a neurological examination, a neuropsychological battery, demographics, and medical history.

Results: The telephone battery was well accepted. The MIS-T required 4 minutes; the CF-T, 3 minutes; and the TICS, 10 minutes. The MIS-T had excellent sensitivity and specificity when compared with the CF-T and the TICS. Using cutscores on all three tests that provide a sensitivity of 78%, specificity was significantly higher for the MIS-T (93%) than for the CF-T (78%, P<.05) or the TICS (80%, P<.05). Combining the MIS-T and CF-T improved discriminative validity but increased screening time and the complexity of scoring. Normative data for the MIS-T, the CF-T, and the TICS for use in settings with different base rates (prevalence) of dementia are presented in this study.

Conclusion: The MIS-T outperforms the CF-T and the TICS as a valid and time-efficient telephone screen for dementia. For applications that require optimal efficiency and accuracy, the MIS-T is recommended.

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