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- Title
Diagnostic Accuracy of the Telephone Interview for Cognitive Status for the Detection of Dementia in Primary Care.
- Authors
Abdulrahman, Herrer; Jansen, Eva; Hoevenaar-Blom, Marieke; Willem van Dalen, Jan; van Wanrooij, Lennard L.; van Bussel, Emma; van Gool, Willem A.; Richard, Edo; Moll van Charante, Eric P.; van Dalen, Jan Willem
- Abstract
<bold>Purpose: </bold>Cognitive diagnostic work-up in primary care is not always physically feasible, owing to chronic disabilities and/or travel restrictions. The identification of dementia might be facilitated with diagnostic instruments that are time efficient and easy to perform, as well as useful in the remote setting. We assessed whether the Telephone Interview for Cognitive Status (TICS) might be a simple and accurate alternative for remote diagnostic cognitive screening in primary care.<bold>Methods: </bold>We administered the TICS (range, 0-41) for 810 of 1,473 older people aged 84.5 (SD, 2.4) years. We scrutinized electronic health records for participants with TICS scores ≤30 and for a random sample of participants with TICS scores >30 for a dementia diagnosis using all data from the Prevention of Dementia by Intensive Vascular Care (preDIVA) trial for 8-12 years of follow-up. We used multiple imputation to correct for verification bias.<bold>Results: </bold>Of the 810 participants, 155 (19.1%) had a TICS score ≤30, and 655 (80.9%) had a TICS score >30. Electronic health records yielded 8.4% (13/154) dementia diagnoses for participants with TICS ≤30 vs none with TICS >30. Multiple imputation for TICS >30 yielded a median of 7/655 (1.1%; interquartile range, 5-8) estimated dementia cases. After multiple imputation, the optimal cutoff score was ≤29, with mean sensitivity 65.4%, specificity 87.8%, positive predictive value 11.9%, negative predictive value 99.0%, and area under the curve 77.4% (95% CI, 56.3%-90.0%).<bold>Conclusions: </bold>In the present older population, the TICS performed well as a diagnostic screening instrument for excluding dementia and might be particularly useful when face-to-face diagnostic screening is not feasible in family practice or research settings. The potential reach to large numbers of people at low cost could contribute to more efficient medical management in primary care.
- Subjects
COGNITIVE interviewing; HEALTH services administration; TELEPHONE interviewing; PRIMARY care; ELECTRONIC health records; DIAGNOSIS of dementia; COGNITION disorders; TELEPSYCHIATRY; TELEPHONES; COGNITION; PRIMARY health care; SENSITIVITY &; specificity (Statistics); PSYCHOSOCIAL factors
- Publication
Annals of Family Medicine, 2022, Vol 20, Issue 2, p130
- ISSN
1544-1709
- Publication type
journal article
- DOI
10.1370/afm.2768