In recent decades, increasing emphasis has been placed on early intervention in the care and treatment of persons with dementia to help provide more efficient medical management and advanced care planning. The family physician (FP) plays a pivotal role in detecting dementia. Telephone-administered diagnostic screening tests might comprise easy and accurate alternatives in the diagnostic workup of dementia. The Telephone Interview for Cognitive Status (TICS) is the most broadly used and researched telephone-administered diagnostic screening instrument for detecting dementia. The research assessed whether the Telephone Interview for Cognitive Status (TICS) might be a simple and accurate alternative for remote diagnostic cognitive screening in primary care.
The TICS (range, 0-41) for 810 of 1,473 older people aged 84.5 (SD, 2.4) years were administered. The electronic health records were scrutinized 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.
Of the 810 participants, 155 (19.1%) had a TICS score ≤30 (mean, 28.0 [2.4]), and 655 (80.9%) had a TICS score >30 (mean, 34.5 [2.2]). The optimal TICS cutoff value for the verified data was at a TICS score of ≤28, with a sensitivity of 76.9%, a specificity of 81.2%, a PPV of 14.7%, and an NPV of 98.8%. The sensitivity analysis using MI showed the imputed data to include a total of 20/810 (2.5%) modeled dementia cases, of whom 13/155 (8.4%) had a TICS score ≤30, and a median of 7 (5.0-8.0) cases had a TICS score >30 (1.1% [7/655]). The optimal TICS cutoff value of the imputed data was at ≤29, with a mean sensitivity of 65.4%, specificity of 87.8%, PPV of 11.9%, and NPV of 99.0%.
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.