Prevalence and correlates of dementia and mild cognitive impairment classified with different versions of the modified Telephone Interview for Cognitive Status (TICS‐m)

Abstract

Objectives The modified Telephone Interview for Cognitive Status (TICS‐m) is an efficient and cost‐effective screening instrument of dementia, but there is less support for its utility in the detection of mild cognitive impairment (MCI). We undertook a comprehensive evaluation of the utility of different TICS‐m versions with or without an education‐adjusted scoring method to classify dementia and MCI in a large population‐based sample. Methods Cross‐sectional assessment of cognition (TICS‐m), depressive symptoms (CES‐D), and apolipoprotein E (APOE) ε4 status was performed on 1772 older adults (aged 71‐78 y, education 5‐16 y, 50% female) from the population‐based older Finnish Twin Cohort. TICS‐m classification methods with and without education adjustment were used to classify individuals with normal cognition, MCI, or dementia. Results The prevalence of dementia and MCI varied between education‐adjusted (dementia = 3.7%, MCI = 9.3%) and unadjusted classifications (dementia = 8.5%‐11%, MCI = 22.3%‐41.3%). APOE ε4 status was associated with dementia irrespective of education adjustment, but with MCI only when education adjustment was used. Regardless of the version, poorer continuous TICS‐m scores were associated with higher age, lower education, more depressive symptoms, male sex, and being an APOE ε4 carrier. Conclusions We showed that demographic factors, APOE ε4 status, and depressive symptoms were similarly related to continuous TICS‐m scores and dementia classifications with different versions. However, education‐adjusted classification resulted in a lower prevalence of dementia and MCI and in a higher proportion of APOE ε4 allele carriers among those identified as having MCI. Our results support the use of education‐adjusted classification especially in the context of MCI.

Diagnosis of Early Alzheimer’s Disease: Clinical Practice in 2021

“…Previous research has shown that clinicians have a tendency to choose one assessment over another due to their familiarity with the assessment, time constraints, or specific resources available to them within their clinic (30), but clinicians need to be aware of, and prepared to use, the most patient-appropriate assessments: the cultural, educational, and linguistic needs of the patient are important considerations (30,36,(56)(57)(58). Some assessments have been translated into different languages or shortened, or have education-adjusted scoring classifications, where required (56)(57)(58).…”

Telephone Interview for Cognitive Status (TICS): Italian adaptation, psychometrics and diagnostics

“…Several versions of the TICS have been developed worldwide, differing, for instance, for the presence or absence of a delayed recall task [ 14 ], although little consensus has been reached as for its optimal format [ 13 , 15 ].…”

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“…A cutoff score ≤of 27 indicates individuals with dementia, whereas scores ranging from 28 to 31 indicate individuals with mild cognitive impairment. [ 9 ] All patients underwent a prospective cognitive function assessment of using the TICS-m at baseline and 3- and 12-months follow-up. The procedure includes an education adjustment, where 5 points are added to the score for patients with less than 8 years of education, 2 points are added to the score for patients with 8 to 10 years of education, no points are added to the score for those with 11 to 15 years for education, whereas 2 points are subtracted from scores of patients with 16 or more years of education.…”