The Modified Telephone Interview for Cognitive Status is More Predictive of Memory Abilities Than the Mini-Mental State Examination.

Although not as popular as the Mini-Mental State Examination (MMSE), the modified Telephone Interview for Cognitive Status (mTICS) has some distinct advantages when screening cognitive functioning in older adults. The current study compared these 2 cognitive screening measures in their ability to predict performance on a memory composite (ie, delayed recall of verbal and visual information) in a cohort of 121 community-dwelling older adults, both at baseline and after 1 year. Both the MMSE and the mTICS significantly correlated with the memory composite at baseline (r's of .41 and .62, respectively) and at 1 year (r's of .36 and .50, respectively). At baseline, stepwise linear regression indicated that the mTICS and gender best predicted the memory composite score (R (2) = .45, P < .001), and the MMSE and other demographic variables did not significantly improve the prediction. At 1 year, the results were very similar. Despite its lesser popularity, the mTICS may be a more attractive option when screening for cognitive abilities in this age range.

Within-session practice effects in patients referred for suspected dementia.

BACKGROUND: Practice effects are improvements in cognitive test performance associated with repeated administrations of same or similar measures and are traditionally seen as error variance. However, there is growing evidence that practice effects provide clinically useful information. METHODS: Within-session practice effects (WISPE) across 2 h were collected from 61 non-consecutive patients referred for suspected dementia and compared to the Mini Mental Status Examination (MMSE), a screening measure of dementia severity. RESULTS: In all patients, WISPE on two cognitive measures were significantly correlated with MMSE, even after controlling for baseline cognitive scores (partial r = 0.47, p < 0.001; partial r = 0.26, p = 0.046). In patients diagnosed with probable Alzheimer's disease, the trend was even stronger (partial r = 0.72, p < 0.01; partial r = 0.58, p = 0.046). In both groups, lower WISPE were associated with lower MMSE scores (i.e. greater dementia severity), even after controlling for initial cognitive scores. CONCLUSION: If future research validates these findings with longitudinal studies, then WISPE may have important clinical applications in dementia evaluations.

Demographic corrections for the modified telephone interview for cognitive status.

Despite the growing use of the modified Telephone Interview for Cognitive Status (mTICS) as a cognitive screening instrument, it does not yet have demographic corrections. Demographic data, mTICS, and a neuropsychological battery were collected from 274 community-dwelling older adults with intact cognition or mild cognitive impairments. Age, education, premorbid intellect, and depression were correlated with mTICS scores. Using regression equations, age and education significantly predicted mTICS total score, and depression and premorbid intellect further enhanced this prediction. These results were comparable when only examining the 153 cognitively intact subjects. By using these corrections, clinicians and researchers can more accurately predict an individual's cognitive status with this telephone screening measure.

Amyloid deposition and cognition in older adults: the effects of premorbid intellect.

Although amyloid deposition remains a marker of the development of Alzheimer's disease, results linking amyloid and cognition have been equivocal. Twenty-five community-dwelling non-demented older adults were examined with (18)F-flutemetamol, an amyloid imaging agent, and a cognitive battery, including an estimate of premorbid intellect and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). In the first model, (18)F-flutemetamol uptake significantly correlated with the Delayed Memory Index of the RBANS (r = -.51, p = .02) and premorbid intellect (r = .43, p = .03). In the second model, the relationship between (18)F-flutemetamol and cognition was notably stronger when controlling for premorbid intellect (e.g., three of the five RBANS Indexes and its Total score significantly correlated with (18)F-flutemetamol, r's = -.41 to -.58). Associations were found between amyloid-binding (18)F-flutemetamol and cognitive functioning in non-demented older adults. These associations were greatest with delayed memory and stronger when premorbid intellect was considered, suggesting that cognitive reserve partly compensates for the symptomatic expression of amyloid pathology in community-dwelling elderly.

Predicting current memory with the modified telephone interview for cognitive status.

The modified Telephone Interview for Cognitive Status (mTICS) is a commonly used screening tool for categorizing mental status of older adults. Recently, prediction equations have been developed to estimate performance on an in-person memory composite based on the mTICS; however, these equations need validation. The current study compared predicted memory functioning based on these equations with observed memory functioning in 101 community-dwelling older adults. Observed and predicted memory composites were comparable for 2 of 6 equations (mTICS total score and immediate recall item), indicating that these equations adequately predict observed memory scores. The predicted memory composite based on the total score was also most highly correlated with the observed memory composite. These results further validate the mTICS, as well as some of the prediction equations, and continue to point out this measure as an efficient tool for screening of cognitive functioning in later life.

Practice effects: a unique cognitive variable.

Practice effects are improvements in cognitive test performance due to repeated evaluation with the same or similar test materials. Prior studies have reported that these improvements can vary with age, education/intellect, and disease status. However, additional information is needed about variables that influence practice effects. The current study prospectively quantified short-term practice effects in 268 community-dwelling older adults and compared these practice effects to demographic variables, global cognition, premorbid intellect, depression, and individual cognitive domains. Overall, practice effects were not significantly related to most demographic and clinical characteristics or individual cognitive domains, which was contrary to our hypotheses. However, since practice effects appear to be uninfluenced by many variables that typically affect cognitive scores, they may be a unique and valuable tool that could be applied in a number of diverse patient groups.

Predicting estimates of premorbid memory functioning: validation in a dementia sample.

Formulae to estimate premorbid memory functioning in a sample of cognitively intact older adults have been developed. These formulae were validated in a small sample of patients with amnestic Mild Cognitive Impairment. However, further validation is clearly needed. The current study applied these formulae to a sample of 1,059 patients referred to a dementia clinic and compared the premorbid estimates of memory functioning with current memory abilities. Large and statistically significant differences were observed in the current sample, with premorbid memory scores exceeding current memory scores. Although some cautions should be observed when using these estimates clinically, growing support for these estimates of premorbid memory abilities may aid clinicians in determining change across time in older patients.