Screening for dementia by telephone using the memory impairment screen

J Am Geriatr Soc. 2003 Oct;51(10):1382-90. doi: 10.1046/j.1532-5415.2003.51455.x.


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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Mass Screening / methods*
  • Neuropsychological Tests*
  • Predictive Value of Tests
  • ROC Curve
  • Sensitivity and Specificity
  • Telephone*