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

Int J Geriatr Psychiatry. 2019 Dec;34(12):1883-1891. doi: 10.1002/gps.5205. Epub 2019 Sep 5.


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.

Keywords: APOE genotype; cognition; cognitive status; dementia; depressive symptoms; education; memory and learning tests; mild cognitive impairment; sex differences; telephone screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / epidemiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Dementia* / diagnosis
  • Dementia* / epidemiology
  • Educational Status
  • Female
  • Finland / epidemiology
  • Humans
  • Male
  • Mass Screening / methods*
  • Neuropsychological Tests*
  • Prevalence
  • Telephone