Validation and Normative Data for the Modified Telephone Interview for Cognitive Status: The Sydney Memory and Ageing Study
Validation and Normative Data for the Modified Telephone Interview for Cognitive Status: The Sydney Memory and Ageing Study
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DOI：
10.1111/jgs.16033
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发表时间：
2019-07-09
影响因子：
6.3
通讯作者：
Kochan, Nicole A.
中科院分区：
文献类型：
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作者：
Bentvelzen, Adam C.;Crawford, John D.;Kochan, Nicole A.
基于电话的认知筛查，如认知状态电话访谈（TICS），可以潜在地减少评估老年人的障碍和成本。然而，临床相关的心理测量特性的验证是缺乏一个大的和全面评估的老年人样本。此外，已发表的规范性数据可能缺乏敏感性，因为它们没有使用基于回归的人口统计学校正或解释随后痴呆的病例。我们使用修改后的TICS（TICS-M;修改后的13项39分版本）解决这些差距，并为临床医生和研究人员提供在线规范计算器。设计前瞻性纵向研究。背景是澳大利亚悉尼。对象：617名社区老年人，年龄71 ~ 91岁。测量所用的措施包括TICS-M，简易精神状态检查（MMSE），Addenbrooke的认知检查修订版（ACE-R），和一个全面的神经心理测试电池。描述性统计，相关性，曲线下面积和回归分析被用来确定TICS-M的有效性和规范性。结果TICS-M总分（平均值24.20;标准差3.76）与MMSE（0.70）和ACE-R（0.80）相关性良好，与非同期进行的神经心理测验相关性中等。21分或更低的临界值可以可靠地区分1年后有和没有痴呆事件的患者（敏感性= 77%;特异性= 88%），但在区分轻度认知障碍和正常认知方面不太可靠。TICS-M评分随年龄增长而下降，随教育程度的提高而增加。排除了偶发痴呆病例的稳健规范样本在TICS-M上的得分较高，变异性低于整个样本。提供了一个在线计算器来计算基于回归的规范和可靠的变化统计。结论：在大样本的社区居住的老年人，TICS-M表现良好的结构效度对典型的筛选工具和神经心理学措施和诊断有效性事件痴呆。所提供的全面的、基于回归的、稳健的规范性数据将有助于提高老年人认知测试的敏感性、可及性和成本效益。
OBJECTIVES Telephone-based cognitive screens, such as the Telephone Interview for Cognitive Status (TICS), can potentially reduce the barriers and costs of assessing older adults. However, validation of clinically relevant psychometric properties is lacking in a large and comprehensively assessed sample of older adults. Furthermore, published normative data may lack sensitivity as they have not used regression-based demographic corrections or accounted for cases with subsequent dementia. We address these gaps using the modified TICS (TICS-M; a modified, 13-item, 39-point version) and provide an online norms calculator for clinicians and researchers. DESIGN Prospective longitudinal study. SETTING Sydney, Australia. PARTICIPANTS A total of 617 community-living older adults, aged from 71 to 91 years. MEASUREMENTS The measures used included the TICS-M, the Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination-Revised (ACE-R), and a comprehensive neuropsychological test battery. Descriptive statistics, correlations, area under the curve, and regression analyses were used to determine the validity and normative properties of the TICS-M. RESULTS TICS-M total scores (mean = 24.20; SD = 3.76) correlated well with the MMSE (0.70) and ACE-R (0.80) and moderately with neuropsychological tests tested noncontemporaneously. A cutoff score of 21 or lower reliably distinguished between those with and without incident dementia after 1 year (sensitivity = 77%; specificity = 88%) but was less reliable at distinguishing mild cognitive impairment from normal cognition. TICS-M scores decreased with age and increased with higher education levels. The robust normative sample, which excluded incident dementia cases, scored higher on the TICS-M and with less variability than the whole sample. An online calculator is provided to compute regression-based norms and reliable change statistics. CONCLUSIONS In a large sample of community-dwelling older adults, the TICS-M performed well in terms of construct validity against typical screening tools and neuropsychological measures and diagnostic validity for incident dementia. The comprehensive, regression-based, and robust normative data provided will help improve the sensitivity, accessibility, and cost-effectiveness of cognitive testing with older adults.