Telephone screening for amnestic mild cognitive impairment.
OBJECTIVE
To evaluate the utility of telephone screening for identifying subjects with amnestic mild cognitive impairment (aMCI) for enrollment in a clinical trial and to identify which elements of the modified Telephone Interview for Cognitive Status (TICS-m) best predicted the in-clinic determination of aMCI.


METHODS
Subjects aged >/=65 years with memory complaints responded to an advertisement for a clinical trial by calling a central telephone recruiting agency. To determine eligibility, subjects went through a stepwise selection procedure involving a review of major protocol inclusion and exclusion criteria, followed by administration of the Category Fluency Test (CFT) and then the TICS-m. Subjects meeting entry criteria, who obtained a score of </=13 on the CFT for "animals" and </=24 on the CFT for "animals" and "fruits" and who scored between 19 and 38 on the TICS-m, were referred for a clinic appointment to determine whether they met clinical criteria for aMCI. Clinical criteria for aMCI required a score of >/=24 on the Mini-Mental State Examination and a score of </=37 on the Rey Auditory Verbal Learning Test. A post hoc analysis was performed using factor analysis and logistic regression models to investigate which elements of the TICS-m best predicted the in-clinic determination of aMCI.


RESULTS
Of 16,988 subjects who called the telephone agency, 8,742 passed the review of inclusion/exclusion criteria; 6,090 met the CFT cut scores and received the TICS-m; 5,223 met cut scores on the TICS-m and were referred for an in-clinic appointment; 747 were seen in the clinic; and 324 met clinical criteria for aMCI. Factor analysis indicated three factors on the TICS-m: language/attention, orientation, and memory. The memory factor, comprising immediate and delayed recall of a word list, was the most important contributor for identifying subjects who met clinical criteria for aMCI.


CONCLUSIONS
Only 2% of subjects who underwent telephone screening were recruited into the study, but 43% of those who passed telephone screening and were seen in the clinic met clinical criteria for aMCI. The word recall tests of the TICS-m were the most important items for identifying which subjects met clinical criteria for aMCI.
Lines
Christopher R
CR
Merck Research Laboratories, West Point, PA, USA. chris_lines@merck.com
McCarroll
Kathleen A
KA
Lipton
Richard B
RB
Block
Gilbert A
GA
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000150:complications / Q000175:diagnosis*; D001288:Attention; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods* / Q000592:standards*; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008568:Memory; D008875:Middle Aged; D015233:Models, Statistical; D009483:Neuropsychological Tests / Q000592:standards; D009949:Orientation; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D017678:Sex Distribution