Dementia screenings over the phone shown to be useful in primary care

A survey conducted over the phone performed well as a screening strategy for dementia in at-risk patients, according to findings from a Dutch study published in Annals of Family Medicine.

“The family physician plays a pivotal role in detecting dementia,” Herrer Abdulrahman, MD, of the department of neurology at the Radboud University Medical Center in the Netherlands, and colleagues wrote. “Despite growing attention for elder care in the Western world, dementia remains underdiagnosed in primary care.”

Using data from the Prevention of Dementia by Intensive Vascular Care (preDIVA) trial, Abdulrahman and colleagues investigated the ease and accuracy of the Telephone Interview for Cognitive Status (TICS) screening method among adults aged 60 to 98 years (mean age, 84.5 years) in primary care settings in the Netherlands. The 11-item screening tool assesses several cognitive domains, rating patients on a points scale of 0 to 41. On average, TICS takes fewer than 10 minutes to complete, according to Abdulrahman and colleagues.

The researchers assessed the electronic health records of 155 participants with TICS scores of 30 or lower (19.1%) and 655 participants with scores above 30 (80.9%) for a diagnosis of dementia during 8 to 12 years of follow up.

According to Abdulrahman and colleagues, 8.4% of participants with a TICS score of 30 or lower received a dementia diagnosis compared with no participants who scored above 30. Individuals who were diagnosed with dementia had a median TICS score of 27.

Compared with participants who scored above 30, participants with a TICS score that was lower than 30 were older on average (P = .01), had fewer years of higher education (P < .001), lower median cognition scores (P < .001) and a greater incidence of stroke (P = .03).

After multiple imputation, the researchers determined that the optimal screening cutoff was a score of 29 or lower, which yielded a mean sensitivity of 65.4%, specificity of 87.8%, positive predictive value of 11.9% and negative predictive value of 99%.

The TICS screening method presents a low-cost way to reach a large number of patients, according to the researchers.

“In an older population, we found the TICS to be a useful diagnostic screening instrument for excluding dementia and that it might be particularly useful in family practice or research settings when face-to-face screening is not feasible,” they wrote.