Applicability of the telephone interview for cognitive status (modified) in a community sample with low education level: association with an extensive neuropsychological battery

Objective To explore the applicability of a Portuguese (PT) version of the Telephone Interview for Cognitive Status (TICS), with a delayed recall item [modified (M)], here termed TICSM-PT, against an extensive (in-person) battery of neuropsychological instruments, in a sample of older individuals with low educational level and without clinically manifest/diagnosed cognitive impairment. Methods Following translation/back-translation and pilot testing in 33 community dwellers, 142 community dwellers aged 52 to 84years (mean=67.45, SD=7.91) were selected from local health care centres for the study (convenience sampling; stratified age and gender). Cronbach's alpha was used to assess internal consistency, and convergent validity was evaluated through the correlation between TICSM-PT and the Mini Mental State Examination (MMSE), as well as with a comprehensive battery of cognitive instruments. Divergent/discriminant validity was assessed through a battery of psychological instruments. The receiver operating curve was determined for TICSM-PT to classify participants with and without possible indication of cognitive impairment. Results TICSM-PT showed a satisfactory internal consistency (Cronbach's alpha=0.705), convergent validity and discriminant validity. TICSM-PT presented a positive association with the global cognitive measures Mini Mental State Examination and the Montreal Cognitive Assessment, and also with most neuropsychological parameters. Receiver operating curve curves presented a sensitivity of 90.6% and specificity of 73.7%. The area under the curve statistic yielded a threshold score equal or below 13.5 for cognitive impairment. Conclusion TICSM-PT is a practical tool for rapid cognitive assessment among older individuals with low educational background.European Commission (FP7): ‘SwitchBox’ (contract HEALTH-F2-2010-259772) and co-financed by the Portuguese North Regional Operational Program (ON.2 – O Novo Norte) under the National Strategic Reference Framework (QREN), through the European Regional Development Fund (FEDER). TCC is a recipient of a doctoral fellowship from the Portuguese Foundation for Science and Technology (FCT; SFRH/BD/90078/2012), CPN, PSM and LA of research fellowships from the ‘MyHealth’ project (DoIT—Desenvolvimento e Operacionalização da Investigação de Translação, contract DoIT-13853) and NCS of a ‘Switchbox’ projec