Comparison of the telephone-Montreal Cognitive Assessment (T-MoCA) and Telephone Interview for Cognitive Status (TICS) as screening tests for early Alzheimer's disease

Abstract

Introduction: Remote screening for cognitive impairment associated with Alzheimer's disease (AD) has grown in importance with the expected rise in prevalence of AD in an aging population and with new potential treatment options. Methods: The Telephone Interview for Cognitive Status (TICS) and new telephone adaptation of the Montreal Cognitive Assessment (T-MoCA) were administered to participants independently classified through in-person clinical evaluation as cognitively normal (CN; n = 167), mild cognitive impairment (MCI; n = 25), or dementia (n = 23). Cerebrospinal fluid AD biomarkers were measured (n = 79). Results: TICS and T-MoCA were highly correlated (r = 0.787; P < 0.001): groups differed on both (CN < 0.001; T-MoCA: F [2210] = 143.72; P < 0.001), both effectively detected cognitive impairment (receiver operating characteristic area under the curve: TICS = 0.889; T-MoCA = 0.902), and both negatively correlated with a composite AD biomarker (tau/amyloid beta 1-42; TICS: r = −0.372; P = 0.001; T-MoCA: r = −0.480; P < 0.001). Discussion: TICS and T-MoCA are effective for remotely detecting cognitive impairment associated with AD in older adults. Strong correlation between tests provides construct validity for the newer T-MoCA. Highlights: Construct validity for the telephone adaptation of the Montreal Cognitive Assessment (T-MoCA) was newly established against the Telephone Interview for Cognitive Status (TICS). TICS and T-MoCA effectively detected cognitive impairment with remote administration. Both tests negatively correlated with a composite cerebrospinal fluid Alzheimer's disease (AD) biomarker (tau/amyloid beta 1-42).