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Alzheimer's disease in the NAS–NRC Registry of ageing twin veterans, IV. Performance characteristics of a two-stage telephone screening procedure for Alzheimer's dementia

Published online by Cambridge University Press:  09 July 2009

Joseph J. Gallos  and
John C. S. Breitner
Joseph J. Gallos*
Affiliation:
Department of Mental Hygiene, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
John C. S. Breitner
Affiliation:
Department of Mental Hygiene, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland; Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA
*
1Address for correspondence: Dr Joseph J. Gallo, Department of Mental Hygiene, Johns Hopkins University School of Hygiene and Public Health, 624 North Broadway, Baltimore, Maryland 21205, USA.
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Synopsis

In the course of a large twin study of Alzheimer's disease we used a two-stage telephone screening procedure. The modified Telephone Interview for Cognitive Status (TICS-m) served as an initial screen for dementia in 12709 individuals. The telephone Dementia Questionnaire (DQ) was then asked of collateral informants for subjects with TICS-m scores below 28, as well as for samples of persons with higher TICS-m scores. Based upon DQ responses, individuals with cognitive impairment not attributable to focal causes underwent assessment for the clinical diagnosis of Alzheimer's disease (‘Alzheimer's dementia’), as did their twins. Well-defined Alzheimer's dementia was apparent in 39 subjects. Employing a cut-off of 27 or lower as indicative of cognitive impairment, the sensitivity of the TICS-m in the detection of Alzheimer's dementia was estimated at >99% and specificity at 86%. Inclusion of the DQ increased the specificity at the 27/28 cut-point to 99%. The TICS-m score was associated with an area under the receiver operating characteristic (ROC) curve of 0·88 (95% confidence interval 0·81 to 0·94). The maximum number of cases of Alzheimer's dementia remaining undetected in the sample was estimated to be 34.

Type
Original Articles
Information
Psychological Medicine , Volume 25 , Issue 6 , November 1995 , pp. 1211 - 1219
Copyright
Copyright © Cambridge University Press 1995

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