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Stroke. 2017 Nov;48(11):2952-2957. doi: 10.1161/STROKEAHA.117.017519. Epub 2017 Oct 17.

Validation of the Telephone Interview of Cognitive Status and Telephone Montreal Cognitive Assessment Against Detailed Cognitive Testing and Clinical Diagnosis of Mild Cognitive Impairment After Stroke.

Author information

1
From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (V.Z., A.K., C.M., A.W., M.D.); German Center for Neurodegenerative Diseases (DZNE), Munich, Germany (M.D.); and Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.).
2
From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany (V.Z., A.K., C.M., A.W., M.D.); German Center for Neurodegenerative Diseases (DZNE), Munich, Germany (M.D.); and Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.). martin.dichgans@med.uni-muenchen.de.

Abstract

BACKGROUND AND PURPOSE:

Assessment of cognitive status poststroke is recommended by guidelines but follow-up can often not be done in person. The Telephone Interview of Cognitive Status (TICS) and the Telephone Montreal Cognitive Assessment (T-MoCA) are considered useful screening instruments. Yet, evidence to define optimal cut-offs for mild cognitive impairment (MCI) after stroke is limited.

METHODS:

We studied 105 patients enrolled in the prospective DEDEMAS study (Determinants of Dementia After Stroke; NCT01334749). Follow-up visits at 6, 12, 36, and 60 months included comprehensive neuropsychological testing and the Clinical Dementia Rating scale, both of which served as reference standards. The original TICS and T-MoCA were obtained in 2 separate telephone interviews each separated from the personal visits by 1 week (1 before and 1 after the visit) with the order of interviews (TICS versus T-MoCA) alternating between subjects. Area under the receiver-operating characteristic curves was determined.

RESULTS:

Ninety-six patients completed both the face-to-face visits and the 2 interviews. Area under the receiver-operating characteristic curves ranged between 0.76 and 0.83 for TICS and between 0.73 and 0.94 for T-MoCA depending on MCI definition. For multidomain MCI defined by multiple-tests definition derived from comprehensive neuropsychological testing optimal sensitivities and specificities were achieved at cut-offs <36 (TICS) and <18 (T-MoCA). Validity was lower using single-test definition, and cut-offs were higher compared with multiple-test definitions. Using Clinical Dementia Rating as the reference, optimal cut-offs for MCI were <36 (TICS) and approximately 19 (T-MoCA).

CONCLUSIONS:

Both the TICS and T-MoCA are valid screening tools poststroke, particularly for multidomain MCI using multiple-test definition.

KEYWORDS:

ROC curve; Telephone Interview of Cognitive Status; Telephone Montreal Cognitive Assessment; mild cognitive impairment; stroke; validation

PMID:
29042492
DOI:
10.1161/STROKEAHA.117.017519
[Indexed for MEDLINE]

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