Use of an Italian version of the telephone interview for cognitive status in Alzheimer's disease

Objectives: Validation of an Italian version of the Telephone Interview for Cognitive Status (I-TICS).

Methods: Telephone administration of the I-TICS within 6 weeks of face-to-face testing with the Mini Mental State Examination (MMSE), in Probable Alzheimer's disease (AD) patients and healthy controls. Two hundred and seven consecutive outpatients with cognitive impairment were recruited from Dementia Clinic of University Campus BioMedico. Of these, 45 probable AD patients with complete data were analyzed. Other dementias, Mild Cognitive Impairment (MCI), and patients with incomplete data were excluded. The control sample consisted of 64 age- and sex-matched healthy subjects. For diagnosis, an extensive clinical evaluation, laboratory testing, brain imaging, EEG, neuropsychological battery and a depression scale were used. For I-TICS validation, telephone I-TICS and face-to-face MMSE were administered.

Results: The I-TICS correlated highly and linearly with the MMSE (Pearson's r=0.904). Conversion equations are provided. Sensitivity and specificity were similar between tests (area under curve=0.894 for the I-TICS; 0.966 for the MMSE). I-TICS sensitivity was 84% and specificity 86% at a cut-off score of 28. No significant difference in accuracy with the MMSE was present. Total agreement between I-TICS and MMSE was 'substantial' at 86% (Cohen's K=0.717). Repeated testing in a subset of patients showed a disease progression related decrease of 4.2 points/year (t=2.664; p=0.018) in I-TICS scores.

Conclusion: The I-TICS is a valid instrument in clinical and research screening and monitoring of AD. Potential applications in other dementias and MCI are worth further studies.