Skip to main content Accessibility help
×
×
Home

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

  • Joseph J. Gallos (a1) and John C. S. Breitner (a1)

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.

Copyright

Corresponding author

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.

References

Hide All
Aneshensel, C. S., Frerichs, R. R., Clark, V. A. & Yokopenic, P. A. (1982 a). Telephone versus in-person surveys of community health status. American Journal of Public Health 72, 10171021.
Aneshensel, C. S., Frerichs, R. R., Clark, V. A. & Yokopenic, P. A. (1982 b). Measuring depression in the community: a comparison of telephone and personal interviews. Public Opinion Quarterly 46, 110121.
Begg, C. B. & Greenes, R. A. (1983). Assessment of diagnostic tests when disease verification is subject to selection bias. Biometrics 39, 207215.
Brandt, J., Spencer, M. & Folstein, M. (1988). The Telephone Instrument for Cognitive Status. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 1, 1117.
Breitner, J. C. S., Welsh, K. A., Magruder-Habib, K. M., Churchill, C. M., Robinette, C. D., Folstein, M. F., Murphy, A. E., Priolo, C. C. & Brandt, J. (1990). Alzheimer's Disease in the National Academy of Sciences Registry of Aging Twin Veterans. I. Pilot investigation. Dementia 1, 297303.
Breitner, J. C. S., Welsh, K. A., Gau, B. A., McDonald, W. M., Steffens, D. C., Saunders, A. M., Magruder, K. M., Helms, M. J., Plassman, B. L., Folstein, M. F., Brandt, J., Robinette, C. D. & Page, W. F. (1995). Alzheimer's Disease in the National Academy of Sciences Registry of Aging Twin Veterans. III. Detection of cases, longitudinal results, and observations on twin concordance. Archives of Neurology (in the press).
Breteler, M. M. B., Claus, J. J., van Duijn, C. M., Launer, L. J. & Hofman, A. (1992). Epidemiology of Alzheimer's disease. Epidemiologic Reviews 14, 5982.
Cain, K. C. & Breslow, N. E. (1988). Logistic regression analysis and efficient design for two-stage studies. American Journal of Epidemiology 128, 11981206.
Centor, R. M. & Schwartz, J. S. (1985). An evaluation of methods for estimating the area under the receiver operating characteristic (ROC) curve. Medical Decision Making 5, 149156.
Duncan-Jones, P. & Henderson, S. (1978). The use of a two-phase design in a prevalence survey. Social Psychiatry 13, 231237.
Eaton, W. & Kessler, L. G. (1985). Epidemiologic Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program. Academic Press, Inc.: New York.
Evans, D. A., Funkenstein, H. H., Albert, M. S., Scherr, P. A., Cook, N. R., Chown, M. J., Hebert, L. E., Hennekens, C. H. & Taylor, J. O. (1989). Prevalence of Alzheimer's disease in a community population of older persons: higher than previously reported. Journal of the American Medical Association 262, 25512556.
Fenig, S., Levav, I., Kohn, R. & Yelin, N. (1993). Telephone vs. face-to-face interviewing in a community psychiatric survey. American Journal of Public Health 83, 896898.
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975). ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.
Folstein, M. F., Bassett, S. S., Anthony, J. C., Romanoski, A. J. & Nestadt, G. R. (1991). Dementia: case ascertainment in a community survey. Journal of Gerontology: Medical Sciences 46, 132138.
Gray, R., Begg, C. B. & Greenes, R. A. (1984). Construction of receiver operating characteristic curves when disease verification is subject to selection bias. Medical Decision Making 4, 151164.
Hanley, J. A. & McNeil, B. J. (1982). The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143, 2936.
Harris, S. J. & Dowson, J. M. (1982). Recall of a ten-word list in the assessment of dementia in the elderly. British Journal of Psychiatry 142, 524527.
Herzog, A. R. & Kulka, R. A. (1989). Telephone and mail surveys with older populations: a methodological overview. In Special Research Methods for Gerontology (ed. Lawton, M. P. and Herzog, A. R.), pp. 6389. Baywood Publishing Company: New York.
Kasper, S., Wehr, T. A., Bartko, J. J., Gaist, P. A. & Rosenthal, N. E. (1989). Epidemiologic findings of seasonal changes in mood and behavior. Archives of General Psychiatry 46, 823833.
Kent, J. & Plomin, R. (1987). Testing specific cognitive abilities by telephone and mail. Intelligence 11, 391400.
Khachaturian, Z. S. (1985). Diagnosis of Alzheimer's disease. Archives of Neurology 42, 10971105.
Macmillan, N. A. & Creelman, C. D. (1991). Detection Theory. Cambridge University Press: New York.
Marcus, A. C. & Crane, L. A. (1986). Telephone surveys in public health research. Medical Care 24, 97112.
Metz, C. E. (1978). Basic principles of ROC analysis. Seminars in Nuclear Medicine 8, 283298.
Mirra, S. S., Heyman, A., McKeel, D., Sumi, S. M., Crain, B. J., Brownlee, L. M., Vogel, F. S., Hughes, J. P., van Belle, G. & Berg, L. (1991). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part III. Standardization of the neuropathologic assessment of AD. Neurology 41, 479486.
Nesselroade, J. R., Federsen, N. L., McClearn, G. E., Plomin, R. & Bergeman, C. S. (1988). Factorial and criterion validities of telephone-assisted cognitive ability measures. Research on Aging 10, 220234.
Pfeffer, R. I., Afifi, A. A. & Chance, J. M. (1987). Prevalence of Alzheimer's disease in a retirement community. American Journal of Epidemiology 125, 420436.
Rocca, W. A., Bonaiuto, S., Lippi, A., Luciani, P., Turtu, F., Cavarzeran, F. & Amaducci, L. (1990). Prevalence of clinically diagnosed Alzheimer's disease and other dementing disorders: a door-to-door survey in Appignano, Macerata Province, Italy. Neurology 40, 626631.
Roccaforte, W. H., Burke, W. J., Bayer, B. L. & Wengel, S. P. (1992). Validation of a telephone version of the Mini-Mental State Examination. Journal of the American Geriatrics Society 40, 697702.
Rorsman, B., Hagnell, O. & Lanke, J. (1986). Prevalence and incidence of senile and multi-infarct dementia in the Lundby study: a comparison between the time periods 1947–1957 and 1957–1972. Neuropsychobiology 15, 122129.
Sackett, D. L. (1979). Bias in analytic research. Journal of Chronic Disease 32, 5163.
Selvin, S. (1991). Statistical Analysis of Epidemiologic Data, pp. 1720. Oxford University Press: New York.
Siemiatycki, J. (1979). A comparison of mail, telephone, and home interview strategies for household health surveys. American Journal of Public Health 69, 238245.
Silverman, J. M., Breitner, J. C. S., Mohs, R. C. & Davis, K. L. (1986). Reliability of the family history method in genetic studies of Alzheimer's disease and related dementias. American Journal of Psychiatry 143, 12791282.
Silverman, J. M., Keefe, R. S., Mohs, R. C. & Davis, K. L. (1989). A study of the reliability of the family history method in genetic studies of Alzheimer disease. Alzheimer's Disease and Associated Disorders 3, 218223.
van Duijn, C. M., Stijnen, T. & Hofman, A. (1991). Risk factors for Alzheimer's disease: overview of the EURODEM collaborative reanalysis of case-control studies. International Journal of Epidemiology 20, S4S12.
Wells, K. B., Burnam, M. A., Leake, B. & Robins, L. N. (1988). Agreement between face-to-face and telephone-administered versions of the depression section of the NIMH Diagnostic Interview Schedule. Journal of Psychiatric Research 22, 207220.
Welsh, K. A., Breitner, J. C. S. & Magruder-Habib, K. (1993). Detection of dementia in the elderly using telephone screening of cognitive status. Neuropsychiatry, Neuropsychology, and Behavioral Neurology 6, 103110.
White, J. E. (1982). A two stage design for the study of the relationship between a rare exposure and a rare disease. American Journal of Epidemiology 115, 119128.
Worth, A. & Tierney, A. J. (1993). Conducting research interviews with elderly people by telephone. Journal of Advanced Nursing 18, 10771084.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed