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Development and piloting of a novel 15‐minute cognitive telephone (FACT) screen to diagnose mild cognitive impairment and dementia
Author(s) -
Ellajosyula Ratnavalli,
Narayanan Jwala,
Ramanan Siddharth,
Dev Nidhi
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.045943
Subject(s) - dementia , cognitive impairment , neuropsychology , cognition , population , medicine , telephone interview , memory clinic , gold standard (test) , orientation (vector space) , gerontology , audiology , psychology , disease , psychiatry , social science , geometry , environmental health , mathematics , sociology
Background It is crucial to follow up patients with mild cognitive impairment (MCI) and dementia. For persons unable to visit hospital for follow‐up, we designed a brief telephone‐screen, the fifteen‐minute assessment of cognition over the telephone (FACT). This was piloted for its ability to diagnose and differentiate patients with MCI and Alzheimer’s disease (AD). Method The FACT consists of 27 items categorized under attention and orientation, memory, language, and executive functions domains. Patients with MCI ( n =40), AD ( n =40) and healthy age and education matched volunteers ( n =23) were administered the FACT a week after presentation and neuropsychological testing at the clinic. Performance on the Addenbrookes Cognitive Examination (ACE III) was used as a gold standard. Result FACT correlated well with ACE III, the Pearson correlation coefficient was 0.82 (p = 0.00). The subcomponents of both tests also showed moderate to high correlations. The area under the ROC curve for FACT discriminating MCI from AD was 0.92 and MCI from healthy volunteers was 0.83. Conclusion The novel telephone interview screen (FACT) was comparable to the ACE III in diagnosing and differentiating patients with MCI from AD. A mobile telephone usage is almost universal across India including poor, illiterate and rural population. Thus the use of FACT as a screening tool may be extended to population surveys, which are crucial in tackling dementia, a major health challenge in India.