Development and standardization of a new telephonic cognitive screening test: The Minnesota Cognitive Acuity Screen (MCAS)

Objective: The aim of this study was to determine the validity and reliabil ity of a telephonically administered cognitive screening battery, consistin g of nine brief tests (orientation, attention, delayed word recall, compreh ension, repetition, naming, computation, judgment, and verbal fluency), to distinguish between patients with dementia and healthy control subjects. Ba ckground: Existing telephonic screening instruments do not take full advant age of strategies that might increase precision. Methods: A total of 228 el derly individuals received a telephone assessment of cognitive function (99 mildly to moderately demented nursing home residents with an established d iagnosis of dementia residing in 1 of 12 nursing facilities, and 129 commun ity-dwelling elderly individuals who were independently screened to verify normal cognitive function). Results: Nurses and psychologists experienced i n telephonic test administration typically completed the screening with eac h subject in less than 20 minutes. At the 100% sensitivity level, the test battery had a specificity of 87%. The post hoc optimal cut-score of the dis criminant analysis yielded a sensitivity of 97.5% and a specificity of 98.5 %. The split-half reliability of the test battery was 0.91. The more powerf ully predictive subtests were orientation, delayed word recall, verbal flue ncy, computation, and judgment. Conclusions: This telephonic screening inst rument appears to have promise to distinguish, with high precision, healthy elderly individuals from those individuals with cognitive impairment. The Minnesota Cognitive Acuity Screen (MCAS) should undergo further study in un selected elderly populations to better understand its value as a screening tool.