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. 2021;83(1):259-268.
doi: 10.3233/JAD-210477.

Validation of the Cognitive Telephone Screening Instruments COGTEL and COGTEL+ in Identifying Clinically Diagnosed Neurocognitive Disorder Due to Alzheimer's Disease in a Naturalistic Clinical Setting

Panagiotis Alexopoulos  1   2   3   4 , Maria Skondra  1   3 , Evagellia Kontogianni  5 , Aikaterini Vratsista  6 , Maria Frounta  4 , Georgia Konstantopoulou  7 , Suzana Ioanna Aligianni  1 , Marina Charalampopoulou  1 , Iliana Lentzari  1 , Philippos Gourzis  1 , Matthias Kliegel  8 , Polychronis Economou  9 , Antonios Politis  5   10
Affiliations

Validation of the Cognitive Telephone Screening Instruments COGTEL and COGTEL+ in Identifying Clinically Diagnosed Neurocognitive Disorder Due to Alzheimer's Disease in a Naturalistic Clinical Setting

Panagiotis Alexopoulos et al. J Alzheimers Dis. 2021.

Abstract

Background: Telephone-based neurocognitive instruments embody valuable tools in identifying cognitive impairment in research settings and lately also in clinical contexts due to the pandemic crisis. The accuracy of the Cognitive Telephone Screening Instrument (COGTEL) in detecting mild- (MiND) and major (MaND) neurocognitive disorder has not been studied yet.

Objective: Comparison of the utility of COGTEL and COGTEL+, which is enriched with orientation items, with the modified Mini-Mental State Examination (3MS) in detecting MiND and MaND due to Alzheimer's disease (AD) and assessment of the impact of COGTEL face-to-face-versus telephone administration on individual performance.

Methods: The study included 197 cognitively intact individuals (CI), being at least 45 years old, 95 and 65 patients with MiND and MaND due to AD, respectively. In 20 individuals COGTEL was administered both in face-to-face and telephone sessions. Statistical analyses included proportional odds logistic regression models, stratified repeated random subsampling used to recursive partitioning to training and validation set (70/30 ratio), and an appropriate F-test.

Results: All studied instruments were significant predictors of diagnostic outcome, but COGTEL+ and 3MS explained more variance relative to the original COGTEL. Except for the validation regression models including COGTEL in which the average misclassification error slightly exceeded 15%, in all other cases the average misclassification errors (%) were lower than 15%. COGTEL administration modality was not related to systematic over- or underestimation of performance on COGTEL.

Conclusion: COGTEL+ is a valuable instrument in detecting MiND and MaND and can be administered in face-to-face or telephone sessions.

Keywords: Mild and major neurocognitive disorder; modified Mini-Mental State Examination; telephone-based neurocognitive testing.

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Conflict of interest statement

Authors’ disclosures available online (https://www.j-alz.com/manuscript-disclosures/21-0477r2).

Figures

Fig. 1
Fig. 1
Weighted density function, scores on the instruments modified mini-mental state examination (3MS), Cognitive Telephone Screening Instrument (COGTEL) and COGTEL plus six orientation items of the Montreal Cognitive Assessment (COGTEL+) and cut-off points for diagnosing minor and major neurocognitive disorder due to Alzheimer’s disease.
Fig. 2
Fig. 2
Scatterplot of the face-to-face COGTEL administration scores versus performance on COGTEL administered over the telephone along with the estimated regression lines (solid line) and the 45-degree line (dotted line).
See this image and copyright information in PMC

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