The Telephone Interview for Cognitive Status.

T now-classic Telephone Interview for Cognitive Status (TICS), introduced in 1988 by Brandt and colleagues (Brandt et al, 1988), has found extensive use in field surveys of cognitive functioning. Fashioned after the Mini-Mental State Examination, it improves on its predecessor in several respects. Verbal reasoning and naming tasks are among the more important additions. But it also shares some limitations. Its initial validation demonstrated a performance difference between individuals with Alzheimer disease and healthy controls. This is not difficult! Like the Mini-Mental State Examination, it has been used extensively in population surveys for identification of cognitive disorders, and in that respect it shares the same limitations of sensitivity and specificity with its predecessor. In truth, neither instrument was originally designed for screening or measurement of cognitive ability within the normal range, or even for those with mild syndromes. In the clinic, the Montreal Cognitive Assessment may be better suited for such purposes, but unfortunately that instrument has no equivalent telephone adaptation. Our group had some difficulty with the TICS item on “where are you now,” as this implied a request for an address (including even a ZIP code), which we often could not verify. Kathleen Welsh-Bohmer and I tried to circumvent this difficulty with a modified version, the TICS-m, but any resulting improvements did not warrant widespread adoption in preference to the TICS. The latter’s contribution to landmark studies such as HRS/ AHEAD (Health and Retirement Study) and its ADAMS (Aging, Demographics, and Memory Study) derivative alone should serve to establish this simple, economical, and clever test as a classic contribution to cognitive neuroscience. One must remember, however, that the TICS is best used as a screening device, and does not serve nearly as well as a cognitive endpoint in itself.