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 reliability of a telephonically administered cognitive screening battery, consisting of nine brief tests (orientation, attention, delayed word recall, comprehension, repetition, naming, computation, judgment, and verbal fluency), to distinguish between patients with dementia and healthy control subjects. Background: Existing telephonic screening instruments do not take full advantage of strategies that might increase precision. Methods: A total of 228 elderly individuals received a telephone assessment of cognitive function (99 mildly to moderately demented nursing home residents with an established diagnosis of dementia residing in 1 of 12 nursing facilities, and 129 community-dwelling elderly individuals who were independently screened to verify normal cognitive function). Results: Nurses and psychologists experienced in telephonic test administration typically completed the screening with each 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 discriminant 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 powerfully predictive subtests were orientation, delayed word recall, verbal fluency, computation, and judgment. Conclusions: This telephonic screening instrument 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 unselected elderly populations to better understand its value as a screening tool.