Evaluating brief cognitive impairment screening instruments among African Americans

Area of Science:

• Neuroscience
• Gerontology
• Public Health

Background:

• Cognitive impairment (CI) assessment tools must be validated across diverse populations.
• The Telephone Interview of Cognitive Status (TICS) and the Short Portable Mental Status Questionnaire (SPMSQ) are commonly used for cognitive screening.
• Racial and educational disparities may influence the accuracy of cognitive assessment tools.

Purpose of the Study:

• To compare the diagnostic accuracy of TICS and SPMSQ in detecting cognitive impairment among African Americans (AA).
• To investigate age-related differences in CI prevalence using both TICS and SPMSQ.
• To examine the impact of education level on CI detection accuracy for TICS and SPMSQ.

Main Methods:

• Secondary data analysis of 396 African American participants from the Carolina African American Twin Study on Aging (CAATSA).
• Comparison of cognitive impairment prevalence rates derived from TICS and SPMSQ.
• Stratified analysis based on age groups (50-64 vs. >64 years) and education levels (≥13 vs. <13 years).

Main Results:

• SPMSQ identified CI in 10.3% of participants, while TICS identified it in 45.0%.
• CI prevalence was significantly higher with TICS across all age and education subgroups compared to SPMSQ.
• For instance, among higher educated individuals, TICS showed 36.7% CI prevalence versus 7.7% with SPMSQ.

Conclusions:

• The TICS may overestimate cognitive impairment in African American populations compared to the SPMSQ.
• Findings suggest potential biases in TICS performance among diverse ethnic and educational groups.
• Further research is needed to refine cognitive screening tools for equitable use across different demographics.