Detecting mild cognitive impairment remotely with the modified memory impairment screen by telephone
Related Experiment Video
Updated: Aug 6, 2025
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Amanda L Stein1, Kathryn A Tolle1,2, Amanda N Stover1,3
1Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati Academic Health Center, Cincinnati, OH, US.
Abstract:
The original Memory Impairment Screen by Telephone (MIST) was designed to identify individuals with dementia but was relatively ineffective for identification of less severe impairment observed in mild cognitive impairment (MCI). We expanded the original MIST to create a modified instrument (mMIST) with greater sensitivity to less severe memory impairment. Older men and women with subjective cognitive decline were assessed by phone with the mMIST and subsequently classified independently with MCI or non-pathological cognitive decline. Participants with MCI produced lower scores on the mMIST than did participants without MCI, 10.8 ± 2.7 vs 13.3 ± 1.3, t = 5.68, p < 0.001, and performance on the mMIST predicted performances on the California Verbal Learning Test (CVLT), Verbal Paired Associate Learning Test (VPAL), Montreal Cognitive Assessment (MoCA) total score, and MoCA memory index score, p < 0.001. Receiver operating characteristic (ROC) analyses identified the optimal cut score on the mMIST to distinguish participants with and without MCI with Sensitivity = 73.1%, Specificity = 79.1%, and AUC = 0.79. Predictive values for distinguishing the amnestic form of MCI (aMCI) from non-amnestic MCI were Sensitivity = 81.8%, Specificity = 30%, and AUC = 0.82. These findings indicate that the mMIST is a valid screening instrument for identifying MCI. It can be administered remotely at low cost and low participant burden. Also, the mMIST has potential utility for remote cross-sectional and longitudinal evaluation in research and clinical contexts. Further investigation is indicated to corroborate its utility for assessment of aging patients and research participants.
Insights
The modified Memory Impairment Screen by Telephone (mMIST) effectively identifies mild cognitive impairment (MCI) in older adults. This validated, low-cost phone screening tool aids remote cognitive assessment for research and clinical use.
Area of Science:
- Gerontology
- Neuroscience
- Psychometrics
Background:
- The original Memory Impairment Screen by Telephone (MIST) was limited in detecting mild cognitive impairment (MCI).
- A modified version, mMIST, was developed to enhance sensitivity for less severe memory deficits.
- Subjective cognitive decline is a precursor to MCI and dementia, necessitating sensitive screening tools.
Purpose of the Study:
- To evaluate the efficacy of the modified Memory Impairment Screen by Telephone (mMIST) in identifying mild cognitive impairment (MCI).
- To assess the mMIST's performance in distinguishing MCI from non-pathological cognitive decline in older adults.
- To determine the mMIST's utility as a remote, low-cost screening instrument for cognitive impairment.
Main Methods:
- Older adults with subjective cognitive decline were assessed via telephone using the mMIST.
- Participants were independently classified as having MCI or non-pathological cognitive decline.
- Receiver operating characteristic (ROC) analyses were used to determine optimal cut-off scores and assess diagnostic accuracy.
Main Results:
- Participants with MCI scored significantly lower on the mMIST compared to those without MCI (10.8 vs 13.3, p < 0.001).
- mMIST performance correlated significantly with established cognitive tests (CVLT, VPAL, MoCA).
- ROC analysis yielded an Area Under the Curve (AUC) of 0.79 for distinguishing MCI and 0.82 for amnestic MCI (aMCI).
Conclusions:
- The mMIST is a valid and sensitive screening tool for identifying mild cognitive impairment (MCI) in older adults.
- Its remote administration, low cost, and minimal participant burden make it suitable for widespread use.
- The mMIST shows potential for both cross-sectional and longitudinal cognitive evaluations in research and clinical settings.
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