Background: Telephone-based cognitive assessments may be preferable to in-person testing
in terms of test burden, economic and opportunity cost.
Objective: We sought to determine the accuracy of telephone-based screening for the identification of
dementia or Mild Cognitive Impairment (MCI).
Methods: Five multidisciplinary databases were searched. Two researchers independently screened articles
and extracted data. Eligible studies compared any multi-domain telephone-based assessment of
cognition to the face-to-face diagnostic evaluation. Where data allowed, we pooled test accuracy metrics
using the bivariate approach.
Results: From 11,732 titles, 34 papers were included, describing 15 different tests. There was variation
in test scoring and quality of included studies. Pooled analyses of accuracy for dementia: Telephone Interview
for Cognitive Status (TICS) (<31/41) sensitivity: 0.92, specificity: 0.66 (6 studies); TICSmodified
(<28/50) sensitivity: 0.91, specificity: 0.91 (3 studies). For MCI: TICS-modified (<33/50) sensitivity:
0.82, specificity: 0.87 (3 studies); Telephone-Montreal Cognitive Assessment (<18/22) sensitivity:
0.98, specificity: 0.69 (2 studies).
Conclusion: There is limited diagnostic accuracy evidence for the many telephonic cognitive screens
that exist. The TICS and TICS-m have the greatest supporting evidence; their test accuracy profiles
make them suitable as initial cognitive screens where face to face assessment is not possible.