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A Comparison of Three Dementia Screening Instruments Administered by Telephone in China

Xuanwu Hospital, Capital University of Medical Sciences, Beijing

Xinqing Zhang

Xuanwu Hospital, Capital University of Medical Sciences, Beijing

James C. Mundt

Healthcare Technology Systems, Wisconsin

Lidong Wang

Xuanwu Hospital, Capital University of Medical Sciences, Beijing

Chao Meng

Xuanwu Hospital, Capital University of Medical Sciences, Beijing

Changbiao Chu

Xuanwu Hospital, Capital University of Medical Sciences, Beijing

Jing Yang

Xuanwu Hospital, Capital Universityof Medical Sciences, Beijing

Piao Chan

Xuanwu Hospital, Capital Universityof Medical Sciences, Beijing

Implementation of valid and efficient case-finding methods to screen for cognitive impairment is important for identifying people during the earliest stages of dementia. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Information-Memory-Concentration Test (IMCT), and Blessed-Roth Dementia Scale (BRDS) are assessment tools commonly used in China. This study investigated the usefulness of administering these scales by telephone.

Subjects (N= 132: 74 females, 58 males) from Xuanwu Hospital, Capital University of Medical Sciences in Beijing, China were recruited for participation in this study; 132 collateral informants who accompanied the subjects to their appointments provided IQCODE and BRDS data. Senior neurologists using Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria (American Psychiatric Publishing, 2000), patient history, physical examination, neuropsychological tests, neuroradiology, and laboratory tests made the dementia diagnoses. Blinded personnel administered the IQCODE, IMCT, and BRDS by telephone and face-to-face in the clinic in counter-balanced administration order. Independent subsamples of 20 subjects were selected for assessment of test-retest and inter-rater reliabilities of the telephone assessments.

Correlations between the face-to-face and telephone administrations of the scales were good, ranging from .80 to .97. The administration order of assessment methods did not affect the results. Inter-rater and test-retest reliabilities were satisfactory. The sensitivity and specificity of each scale exceeded 80 percent, demonstrating scale validity and clinical utility.

The results support reliable and valid administration of these dementia assessments in person or over the telephone. The appropriate selection of assessment instruments is dependent upon the characteristics of the patient population and the intended use of the results. Use of telephone assessments may provide a valid and efficient method to screen elderly people for early detection of dementia symptoms and to monitor the effectiveness of treatment.

Key Words: BRDS • cognitive • IMCT • IQCODE • neuropsychology • reliability • scale • screen • validity

Dementia, Vol. 3, No. 1, 69-81 (2004)
DOI: 10.1177/1471301204039325


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