Variation in responses to a cognitive screening tool in older adults receiving aged care services

Background Current screening assessment approaches for cognitive function are summarised using a single composite score indicating whether or not an individual has a cognitive impairment. Despite measuring different cognitive domains such as short-term memory, orientation and praxis, domain-specific responses are often not reported, making it difficult to determine the most relevant treatment strategies. The Telephone Interview for Cognitive Status-Modified (TICS-M) is a commonly used telephone-based screening instrument for cognitive performance and examines eight different cognitive domains including short-term memory, language, concentration, orientation, mathematical skills, praxis, conceptual knowledge and delayed recall. Objective To describe the variation in participant responses in each of the eight TICS-M domains. Method Australians contributing to a broader study of social networks, wellbeing and cognition among clients aged 65+ years accessing community aged care services completed the TICS-M in October 2018. Descriptive analyses of each domain were carried out. Independent samples t-test was conducted to compare domain scores for participants with and without cognitive impairment. Results One hundred and one participants (mean age 80.0±6.5) completed the TICS-M. Most were female (80.3%), living alone (51.0%), receiving the pension (89.2%), and completed high school (78.3%). The mean TICS-M score was 31.4 (SD=5.2) and majority of participants had no cognitive impairment (70.6%). Only the delayed recall domain reported a significant recency effect for individuals without cognitive impairment (94.1% vs 75% correctly recalled). There was no significant differences in participant’s responses to the other domains. Conclusion Considering domain-specific responses as complementary to a single composite score may enhance the utility of the TICS-M and identify individuals with early memory problems. Observing variations in individual responses to each cognitive domain may further improve the quality of medical feedback and the delivery of person-centred community aged care activities. This includes adopting targeted treatment strategies that could protect against further decline in ageing Australians.