Convergence and equating norms between the Telephone Interview for Cognitive Status (TICS), the MMSE and the MoCA in an Italian population sample

Background

This study aimed at testing the convergence and deriving equating norms between the Telephone Interview for Cognitive Status (TICS) and the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) in an Italian population sample.

Methods

Four-hundred and eighty two healthy Italian native-speaker (300 females; age: 57.8 ± 15.5, range = 20–94; education: 13.1 ± 3.8, range = 5–25) underwent the TICS (range = 1–41), MMSE and MoCA. An additional Delayed Recall of the 10-word list was administered as the last task of the TICS to compute a further total (TICS_&DR; range = 1–51). Convergence between the TICS/TICS_&DR and in-person screeners was tested via Bonferroni-corrected Spearman’s coefficients, whilst equating norms were derived via a Log-linear Smoothing Equipercentile Equating (LSEE) approach. A two one-sided test (TOST) procedure was run to test the equivalence between empirical and LSEE-derived scores.

Results

TICS scores converged with both MMSE (r_s=0.34; p <.001) and MoCA scores (r_s=0.42; p <.001)– the same being true for the TICS_&DR (MMSE: r_s=0.36; p <.001; MoCA: r_s=0.42; p <.001). Cross-walks were estimated to derive TICS/TICS_&DR scores from the MMSE/MoCA, and vice-versa. The algorithm could not compute the conversions for TICS, MMSE and MoCA scores < 22, <21 and < 14, respectively. TOST procedures revealed that all comparisons yielded equivalence except for those aimed at deriving TICS from MMSE scores and TICS_&DR from both the MMSE and the MoCA.

Discussion

The Italian TICS validly captures examinees’ cognitive efficiency as measured by MMSE or MoCA; derived cross-walks between the TICS and MMSE/MoCA allows for a flexible use of in-person and telephone-based screeners.