Prediction of Cognitive and Functional Decline Using the Telephone-Administered Minnesota Cognitive Acuity Screen.

OBJECTIVES

To examine whether a telephone-based cognitive assessment-the Minnesota Cognitive Acuity Screen (MCAS)-is effective in predicting cognitive and functional decline in older adults with mild cognitive impairment (MCI) and conversion to dementia.

DESIGN

Longitudinal.

SETTING

Academic medical center.

PARTICIPANTS

Individuals aged 60 to 84 with MCI (N = 61).

MEASUREMENTS

An initial office visit consisting of a neurological examination, Clinical Dementia Rating Scale (CDR), and neuropsychological testing using the Dementia Rating Scale-2 (DRS-2), followed by the MCAS within 1 month. Participants completed up to three follow-up in-office neuropsychological assessments, originally scheduled 1 year apart. A multidisciplinary consensus group determined diagnosis (MCI, dementia) at each assessment.

RESULTS

Higher baseline MCAS total scores emerged as a significant predictor of slower functional decline (P = .002) and dementia conversion (P = .02). An increase in score from 43 to 50 points (1st to 3rd quartile) was associated with a 0.59-point (95% confidence interval (CI) = 0.23-0.95) lower CDR score at follow-up, and a 71% (95% CI = 1.11-2.63) increase in median time to dementia conversion from 2 years to 3.5 years. Of the MCAS subscales, delayed word recall predicted functional decline alone (P < .001), whereas computation was nominally associated with cognitive (P = .01) and functional (P = .01) decline.

CONCLUSION

The brief telephone-administered MCAS provides valuable information about future cognitive and functional decline in older adults with MCI and predicted conversion from MCI to dementia. These findings provide additional support for use of MCAS in clinical and research settings. The instrument may be particularly valuable in settings in which an office visit is difficult.