Mangione C M, Seddon J M, Cook E F, Krug J H, Sahagian C R, Campion E W, Glynn R J
Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston 02114.
J Am Geriatr Soc. 1993 May;41(5):491-7. doi: 10.1111/j.1532-5415.1993.tb01883.x.
To determine medical, ophthalmologic, and demographic predictors of cognitive function scores as measured by the Telephone Interview for Cognitive Status (TICS), an adaptation of the Folstein Mini-Mental Status Exam. A secondary objective was to perform an item-by-item analysis of the TICS scores to determine which items correlated most highly with the overall scores.
Cross-sectional cohort study.
The Glaucoma Consultation Service of the Massachusetts Eye and Ear Infirmary.
472 of 565 consecutive patients age 65 and older who were seen at the Glaucoma Consultation Service between November 1, 1987 and October 31, 1988.
Each subject had a standard visual examination and review of medical history at entry, followed by a telephone interview that collected information on demographic characteristics, cognitive status, health status, accidents, falls, symptoms of depression, and alcohol intake.
A multivariate linear regression model of correlates of TICS score found the strongest correlates to be education, age, occupation, and the presence of depressive symptoms. The only significant ocular condition that correlated with lower TICS score was the presence of surgical aphakia (model R2 = .46). Forty-six percent (216/472) of patients fell below the established definition of normal on the mental status scale. In a logistic regression analysis, the strongest correlates of an abnormal cognitive function score were age, diabetes, educational status, and occupational status. An item analysis using step-wise linear regression showed that 85 percent of the variance in the TICS score was explained by the ability to perform serial sevens and to repeat 10 items immediately after hearing them. Educational status correlated most highly with both of these items (Kendall Tau R = .43 and Kendall Tau R = .30, respectively).
Education, occupation, depression, and age were the strongest correlates of the score on this new screening test for assessing cognitive status. These factors were stronger correlates of the TICS score than chronic medical conditions, visual loss, or medications. The Telephone Interview for Cognitive Status is a useful instrument, but it may overestimate the prevalence of dementia in studies with a high prevalence of persons with less than a high school education.
通过对认知状态电话访谈（TICS，福尔斯坦简易精神状态检查的改编版）所测得的认知功能分数，确定医学、眼科及人口统计学方面的预测因素。次要目的是对TICS分数进行逐项分析，以确定哪些项目与总分的相关性最高。
横断面队列研究。
马萨诸塞州眼耳医院青光眼咨询服务部。
1987年11月1日至1988年10月31日期间在青光眼咨询服务部就诊的565例65岁及以上连续患者中的472例。
每位受试者在入组时接受标准视力检查并回顾病史，随后进行电话访谈，收集有关人口统计学特征、认知状态、健康状况、事故、跌倒、抑郁症状及酒精摄入量的信息。
TICS分数相关因素的多变量线性回归模型发现，最强相关因素为教育程度、年龄、职业及抑郁症状的存在。与较低TICS分数相关的唯一显著眼部状况是手术性无晶状体（模型R2 = 0.46）。46%（216/472）的患者在精神状态量表上低于既定的正常定义。在逻辑回归分析中，认知功能分数异常的最强相关因素为年龄、糖尿病、教育程度及职业状况。使用逐步线性回归的项目分析表明，TICS分数中85%的变异可由进行连续减7运算的能力以及听到10个项目后立即重复的能力来解释。教育程度与这两个项目的相关性最高（肯德尔Tau R分别为0.43和0.30）。
教育程度、职业、抑郁及年龄是这项评估认知状态的新筛查测试分数的最强相关因素。这些因素与TICS分数的相关性比慢性疾病、视力丧失或药物更强。认知状态电话访谈是一种有用的工具，但在受教育程度低于高中的人群患病率较高的研究中，它可能高估痴呆的患病率。
