Fostering the Efficacy of Dementia Screening

Abstract: Limitations in staff resources at memory clinics in Germany can limit their ability to perform diagnostic procedures. Because of demographic changes, an increasing number of people are expected to develop mild cognitive impairment and dementia and thus require effective screening to enable early diagnosis. Telemedicine screening instruments may help identify individuals at risk. We invited N = 30 memory clinic patients to participate in both a telemedicine and an in-person interview. The telephone interview consisted of the German version of a word-retrieval test (Word Finding Test, WoFi 1), the latter a parallel version of the WoFi (WoFi 2), as well as routine diagnostic procedures for assessing neurocognitive impairment. We compared the results of WoFi 1 and 2 with each other and with the results of the neuropsychological cognitive test battery. The analyses included 13 patients diagnosed with Alzheimer’s disease and 13 with mild cognitive impairment; we excluded 4 patients with depressive disorder from the analyses. The scores on WoFi 1 and 2 correlated highly with each other ( ρ = 0.814, p < .001); remote WoFi correlated highly with other verbal word retrieval tests such as semantic (β = 0.760; p < .001), phonemic fluency (β = 0.639; p = .002), and a global cognitive status score (β = 0.591; p = .009). Participants performed better when assessed in person: The mean WoFi score was 87.00 (remotely) and 93.96 (in person). The gold standard for neuropsychological testing is face-to-face interaction between the investigator and the interviewee, but this approach requires significant staff resources and time. The study indicates that a brief, feasible telemedicine screening tool may help identify individuals who could benefit from further cognitive evaluation.