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TICS™

Telephone Interview for Cognitive Status™

Jason Brandt, PhD, and Marshal F. Folstein, MD

Purpose:
Assesses cognitive status by telephone
Format:
Paper and pencil
Age range:
60 years to 98 years
Time:
10 minutes or less and score
Qualification level:
S
S
A degree, certificate, or license to practice in a health care profession or occupation, including (but not limited to) the following: medicine, neurology, nursing, occupational therapy and other allied health care professions, physician's assistants, psychiatry, social work; plus appropriate training and experience in the ethical administration, scoring, and interpretation of clinical behavioral assessment instruments. Certain health care providers may be eligible to purchase selected "B" and "C" level instruments within their area of expertise. Specifically, relevant supervised clinical experience using tests (i.e., internship, residency, etc.) in combination with formal coursework ( i.e., Tests and Measurement, Individual Assessment, or equivalent) qualifies a health care provider to purchase certain restricted products. Any PAR Customer already qualified to purchase a "B" or "C" level product, is also qualified to purchase an "S" level product. If you are not already qualified to purchase a "B"or "C" level product from PAR, please download and complete the special Qualification Form for Medical and Allied Health Professionals. (You will need Adobe Acrobat to view.) Close

The TICS is a brief, standardized test of cognitive functioning that was developed for use in situations where in-person cognitive screening is impractical or inefficient (e.g., large-scale population screening, epidemiological surveys, with patients who are unable to appear in person for clinical follow-up).

Although the TICS is designed to be administered using the telephone, it also may be administered face-to-face. Because it does not require vision, the TICS is particularly useful for examining visually impaired individuals and individuals who are unable to read or write. The test was standardized and validated for use with English-speaking adults ages 60-98 years.

Research has demonstrated that psychological data obtained over the telephone are as reliable and valid as those obtained through face-to-face interaction. The TICS correlates highly with the Mini-Mental® State Examination (MMSE®). It has high test-retest reliability and excellent sensitivity and specificity for the detection of cognitive impairment. Among elderly populations, TICS scores approximate a normal distribution and are not subject to the ceiling effects that limit the usefulness of many mental status examinations.

Before administering the telephone interview, the examiner must speak with someone at the same location (e.g., family member, caregiver) who will serve as a proctor to ensure that the environment is appropriate for testing and that the examinee is able to hear spoken language at a conversational volume.

The test materials consist of the Professional Manual and the Record Form. To assist in test administration, the Record Form provides specific instructions for administration, the exact instructions for both the examinee and the proctor, and the scoring criteria for each TICS item.

The 11 test items usually take less than 10 minutes to administer and score. All examinee responses are recorded verbatim. The individual item scores are summed to obtain the TICS Total score. The TICS Total score provides a measure of global cognitive functioning and can be used to monitor changes in cognitive functioning over time.

The impairment ranges have been shown to adequately distinguish between normal participants and patients with cognitive impairment. The appropriate normative reference group for interpretation will depend on the reason for the evaluation and on the examinee's age and level of education.

TICS results are reported using a qualitative impairment range and T scores.

Qualitative impairment range

The TICS Total score can be interpreted by means of four qualitative impairment ranges: Unimpaired, Ambiguous, Mildly Impaired, and Moderately to Severely Impaired (based on the results from six nondemented and six cognitively impaired elderly groups representing diverse race/ethnicity).

T scores

  • For individuals ages 60-89 years with at least 12 years of education, TICS T scores are provided based on the results from a normative sample of 6,338 participants.
  • For individuals ages 65 years or older with less than 12 years of education (based on the results from a sample of 388 participants), T scores may be obtained through a process of equating TICS and MMSE Total scores.

The TICS is designed to provide a brief overall assessment of cognitive status; it should not be used alone to diagnose any specific neurological or psychiatric disorder. Specifying the precise nature and cause of cognitive impairment requires a comprehensive assessment that includes diagnostic testing and a complete medical and neuropsychiatric history. In addition to measuring an individual's overall cognitive functioning with the TICS Total score, clinicians also may wish to examine an individual's performance on specific items.

The Professional Manual provides information about the development, reliability, and validity of the instrument, as well as data based on both normative and clinical groups. Two case studies are presented to illustrate appropriate uses of the instrument.

Note: The Mini-Mental® State Examination (MMSE®) is a brief and valid measure for assessing cognitive function in adults, making it a useful companion to the TICS. Click here for more information on the MMSE.