PHI stands for "Protected Health Information" (Y = Yes, N = No)
| Display | Field | Phi | Field type | Condition choices | Field note | Header | |
|---|---|---|---|---|---|---|---|
| 1. Please tell me your name. Score one point for first name and one point for last name | tics_1 | N | text | - | Max Score: 2 | - | |
| 2. What is today's date? Score one point for month, date,year,day of week and season.If incomplete ask specifics | tics_2 | N | text | - | Max Score: 5 | - | |
| 3. Where are you right now? Score one point for house number, street, city, state and zip.If incomplete ask specifics | tics_3 | N | text | - | Max Score: 5 | - | |
| 4. Count backwards from 20 to 1 Score two points if completely correct on the first trial; one point if completely correct on 2nd trial; no poins for anything else | tics_4 | N | text | - | Max Score: 2 | - | |
| 5. I am going to read you a list of ten words.Please listen carefully and try to remember them.When I am done, tell me as many words as you can , in any order.Ready? The words are cabin, pipe, elephant, chest, silk, theater, watch, whip, pillow, giant Score one point for each correct response.No penalty for repetitions or intrusions | tics_5 | N | text | - | Max Score: 10 | - | |
| 6. 100 minus 7 equals what? And 7 from that? etc. Stop at 5 serial subtractions.Do not inform the subject of incorrect responses, but allow subtractions to be made from his/her last response (e.g. 93-85-78-71-65 would get 3 points) | tics_6 | N | text | - | Max Score: 5 | - | |
| 7. What do people use to cut paper? Score one point for scissors or shears only | tics_7 | N | text | - | Max Score: 1 | - | |
| How many things in a dozen? | tics7b | N | text | - | Max Score: 1 | - | |
| What do you call the prickly green plant that lives in the desert? Score one point for cactus only | tics7c | N | text | - | Max Score: 1 | - | |
| What animal does wool come from? Score one point for sheep or lamb only | tics7d | N | text | - | Max Score: 1 | - | |
| 8. Say this: "No ifs ands or buts." Say this: "Methodist Episcopal." Score one point for each complete repetition on the first trial. Repeat only if poorly presented | tics_8 | N | text | - | Max Score: 2 | - | |
| 9. Who is the President of the United States right now? Who is the Vice-President? Score one point each for correct first and last name. | tics_9 | N | text | - | Max Score: 2 | - | |
| 10. With your finger, tap 5 times on the part of the phone you speak into. Score two points if 5 taps are heard; one point if the subject taps phone more or less than 5 times | tics_10 | N | text | - | Max Score: 2 | - | |
| 11. I am going to give you a word and I want you to give me the opposite. For example, the opposite of hot is cold.What is the opposite of "West"? Score one point if "east" | tics_11 | N | text | - | Max Score: 1 | - | |
| What is the opposite of "generous"? Score one point if "selfish","greedy","stingy","tight","cheap","mean", "meager","skimpy" or other good antonym | tics_12 | N | text | - | Max Score: 1 | - | |
| 12. Total Score | tics_tot | N | calc | sum([tics_1] ,[tics_2] ,[tics_3] , [tics_4] ,[tics_5] ,[tics_6] ,[tics_7] ,[tics7b] ,[tics7c] ,[tics7d] ,[tics_8] ,[tics_9] ,[tics_10] ,[tics_11] ,[tics_12]) | - | - | |
| Adapted, with permission from Brandt J, Spencer M, Folstein M, "The Telephone Interview for Cognitive Status", Neuropsychiatry, Neuropsychology and Behavioral Neurology, Vol 1, No. 2,pp. 111-117. 1988. | adapted_with_permission_fr | N | descriptive | - | - | - | |
| Notes | telephone_interview_for_cognitive_statuscsv_notes | Y | notes | - | - | - |