Development and Validation of Telephone Cognitive Testing for Community-Dwelling Older Adults (TCTCOA) in China

With the global acceleration of population ageing, cognitive health remains critical to the well-being of older adults. This study aimed to develop and validate Telephone Cognitive Testing for Community-dwelling Older Adults (TCTCOA), a culturally and contextually tailored cognitive assessment tool designed for healthy, community-dwelling older adults in China. TCTCOA included five cognitive domains-episodic memory, working memory, processing speed, executive function, and abstract reasoning and concept formation-assessed using culturally adapted tasks. A sample of 112 community-dwelling older adults aged 60 and above participated in the study. Sixty-eight participants completed TCTCOA via telephone and face-to-face modalities, alongside the Montreal Cognitive Assessment (MoCA) for validation. Pearson's correlations, structural validity, and convergent validity were analyzed to evaluate the tool. TCTCOA demonstrated strong correlations between telephone and face-to-face modes (r = 0.72) and moderate correlations with the MoCA. Subtests showed no ceiling or floor effects, and the composite scores followed a normal distribution. The tool's structural validity was supported by factor analysis, identifying general cognitive ability and efficiency as core components. TCTCOA is a valid, reliable, and accessible telephone-based cognitive assessment tool. It is suitable for healthy older adults in community settings, offering a practical alternative to traditional face-to-face cognitive evaluations. Its design overcomes cultural, educational, and logistical barriers, making it an effective resource for cognitive health monitoring in China.