scholarly journals The Colorado Cognitive Assessment (CoCA): Development of an Advanced Neuropsychological Screening Tool

2019 ◽  
Vol 35 (2) ◽  
pp. 176-187
Author(s):  
Ashita S Gurnani ◽  
Shayne S-H Lin ◽  
Brandon E Gavett
Keyword(s):  
Construct Validity ◽  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Analysis Model ◽  
Factor Analysis Model

Abstract Objective The Colorado Cognitive Assessment (CoCA) was designed to improve upon existing screening tests in a number of ways, including enhanced psychometric properties and minimization of bias across diverse groups. This paper describes the initial validation study of the CoCA, which seeks to describe the test; demonstrate its construct validity; measurement invariance to age, education, sex, and mood symptoms; and compare it to the Montreal Cognitive Assessment (MoCA). Method Participants included 151 older adults (MAge = 71.21, SD = 8.05) who were administered the CoCA, MoCA, Judgment test from the Neuropsychological Assessment Battery (NAB), 15-item version of the Geriatric Depression Scale (GDS-15), and 10-item version of the Geriatric Anxiety Scale (GAS-10). Results A single-factor confirmatory factor analysis model of the CoCA fit the data well, CFI = 0.955; RMSEA = 0.033. The CoCA factor score reliability was .84, compared to .74 for the MoCA. The CoCA had stronger disattenuated correlations with the MoCA (r = .79) and NAB Judgment (r = .47) and weaker correlations with the GDS-15 (r = −.36) and GAS-10 (r = −.15), supporting its construct validity. Finally, when analyzed using multiple-indicators, multiple-causes (MIMIC) modeling, the CoCA showed no evidence of measurement noninvariance, unlike the MoCA. Conclusions These results provide initial evidence to suggest that the CoCA is a valid cognitive screening tool that offers numerous advantages over the MoCA, including superior psychometric properties and measurement noninvariance. Additional validation and normative studies are warranted.

The Colorado Cognitive Assessment (CoCA): Development of an Advanced Neuropsychological Screening Tool

2019 ◽  
Author(s):  
Ashita S. Gurnani ◽  
Shayne S.-H. Lin ◽  
Brandon E Gavett
Keyword(s):  
Construct Validity ◽  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Depression Scale ◽  
Internal Consistency Reliability ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Analysis Model ◽  
Factor Analysis Model

Objective: The Colorado Cognitive Assessment (CoCA) was designed to improve upon existing screening tests in a number of ways, including enhanced psychometric properties and minimization of bias across diverse groups. This paper describes the initial validation study of the CoCA, which seeks to describe the test; demonstrate its construct validity; measurement invariance to age, education, sex, and mood symptoms; and compare it to the Montreal Cognitive Assessment (MoCA). Method: Participants included 151 older adults (MAge = 71.21, SD = 8.05) who were administered the CoCA, MoCA, Judgment test from the Neuropsychological Assessment Battery (NAB), 15-item version of the Geriatric Depression Scale (GDS-15), and 10-item version of the Geriatric Anxiety Scale (GAS-10). Results: A single factor confirmatory factor analysis model of the CoCA fit the data well, CFI = 0.955; RMSEA = 0.033. The CoCA’s internal consistency reliability was .84, compared to .74 for the MoCA. The CoCA had stronger disattenuated correlations with the MoCA (r = .79) and NAB Judgment (r = .47) and weaker correlations with the GDS-15 (r = -.36) and GAS-10 (r = -.15), supporting its construct validity. Finally, when analyzed using multiple indicators, multiple causes (MIMIC) modeling, the CoCA showed no evidence of measurement non-invariance, unlike the MoCA. Conclusions: These results provide initial evidence to suggest that the CoCA is a valid cognitive screening tool that offers numerous advantages over the MoCA, including superior psychometric properties and measurement non-invariance. Additional validation and normative studies are warranted.

P3-468: CONSTRUCT VALIDITY OF THE VISUAL COGNITIVE ASSESSMENT TEST (VCAT): AN INTERNATIONAL LANGUAGE-NEUTRAL COGNITIVE SCREENING TOOL

2006 ◽  
Vol 14 (7S_Part_24) ◽  
pp. P1299-P1300
Author(s):  
Audrey Low ◽  
Levinia Lim ◽  
Linda Lay Hoon Lim ◽  
Benjamin Wong ◽  
Eveline Silva ◽  
...  
Keyword(s):  
Construct Validity ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Cognitive Screening ◽  
International Language ◽  
Visual Cognitive

The Montreal Cognitive Assessment (MoCA) in geriatric rehabilitation: psychometric properties and association with rehabilitation outcomes

2011 ◽  
Vol 23 (10) ◽  
pp. 1582-1591 ◽  
Author(s):  
Lisa Sweet ◽  
Mike Van Adel ◽  
Valerie Metcalf ◽  
Lisa Wright ◽  
Anne Harley ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Rehabilitation Program ◽  
Cognitive Status ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
Geriatric Rehabilitation ◽  
Cognitive Screening ◽  
Rehabilitation Outcome

ABSTRACTBackground:Cognitive status has been reported to be an important predictor of rehabilitation outcome. The Montreal Cognitive Assessment (MoCA) was designed to overcome some of the limitations of established cognitive screening tools such as the Mini-Mental State Examination (MMSE). The purpose of this study is to evaluate the psychometric characteristics of the MoCA as a screening tool in a geriatric rehabilitation program and its ability to predict rehabilitation outcome.Methods:Forty-seven geriatric rehabilitation program patients participated in the study. Assessments of each patient's functional (Functional Independence Measure) and cognitive status (MMSE and MoCA) were performed. Information on discharge destinations were obtained and rehabilitation efficacy and efficiency scores were calculated.Results:Significant correlations were found between the MoCA and other cognitive status measures. Cognitive status at admission and successful rehabilitation were also associated. Defining rehabilitation success on the basis of relative functional efficacy (an indicator that includes the patient's potential for improvement), the sensitivity and specificity of the MoCA were 80% and 30% respectively. The attention subscale of the MoCA was also uniquely predictive of rehabilitation success. The attention subscale (cutoff 5/6) of the MoCA had a sensitivity of 40% and specificity of 90%, as did the MMSE.Conclusions:As a cognitive screening tool, the MoCA appears to have acceptable psychometric properties. Results suggest that the MoCA can have a considerable advantage over the MMSE in sensitivity and equivalence in specificity using both total and attention scale scores. The MoCA may be a more useful measure for detecting cognitive impairment and predicting rehabilitation outcome in this population.

Construct validity of the Visual Cognitive Assessment Test (VCAT)—a cross-cultural language-neutral cognitive screening tool

2019 ◽  
Vol 32 (1) ◽  
pp. 141-149 ◽  
Author(s):  
Audrey Low ◽  
Levinia Lim ◽  
Linda Lim ◽  
Benjamin Wong ◽  
Eveline Silva ◽  
...  
Keyword(s):  
Construct Validity ◽  
Internal Consistency ◽  
Cognitive Assessment ◽  
Roc Analysis ◽  
Screening Tool ◽  
Area Under The Curve ◽  
Cross Cultural ◽  
Cognitive Screening ◽  
Domain Specific ◽  
Visual Cognitive

ABSTRACTBackground:The Visual Cognitive Assessment Test (VCAT) is a language-neutral cognitive screening tool designed for use in culturally diverse populations without the need for translations or adaptations. While it has been established to be language-neutral, the VCAT’s construct validity has not been investigated.Methods:471 participants were recruited, comprising 233 healthy comparisons, 117 mild cognitive impairment (MCI), and 121 mild Alzheimer’s disease (AD) patients. VCAT and domain-specific neuropsychological tests were administered in the same sitting. Construct validity was assessed by analyzing domain-specific associations between the VCAT and well-established cognitive assessments. Reliability (internal consistency) was measured by Cronbach’s alpha. Diagnostic ability (area under the curve) and recommended cutoffs were determined by receiver operating characteristic (ROC) analysis.Results:The VCAT and its subdomains demonstrated good construct validity in terms of both convergent and divergent validity and good internal consistency (α = .74). ROC analysis found that the VCAT was on par with the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at distinguishing between healthy comparisons, MCI, and mild AD. Consistent with previous studies, VCAT scores were not affected by language of administration or ethnicity in our cohort. Findings suggest the following cutoffs: Dementia 0–19, MCI 20–24, Normal 25–30.Conclusion:This study established the construct validity of the VCAT, which is vital to ensure its subdomains effectively measure the cognitive processes they were designed to. The VCAT is capable of detecting early cognitive impairments and allows for meaningful cross-cultural comparisons, especially useful for international collaborations and clinical trials, and for clinical use in diverse multiethnic populations.

scholarly journals Screening tools for the identification of dementia for adults with age-related acquired hearing or vision impairment: a scoping review

2017 ◽  
Vol 29 (11) ◽  
pp. 1771-1784 ◽  
Author(s):  
Annie Pye ◽  
Anna Pavlina Charalambous ◽  
Iracema Leroi ◽  
Chrysoulla Thodi ◽  
Piers Dawes
Keyword(s):  
Hearing Impairment ◽  
Cognitive Assessment ◽  
Negative Impact ◽  
Sensory Modality ◽  
Vision Impairment ◽  
Assessment Tools ◽  
Screening Tools ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Age Related

ABSTRACTBackground:Cognitive screening tests frequently rely on items being correctly heard or seen. We aimed to identify, describe, and evaluate the adaptation, validity, and availability of cognitive screening and assessment tools for dementia which have been developed or adapted for adults with acquired hearing and/or vision impairment.Method:Electronic databases were searched using subject terms “hearing disorders” OR “vision disorders” AND “cognitive assessment,” supplemented by exploring reference lists of included papers and via consultation with health professionals to identify additional literature.Results:1,551 papers were identified, of which 13 met inclusion criteria. Four papers related to tests adapted for hearing impairment; 11 papers related to tests adapted for vision impairment. Frequently adapted tests were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MOCA). Adaptations for hearing impairment involved deleting or creating written versions for hearing-dependent items. Adaptations for vision impairment involved deleting vision-dependent items or spoken/tactile versions of visual tasks. No study reported validity of the test in relation to detection of dementia in people with hearing/vision impairment. Item deletion had a negative impact on the psychometric properties of the test.Conclusions:While attempts have been made to adapt cognitive tests for people with acquired hearing and/or vision impairment, the primary limitation of these adaptations is that their validity in accurately detecting dementia among those with acquired hearing or vision impairment is yet to be established. It is likely that the sensitivity and specificity of the adapted versions are poorer than the original, especially if the adaptation involved item deletion. One solution would involve item substitution in an alternative sensory modality followed by re-validation of the adapted test.

Psychometric Properties of the Persian Adaptation of Mini-Cog Test in Iranian Older Adults

2017 ◽  
Vol 86 (3) ◽  
pp. 266-280 ◽  
Author(s):  
Mohammad Rezaei ◽  
Vahid Rashedi ◽  
Gohar Lotfi ◽  
Peymaneh Shirinbayan ◽  
Mahshid Foroughan
Keyword(s):  
Older Adults ◽  
Psychometric Properties ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Validity And Reliability ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Mental Test Score ◽  
Persian Version ◽  
People With Dementia

The aim of this study was to assess the psychometric properties of the Mini-Cog in Iranian older adults. It was a cross-sectional study; 50 older people with dementia and 50 without dementia who matched for age, gender, and education entered the study. The diagnostic and statistical manual of mental disorders criteria for dementia were used as gold standard. A battery of scales included the abbreviated mental test score (AMTS), the Geriatric Depression Scale, and the Mini-Cog was performed. Validity and reliability of the Mini-Cog determined using the Pearson product-moment correlation coefficient (Pearson’s r), Cronbach’s alpha, and Receiver Operating Characteristic (ROC) curve analysis. The Persian version of Mini-Cog showed a good inter-rater reliability ( K = 0.76, p < .01) and a positive concurrent validity ( r = 0.39, p < .01) with the AMTS. The sensitivity and specificity were 88% and 62.8%, respectively, using the original cutoff point of 2. The findings showed that the Persian version of Mini-Cog have an acceptable sensitivity, specificity, and substantial overall agreement with the AMTS.

scholarly journals Who Is Classified as Untestable on Brief Cognitive Screens in an Acute Stroke Setting?

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 95 ◽  
Author(s):  
Emma Elliott ◽  
Bogna A. Drozdowska ◽  
Martin Taylor-Rowan ◽  
Robert C. Shaw ◽  
Gillian Cuthbertson ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Odds Ratio ◽  
National Institutes Of Health ◽  
Screening Tests ◽  
Stroke Severity ◽  
Modified Rankin Scale ◽  
Cognitive Screening ◽  
Dementia Diagnosis ◽  
Nihss Score ◽  
Test Completion

Full completion of cognitive screening tests can be problematic in the context of a stroke. Our aim was to examine the completion of various brief cognitive screens and explore reasons for untestability. Data were collected from consecutive stroke admissions (May 2016–August 2018). The cognitive assessment was attempted during the first week of admission. Patients were classified as partially untestable (≥1 test item was incomplete) and fully untestable (where assessment was not attempted, and/or no questions answered). We assessed univariate and multivariate associations of test completion with: age (years), sex, stroke severity (National Institutes of Health Stroke Scale (NIHSS)), stroke classification, pre-morbid disability (modified Rankin Scale (mRS)), previous stroke and previous dementia diagnosis. Of 703 patients admitted (mean age: 69.4), 119 (17%) were classified as fully untestable and 58 (8%) were partially untestable. The 4A-test had 100% completion and the clock-draw task had the lowest completion (533/703, 76%). Independent associations with fully untestable status had a higher NIHSS score (odds ratio (OR): 1.18, 95% CI: 1.11–1.26), higher pre-morbid mRS (OR: 1.28, 95% CI: 1.02–1.60) and pre-stroke dementia (OR: 3.35, 95% CI: 1.53–7.32). Overall, a quarter of patients were classified as untestable on the cognitive assessment, with test incompletion related to stroke and non-stroke factors. Clinicians and researchers would benefit from guidance on how to make the best use of incomplete test data.

The Utility of Cognitive Screeners in the Detection of Dementia Spectrum Disorders in Spanish-Speaking Populations

2020 ◽  
pp. 089198872091551
Author(s):  
Shanna L. Burke ◽  
Adrienne Grudzien ◽  
Aaron Burgess ◽  
Miriam J. Rodriguez ◽  
Yesenia Rivera ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Normative Data ◽  
Screening Tools ◽  
Screening Tests ◽  
Culturally Appropriate ◽  
Cognitive Screening ◽  
Spanish Speaking ◽  
Search Terms ◽  
Mini Mental Status Examination ◽  
Spectrum Disorders

Increasing rates of dementia spectrum disorders among Spanish-speaking geriatric populations necessitate the development of culturally appropriate cognitive screening tests that can identify neurodegenerative disorders in their earliest stages when emerging disease-modifying treatments are most likely to be effective. This scoping review identified 26 brief Spanish language cognitive screening tools (<20 minutes) by searching academic databases using a combination of search terms. Results suggest that the Mini-Mental Status Examination and Montreal Cognitive Assessment appear to be less valid than other screeners. Instruments such as the 7-Minute Screen and Mini-Cog evidence higher classification rates of dementia, while Phototest detected mild cognitive impairment at higher rates more consistently than other screeners. Different sensitivity and specificity outcomes and cutoffs were observed when the same cognitive screener was evaluated in different countries. Results indicate that it is imperative to increase nation-specific validation and normative data for these instruments to best serve diverse populations.

scholarly journals DO PERSONALITY TRAITS INFLUENCE PERCEPTIONS OF COGNITIVE CHANGE IN COMMUNITY DWELLING OLDER ADULTS?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S893-S894
Author(s):  
Thomas M Meuser ◽  
Regula H Robnett
Keyword(s):  
Personality Traits ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cognitive Change ◽  
Community Dwelling ◽  
Self Report ◽  
Sample Population ◽  
Big Five Personality ◽  
Cognitive Screening ◽  
Influence Perceptions

Abstract Recent research has linked personality traits and risk for cognitive impairment in advancing age. Associations with neuroticism are particularly robust. Both longstanding and recent elevations may predict dementia. Other traits – conscientiousness and openness to experience – also show unique associations. These findings derive mainly from large sample population studies and smaller clinical investigations. Relevance to the general population is unclear. We investigated the “big five” personality traits and cognition in 232 community-dwelling adults (73% female, 97% Caucasian, mean age 72 years). Scores on a self-report screen for dementia – the AD8 – framed the sample: 77% scored 0 points, no dementia; 23% scored 2+, possible dementia. Age and personality were independent variables in a binary logistic regression with AD8 status as dependent. All predictors but one, extraversion, were significant (p &lt; .05), suggesting that personality traits may influence perceptions of cognitive change. Higher agreeableness and neuroticism predicted possible dementia status on the AD8, whereas higher openness and conscientiousness predicted normal cognition. Interestingly, most in the AD8 positive group (70%) denied having “more problems with memory than most” on the Geriatric Depression Scale. These perceptions would seem incompatible, especially for true positive cases. Our findings suggest that the role of personality in dementia screening (and, perhaps, diagnosis) may be more nuanced than indicated in other studies. Longstanding traits and present perceptions are both elements of the evaluative process, as much as test scores and reported history. Our findings speak to the value of a person-centered, context-aware approach in cognitive screening.

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