The AVERT MoCA Data: Scoring Reliability in a Large Multicenter Trial

Assessment ◽  
2018 ◽  
Vol 27 (5) ◽  
pp. 976-981 ◽  
Author(s):  
Toby B. Cumming ◽  
Danielle Lowe ◽  
Thomas Linden ◽  
Julie Bernhardt
Keyword(s):  
Cognitive Assessment ◽  
Interrater Reliability ◽  
Screening Tool ◽  
Multicenter Trial ◽  
Scoring Rules ◽  
Independent Data ◽  
Cognitive Screening ◽  
Subjective Judgement ◽  
Trail Making ◽  
Data Checking

The Montreal Cognitive Assessment (MoCA) is a widely used cognitive screening tool in stroke. As scoring the visuospatial/executive MoCA items involves subjective judgement, reliability is important. Analyzing data on these items from A Very Early Rehabilitation Trial (AVERT), we compared the original scoring of assessors ( n = 102) to blind scoring by a single, independent rater. In a sample of scoresheets from 1,119 participants, we found variable interrater reliability. The match between original assessors and the independent rater was the following: trail-making 97% (κ = 0.94), cube copy 90% (κ = 0.80), clock contour 92% (κ = 0.49), clock numbers 89% (κ = 0.67), and clock hands 72% (κ = 0.46). For all items except clock contour, the independent rater was “stricter” than the original assessors. Discrepancies were typically errors in original scoring, rather than borderline differences in subjective judgement. In trials that include the MoCA, researchers should emphasize scoring rules to assessors and implement independent data checking, especially for clock hands, to maximize accuracy.

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.

Independent Older Adult’s IADL and Executive Function According to Cognitive Performance

2020 ◽  
Vol 40 (3) ◽  
pp. 183-189
Author(s):  
Orit Lahav ◽  
Noomi Katz
Keyword(s):  
Executive Function ◽  
Cognitive Assessment ◽  
Daily Living ◽  
Screening Tool ◽  
Cognitive Screening ◽  
Female Age ◽  
Gender And Age ◽  
Cognitive Levels ◽  
And Gender ◽  
Independent Elderly

Participation in Instrumental Activities of Daily Living (IADL) is essential in occupational therapy aiming to improve the life situation of elderly. Effective executive function (EF) is important to successful functioning in IADL. The purpose of this study was to examine EF and IADL performance differences according to cognitive levels as measured by the Montreal Cognitive Assessment (MoCA), age, and gender. In all, 80 elderly (49% female; age M = 73.4) were assessed at home, with Weekly Calendar Planning Activity (WCPA-10), IADL scale, and MoCA as a cognitive screening tool for dividing into normal cognitive (NC) level and mild cognitive impairment (MCI). The comparison between the MoCA groups on the WCPA-10 and IADL shows significant differences between the groups; gender and age differed only in IADL. IADL and WCPA-10 performance among independent elderly relates to their cognitive level. We suggest that intervention that will focus on EF may assist in improving performance and maintaining participation in occupation.

scholarly journals Assessing Capacity in the Elderly: Comparing the MoCA with a Novel Computerized Battery of Executive Function

2017 ◽  
Vol 7 (2) ◽  
pp. 249-256 ◽  
Author(s):  
Megan Brenkel ◽  
Kenneth Shulman ◽  
Elias Hazan ◽  
Nathan Herrmann ◽  
Adrian M. Owen
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
The Elderly ◽  
Cognitively Impaired ◽  
Cognitive Screening ◽  
Decision Making Capacity ◽  
Brain Sciences ◽  
Cognitively Intact

Background/Aims: Clinicians are increasingly being asked to provide their opinion on the decision-making capacity of older adults, while validated and widely available tools are lacking. We sought to identify an online cognitive screening tool for assessing mental capacity through the measurement of executive function. Methods: A mixed elderly sample of 45 individuals, aged 65 years and older, were screened with the Montreal Cognitive Assessment (MoCA) and the modified Cambridge Brain Sciences Battery. Results: Two computerized tests from the Cambridge Brain Sciences Battery were shown to provide information over and above that obtained with a standard cognitive screening tool, correctly sorting the majority of individuals with borderline MoCA scores. Conclusions: The brief computerized battery should be used in conjunction with standard tests such as the MoCA in order to differentiate cognitively intact from cognitively impaired older adults.

scholarly journals A-021 Normative Data on Montreal Cognitive Assessment Total Scores in Healthy Controls

2020 ◽  
Vol 35 (6) ◽  
pp. 811-811
Author(s):  
Ratcliffe L ◽  
Marker C
Keyword(s):  
Cognitive Assessment ◽  
Normative Data ◽  
Screening Tool ◽  
Geographical Location ◽  
Healthy Adults ◽  
Montreal Cognitive Assessment ◽  
Healthy Controls ◽  
Strongly Correlated ◽  
Cognitive Screening ◽  
Cutoff Scores

Abstract The Montreal Cognitive Assessment (MoCA) is considered to be a suitable, sensitive, and specific cognitive screening tool for detecting mild cognitive impairment. Research has reported variable cutoff scores for the MoCA based upon geographical location. The aim of the present study is to provide normative data in a sample of cognitively healthy adults. Data was collected through the National Alzheimer’s Coordinating Center (NACC). A population of healthy adults (N = 3610) was examined (66% female, 78% Caucasian, 16% African American, 6% Other). MoCA normative data were derived from age and education, which were found to be weakly but significantly associated with age (r = −.203, p = .000) and more strongly correlated with education (r = .402, p = .000). Total scores (M = 26.25, SD = 2.75) were at the suggested cutoff for impairment (< 26). Based on an ANOVA, age had a significant effect on MoCA scores (F (6, 3603) = 25.30, p < .001). A second ANOVA revealed that education also had a significant effect on MoCA scores (F (2, 3582) = 290.56, p < .001). Individuals with higher levels of education obtained higher MoCA scores. Performance was also found to decrease slightly with age. Therefore, clinicians should use caution when applying the recommended cutoff scores.

scholarly journals The Montreal Cognitive Assessment as a Cognitive Screening Tool in Athletes

2019 ◽  
Vol 46 (3) ◽  
pp. 311-318 ◽  
Author(s):  
Chantel Teresa Debert ◽  
Joan Stilling ◽  
Meng Wang ◽  
Tolulope Sajobi ◽  
Kristina Kowalski ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Sports Medicine ◽  
High Performance ◽  
Screening Tool ◽  
Sport Participation ◽  
Clinical Care ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
National Team

ABSTRACT:Background: The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool known to accurately measure mild cognitive impairment (MCI) in many different neurological populations. Objective: We aimed to determine whether a sport-related concussion (SRC) history and other concussion modifiers influence global cognitive function in high-performance athletes. Methods: A cross-sectional study of 326 varsity and national team athletes aged 18–36 years was completed at the University of Calgary Sports Medicine Clinic, Calgary, Alberta, Canada. Logistic regression analysis was used to examine the association between the total MoCA score, MoCA subscales, and number of previous SRC, adjusting for age, sex, sport participation (SP), and concussion modifiers. Results: Athletes with a history of three or more SRC were 5.36 times more likely to score less than 26/30 on the MoCA (the cutoff for MCI) compared to athletes with two or less SRC (p = 0.02). Males were 2.23 times more likely to have MCI than females (p = 0.0004). There was a significant relationship between the number of previous concussions and the MoCA subscales of attention (p = 0.05) and abstraction (p = 0.003). Age, SP, and concussion modifiers (migraine, depression, anxiety, and attention deficit and hyperactivity disorder) did not influence the relationship between MoCA and previous concussion history. Conclusion: In the appropriate clinical context, cognitive screening with the MoCA may benefit clinical care in athletes with multiple previous SRC, but should not replace a full neuropsychological assessment. Thus, further research is needed to compare the MoCA to full neuropsychological assessments in this population.

scholarly journals Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience

2016 ◽  
Vol 43 (4) ◽  
pp. 513-517 ◽  
Author(s):  
Mervin Blair ◽  
Kristy Coleman ◽  
Sarah Jesso ◽  
Véronique Desbeaumes Jodoin ◽  
Kathy Smolewska ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Depressive Symptomatology ◽  
Negative Impact ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
The Impact

AbstractObjective:The Montreal Cognitive Assessment (MoCA) is a general cognitive screening tool that has shown sensitivity in detecting mild levels of cognitive impairment in various clinical populations. Although mood dysfunction is common in referrals to memory clinics, the influence of mood on the MoCA has to date been largely unexplored.Method:In this study, we examined the impact of mood dysfunction on the MoCA using a memory clinic sample of individuals with depressive symptoms who did not meet criteria for a neurodegenerative disease.Results:Half of the group with depressive symptoms scored below the MoCA-suggested cutoff for cognitive impairment. As a group, they scored below healthy controls, but above individuals with Alzheimer’s disease and frontotemporal dementia. A MoCA subtask analysis revealed a pattern of executive/attentional dysfunction in those with depressive symptoms.Conclusions:This observed negative impact of depressive symptomatology on the MoCA has interpretative implications for its utility as a cognitive screening tool in a memory clinic setting.

scholarly journals Cut-off points of the Portuguese version of the Montreal Cognitive Assessment for cognitive evaluation in Parkinson’s disease

2019 ◽  
Vol 13 (2) ◽  
pp. 210-215
Author(s):  
Kelson James Almeida ◽  
Larissa Clementino Leite de Sá Carvalho ◽  
Tomásia Henrique Oliveira de Holanda Monteiro ◽  
Paulo Cesar de Jesus Gonçalves Júnior ◽  
Raimundo Nonato Campos-Sousa
Keyword(s):  
Cognitive Assessment ◽  
Screening Tool ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Dementia Diagnosis ◽  
Cross Sectional ◽  
Portuguese Version ◽  
Cognitive Evaluation ◽  
Normal Cognition ◽  
Movement Disorder Society

ABSTRACT. The Movement Disorder Society has published some recommendations for dementia diagnosis in Parkinson disease (PD), proposing the Montreal Cognitive Assessment (MOCA) as a cognitive screening tool in these patients. However, few studies have been conducted assessing the Portuguese version of this test in Brazil (MOCA-BR). Objective: the aim of the present study was to define the cut-off points of the MOCA-BR scale for diagnosing Mild Cognitive Impairment (PD-MCI) and Dementia (PD-D) in patients with PD. Methods: this was a cross-sectional, analytic field study based on a quantitative approach. Patients were selected after a consecutive assessment by a neurologist, after an extensive cognitive evaluation, and were classified as having normal cognition (PD-N), PD-MCI or PD-D. The MOCA-BR was then applied and 89 patients selected. Results: on the cognitive assessment, 30.3% were PD-N, 41.6% PD-MCI and 28.1% PD-D. The cut-off score on the MOCA-Br to distinguish PD-N from PD-D was 22.50 (95% CI 0.748-0.943) for sensitivity of 85.5% and specificity of 71.1%. The cut-off for distinguishing PD-D from MCI was 17.50 (95% CI 0.758-0.951) for sensitivity of 81.6% and specificity of 76%.

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