Moreover, information regarding single items can further help practitioners interpret test scores by qualitatively assigning different weights to different items. A widespread approach that allows a flexible use of cognitive screening tests is to provide norms for their domain-specific sub-tests. Psychometric investigations on the MoCA have been carried out both at the sub-test and the single-item levels. In Italy, the MoCA has been adapted and standardized-and both its statistical properties and clinical usability thoroughly examined. The MoCA is a rapid (5–10’) screening test which evaluates both non-instrumental (executive functioning, attention) and instrumental (language, memory, visuo-spatial abilities, orientation) domains. The Montreal Cognitive Assessment (MoCA) is one of the most widespread and psychometrically robust screening tools for cognitive impairments of graded severity. Fine-grained, adaptive psychometric approaches can thus help solve interpretation issues to facilitate diagnostic processes by magnifying informativity. Compared to screening tests for dementia, those aimed at detecting mild-to-moderate cognitive impairment may be harder for practitioners to interpret because of (a) the magnitude of the target construct (i.e., the deficit) being less obvious and (b) the amount of information provided by the test being limited. Italian practitioners should consider an adaptive use of region-specific norms for the MoCA.Ĭognitive screening/first-level tests allow an estimate of global efficiency/functioning by adequately balancing between informativity and practicality of usage. Item-level information herewith provided for the Italian MoCA can help interpret its scores by Italian practitioners. Memory items showed high discriminative capability, along with certain items assessing executive functions and orientation. Several items proved to be scarcely sensitive, especially the place item from Orientation and the letter detection task. Substantial disagreements with previous ESs classifications were detected. No sex differences were detected when tested along with age and education. ResultsĪge and education significantly predicted all MoCA measures except for Orientation, which was related to age only. Agreement with previous ESs classification was assessed via Cohen’s k. Normative values were derived by means of the Equivalent Scores (ESs) method, applied to the MoCA and its sub-scales. Item Response Theory (IRT) was adopted to assess item difficulty and discrimination.
Methodsįive hundred and seventy nine healthy individuals from Northern Italy (208 males, 371 females age: 63.4 ± 15, 21–96 education: 11.3 ± 4.6, 1–25) were administered the MoCA. This study thus aimed at providing: (i) updated, region-specific norms for the Italian MoCA, by also (ii) comparing them to pre-existing ones with higher geographical coverage (iii) information on sensitivity and discriminative capability at the item level. The availability of fine-grained, culture-specific psychometric outcomes can favor the interpretation of scores of the Montreal Cognitive Assessment (MoCA), the most frequently used instrument to screen for mild cognitive dysfunctions in both instrumental and non-instrumental domains.
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