![]() ![]() ![]() Post hoc record review showed that one participant had sustained head trauma and thus was excluded from subsequent analysis, resulting in a final analyzed sample of 42 cases. In addition, patients with possible dementia with Lewy bodies as determined at their initial neurology visit were excluded due to possible fluctuations in cognition. Exclusion criteria included: Non-English speaking, severe mental illness, substance abuse, history of traumatic brain injury, recently prescribed memory loss medication and severe cognitive impairment that would preclude their ability to provide informed consent. Participants were tested on average 14.1 ( SD = 1.8 range = 9–18) days apart. All study tests were administered by trained psychometricians. Two weeks later, participants retuned to clinic for a research appointment and received the alternate version. Participants who agreed to participate were consented and randomly assigned to receive either the MoCA or eMoCA during their clinical appointment with neuropsychology. The sample was 60.5% female and predominantly Caucasian (86%). Participants had a mean of 14.8 years of education ( SD = 2.8 range = 10–20) with a mean estimated premorbid intelligence of 105.7 ( SD = 12.8) based on a single-word reading test. As these patients were new referrals, diagnostic information was not available differential diagnoses included probable Alzheimer’s disease, frontotemporal dementias, mild cognitive impairment, vascular dementia, and subjective cognitive impairment. Participants included 43 new adult patients (Age: M = 71.6, SD = 8.8 range = 47–89) referred for neuropsychological testing after presenting to an outpatient neurology specialty clinic with primary memory complaints. This study was conducted in accordance with guidelines on human subjects research and approved by the Cleveland Clinic Institutional Review Board. Given that content is identical and only the method of administration differs, it was hypothesized that there would be no significant differences between the total score or individual domain scores between the analog version and the electronic version and a high rate of agreement between tasks, thereby providing evidence of convergent validity. The aim of the present study is to determine the validity of the eMoCA by comparing it to the standard paper-and-pencil MoCA in an outpatient memory disorders clinic. Prior to clinical implementation of any electronic measure, however, the validity of any new assessment method should be established. If research can demonstrate that the electronic version of the MoCA performs similarly to the pencil-and-paper version, the ability to utilize a tablet-based assessment would facilitate electronic data capture, and increase both reliability and clinical efficiency by automating scoring procedures. Although the measure is purported to be the same as the current pencil-and-paper standard, the method of administration may influence test performance and the resulting scores, particularly given that the assessment is typically administered in an older adult population who may have less familiarity with utilizing a stylus pen and tablet computer. With increasing advances in technology, integration of electronic assessments into clinical practice has the potential to improve the reliability and efficiency of cognitive testing as well as assisting integrating scores into the electronic health record. Īn electronic version (eMoCA) of the measure, administered on a tablet computer, has recently been developed by the authors of the MoCA. The MoCA has been demonstrated to have adequate construct validity as compared to standard neuropsychological tests measuring similar cognitive constructs and to be sensitive in identifying cognitive impairment in a number of clinical populations including mild cognitive impairment, Alzheimer’s disease, and Parkinson’s disease. ![]() The MoCA takes approximately 10 minutes to administer and evaluates several cognitive domains including visuospatial ability, executive functioning, language, memory, attention, and orientation. ![]() The Montreal Cognitive Assessment (MoCA) is a validated brief paper-and-pencil cognitive screening measure that is commonly employed in clinical practice and research settings. Cognitive assessment is a critical component of clinical care for individuals with neurological disease. ![]()
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