The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment

Abstract

BackgroundA need exists for easily administered assessment tools to detect mild cognitive changes that are more comprehensive than screening tests but shorter than a neuropsychological battery and that can be administered by physicians, as well as any health care professional or trained assistant in any medical setting. The Toronto Cognitive Assessment (TorCA) was developed to achieve these goals.MethodsWe obtained normative data on the TorCA (n = 303), determined test reliability, developed an iPad version, and validated the TorCA against neuropsychological assessment for detecting amnestic mild cognitive impairment (aMCI) (n = 50/57, aMCI/normal cognition). For the normative study, healthy volunteers were recruited from the Rotman Research Institute registry. For the validation study, the sample was comprised of participants with aMCI or normal cognition based on neuropsychological assessment. Cognitively normal participants were recruited from both healthy volunteers in the normative study sample and the community.ResultsThe TorCA provides a stable assessment of multiple cognitive domains. The total score correctly classified 79% of participants (sensitivity 80%; specificity 79%). In an exploratory logistic regression analysis, indices of Immediate Verbal Recall, Delayed Verbal and Visual Recall, Visuospatial Function, and Working Memory/Attention/Executive Control, a subset of the domains assessed by the TorCA, correctly classified 92% of participants (sensitivity 92%; specificity 91%). Paper and iPad version scores were equivalent.ConclusionsThe TorCA can improve resource utilization by identifying patients with aMCI who may not require more resource-intensive neuropsychological assessment. Future studies will focus on cross-validating the TorCA for aMCI, and validation for disorders other than aMCI.

Mobile Technology for Cognitive Assessment of Older Adults: A Scoping Review

“…Thirteen articles described new tests that took advantage of the mobile platform. Five discussed short tests for mass screening (Brouillette et al, 2013; Onoda et al, 2013; Onoda & Yamaguchi, 2014; Possin et al, 2018; Scanlon et al, 2016), five discussed test batteries covering several domains of cognitive function (Freedman et al, 2018; Kokubo et al, 2018; Makizako et al, 2013; Rentz et al, 2016; Zorluoglu et al, 2015), and three described tests designed for repeated administration (Allard et al, 2014; Jongstra et al, 2017; Lange & Suss, 2014). Screening tests require a relatively short time to complete and focus on general cognitive function or a few specific domains known to change in the early stages of cognitive decline.…”

Association Between Cerebrospinal Fluid Biomarkers and Age-related Brain Changes in Patients with Normal Pressure Hydrocephalus

“…As part of the clinical evaluation all participants underwent a cognitive assessment. However, different tests (i.e., Montreal Cognitive Assessment (MoCA) 11 , Toronto Cognitive Assessment (TorCA) 12 ) were used to assess the cognitive status.…”

Post-Concussion Syndrome and Sleep Apnea: A Retrospective Study

“…Neuropsychological measures were obtained from raw Toronto Cognitive Assessment (TorCA) [17] domain scores that the patient completed on their initial consultation at the UHN Concussion Clinic. The TorCA is a comprehensive neuropsychological test with 27 subtests designed to detect cognitive impairment.…”

“…The TorCA is a comprehensive neuropsychological test with 27 subtests designed to detect cognitive impairment. It tests seven cognitive domains including orientation, immediate recall, delayed recall, delayed recognition, visuospatial function, working memory/attention/executive control, and language [17].…”