Validation studies of the Portuguese experimental version of the Montreal Cognitive Assessment (MoCA): confirmatory factor analysis

Abstract

The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument created with the purpose of overcoming some of the insufficiencies of the Mini-Mental State Examination (MMSE). The MoCA evaluates more cognitive areas and is comprised of more complex tasks as compared with the MMSE, which makes it a more sensitive instrument in the detection of Mild Cognitive Impairment (MCI), a state that often progresses to dementia. In this study we performed an analysis of the psychometric and diagnostic properties of the Portuguese experimental version of the MoCA in a clinical sample of 212 subjects with MCI and several dementia subtypes in a memory clinic setting. Additionally, we performed a Confirmatory Factor Analysis (CFA) to assess the MoCA's latent factorial structure. In a clinical population, the MoCA is a valid and reliable instrument with good psychometric properties, revealing high sensitivity in identifying MCI and dementia patients who generally score within the normal range on the MMSE. By using the parcels method, CFA results showed very good/excellent adjustment indexes. The practical implications of this CFA study allow us to propose a two factor model factorial structure for the MoCA: a first factor designated Memory, which includes memory, language and orientation subtests (the latter being closely correlated with the former), and a second factor designated Attention/Executive Functions, comprised of attention, executive functions and visuospacial abilities tasks.

Validez de la Escala de Evaluación Cognitiva de Montreal (MoCA) para determinar deterioro cognitivo en pacientes con esquizofrenia

“…32 La MoCA, como instrumento cognitivo de tamizaje, mostró una adecuada validez concurrente al ser comparada tanto con los puntajes obtenidos con el MMSE como con la gravedad global observada en la sintomatología cognitiva evaluada por la PANSS, lo que es consistente con lo reportado en otros estudios. [33][34][35] La gravedad del cuadro sindromá-tico en los pacientes no es estable a lo largo del tiempo, por lo que aun cuando se observa una adecuada validez concurrente de la MoCA con la subescala cognitiva de la PANSS, será necesario determinar si ésta, al igual que la PANSS, es sensible a los probables cambios cognitivos observados a lo largo del padecimiento.…”

Mild cognitive impairment (part 1): clinical characteristics and predictors of dementia

“…The MoCA (Montreal Cognitive Assessment) is a brief cognitive test specifically developed to screen for mild cognitive deficits and has been regarded as a suitable test for initial workup of subjects with suspected MCI. 38,39 It has been translated to and validated in European Portuguese 40 and Brazilian Portuguese, 41 but further studies are still needed to assess its potential as a screening tool for MCI in our population, particularly among less educated samples. Another interesting assessment strategy is the use of computer-based cognitive tests.…”

The Montreal Cognitive Assessment (MoCA) is Sensitive to Head Injury and Cognitive Impairment in a Residential Alcohol and Other Drug Therapeutic Community

“…However, factor analyses of the MoCA have demonstrated that domains may be grouped differently (e.g., Duro, Simões, Ponciano, & Santana, 2010;Freitas et al, 2012). Given the multi-process nature of neuropsychological tasks, whereby any single task may tap into a range of perceptual, cognitive and motor abilities, and the overlapping nature of the cognitive domains assessed by the MoCA (Freitas et al, 2012), we created an additional score for analysis of executive function.…”