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Construct Validity of the Montreal Cognitive Assessment (MoCA)

Published online by Cambridge University Press:  24 November 2011

Sandra Freitas ,
Mário R. Simões ,
João Marôco ,
Lara Alves  and
Isabel Santana
Sandra Freitas*
Affiliation:
Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo Comportamental (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
Mário R. Simões
Affiliation:
Centro de Investigação do Núcleo de Estudos e Intervenção Cognitivo Comportamental (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
João Marôco
Affiliation:
Psychology and Health Research Unit (UIPES) & Departamento de Estatística, ISPA – Instituto Universitário, Lisboa, Portugal
Lara Alves
Affiliation:
Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
Isabel Santana
Affiliation:
Neurology Department of the Coimbra University Hospital & Faculty of Medicine, University of Coimbra, Coimbra, Portugal
*
Correspondence and reprint requests to: Sandra Freitas, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802 Coimbra, Portugal. E-mail: sandrafreitas0209@gmail.com
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Abstract

The Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of cognitive impairment. The present study aims to assess the construct related validity of the MoCA through the establishment of the factorial, convergent, and discriminant related validities, and the reliability of data. In a Portuguese sample of 830 participants, several models were tested using Confirmatory Factor Analysis. Although all tested models showed a good fit, the six-factor model based on the conceptual model proposed by the MoCA's authors showed a significantly better fit. The results allowed us to establish the factorial, convergent, and discriminant validity of this six-dimensional structure. An overall psychometric adequacy of the items, and a good reliability were also found. This study contributes to overcome an important gap in the construct related validity of this instrument. The present findings corroborate the six-dimensional structure of the MoCA and provide good evidence of the construct related validity. The MoCA has proved to be an appropriate measure for cognitive screening taking into account different cognitive domains, which will enable clinicians and researchers to use this test and its six latent dimensions to achieve a better understanding of the individuals’ cognitive profile. (JINS, 2012, 18, 242–250)

Keywords

Cognitive disordersAlzheimer diseaseNeuropsychological testPsychometricsValidity and reliabilityFactor analysis
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 2 , March 2012 , pp. 242 - 250
Copyright
Copyright © The International Neuropsychological Society 2011

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References

Alves, L., Simões, M.R., Martins, C. (2009). Teste de Leitura de Palavras Irregulares (TeLPI) [Reading Word Irregular Test]. Coimbra, Portugal: Serviço de Avaliação Psicológica da Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra [Psychological Assessment Department, Faculty of Psychology and Educational Sciences, University of Coimbra].Google Scholar
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. – Text Revised). Washington, DC: American Psychiatric Association Press.Google Scholar
Appels, B.A., Scherder, E. (2010). The diagnostic accuracy of dementia-screening instruments with an administration time of 10 to 45 minutes for use in secondary care: A systematic review. American Journal of Alzheimer's Disease and Other Dementias, 25(4), 301–316. doi:10.1177/1533317510367485Google Scholar
Barreto, J., Leuschner, A., Santos, F., Sobral, M. (2008). Escala de Depressão Geriátrica [Geriatric Depression Scale]. In Grupo de Estudos de Envelhecimento Cerebral e Demências [Study Group on Brain Aging and Dementia] (Ed.), Escalas e testes na demência [Scales and tests in dementia] (pp. 69–72). Lisbon: GEECD.Google Scholar
Byrne, B.M. (2010). Structural equation modeling with Amos: Basic concepts, applications, and programming (2nd ed.). New York: Routledge.Google Scholar
Duro, D., Simões, M.R., Ponciano, E., Santana, I. (2010). Validation studies of the Portuguese experimental version of Montreal Cognitive Assessment (MoCA): Confirmatory factor analysis. Journal of Neurology, 257(5), 728–734. doi:10.1007/s00415-009-5399-5CrossRefGoogle ScholarPubMed
Folstein, M., Folstein, S., McHugh, P. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.CrossRefGoogle Scholar
Fornell, C., Larcker, D.F. (1981). Evaluating SEM with unobserved variables and measurement error. Journal of Marketing Research, 18, 39–50.Google Scholar
Freitas, S., Santana, I., Simões, M.R. (2010). The sensitivity of the MoCA and MMSE to cognitive decline: A longitudinal study. Alzheimer's & Dementia, 6(4), S353–S354.Google Scholar
Freitas, S., Simões, M.R., Alves, L., Santana, I. (2011). Montreal Cognitive Assessment (MoCA): Normative study for the Portuguese population. Journal of Clinical and Experimental Neuropsychology, doi:10.1080/13803395.2011.589374Google Scholar
Freitas, S., Simões, M.R., Martins, C., Vilar, M., Santana, I. (2010). Estudos de adaptação do Montreal Cognitive Assessment (MoCA) para a população portuguesa [Montreal Cognitive Assessment (MoCA): Portuguese adaptation studies]. Avaliação Psicológica, 9(3), 345–357.Google Scholar
Garret, C., Santos, F., Tracana, I., Barreto, J., Sobral, M., Fonseca, R. (2008). Avaliação Clínica da Demência [Clinical Dementia Rating Scale]. In Grupo de Estudos de Envelhecimento Cerebral e Demências [Study Group on Brain Aging and Dementia] (Ed.), Escalas e testes na demência [Scales and tests in dementia] (pp. 17–32). Lisbon: GEECD.Google Scholar
Ginó, S., Mendes, T., Ribeiro, F., Mendonça, A., Guerreiro, M., Garcia, C. (2008). Escala de Queixas de Memória [Memory Complaints Scale]. In Grupo de Estudos de Envelhecimento Cerebral e Demências [Study Group on Brain Aging and Dementia] (Ed.), Escalas e testes na demência [Scales and tests in dementia] (pp. 117–120). Lisbon: GEECD.Google Scholar
Guerreiro, M. (1998). Contributo da Neuropsicologia para o estudo das demências [Contribution of Neuropsychology to the study of dementia] (Unpublished doctoral dissertation). University of Lisbon, Lisbon.Google Scholar
Guerreiro, M., Fonseca, S., Barreto, J., Garcia, C. (2008). Escala de avaliação da Doença de Alzheimer [Alzheimer's disease assessment scale]. In Grupo de Estudos de Envelhecimento Cerebral e Demências [Study Group on Brain Aging and Dementia] (Ed.), Escalas e testes na demência [Scales and tests in dementia] (pp. 42–68). Lisbon: GEECD.Google Scholar
Hair, J.F., William, C.B., Barry, J.B., Rolph, E.A., Ronald, L.T. (2010). Multivariate data analysis (7th ed.). New Jersey: Pearson Education.Google Scholar
Himmelfarb, S. (1993). The measurement of attitudes. In A.H. Eagly & S. Chaiken (Eds.), The psychology of attitudes (pp. 23–87). Orlando: Harcourt Brace Jovanovich Inc.Google Scholar
Hughes, C.P., Berg, L., Danziger, W.L., Coben, L.A., Martin, R.L. (1982). A new clinical scale for the staging of dementia. The British Journal of Psychiatry, 140, 566–572.Google Scholar
Ismail, Z., Rajji, T.K., Shulman, K.I. (2009). Brief cognitive screening instruments: An update. International Journal of Geriatric Psychiatry, 25(2), 111–120. doi:10.1002/gps.2306CrossRefGoogle Scholar
Jacova, C., Kertesz, A., Blair, M., Fisk, J.D., Feldman, H.H. (2007). Neuropsychological testing and assessment for dementia. Alzheimer's Dementia, 3(4), 299–317. doi:10.1016/j.jalz.2007.07.011Google Scholar
Jones, R.N., Gallo, J.J. (2000). Dimensions of the Mini-Mental State Examination among community dwelling older adults. Psychological Medicine, 30, 605–618.CrossRefGoogle ScholarPubMed
Koski, L., Xie, H., Finch, L. (2009). Measuring cognition in a geriatric outpatients clinic: Rash analysis of the Montreal Cognitive Assessment. Journal of Geriatric Psychiatry and Neurology, 22(3), 151–160. doi:10.1177/0891988709332944CrossRefGoogle Scholar
Koski, L., Xie, H., Konsztowicz, S. (2011). Improving precision in the quantification of cognition using the Montreal Cognitive Assessment and the Mini-Mental State Examination. International Psychogeriatrics, 1, 1–9. doi:10.1017/S1041610210002450Google Scholar
Lonie, J.A., Tierney, K.M., Ebmeier, K.P. (2009). Screening for mild cognitive impairment: A systematic review. International Journal of Geriatric Psychiatry, 24(9), 902–915. doi:10.1002/gps.2208CrossRefGoogle ScholarPubMed
Marôco, J. (2010). Análise de equações estruturais: Fundamentos teóricos, software & aplicações [Structural equations analysis: Theoretical foundations, software & applications]. Pêro Pinheiro: ReportNumber.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., Stadlan, E.M. (1984). Clinical diagnosis of Alzheimer's disease: Report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer's disease. Neurology, 34, 939–944.Google Scholar
Nasreddine, Z., Phillips, N.A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for Mild Cognitive Impairment. American Geriatrics Society, 53(4), 695–699. doi:10.1111/j.1532-5415.2005.53221.xCrossRefGoogle Scholar
Petersen, R.C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256(3), 183–194. doi:10.1111/j.1365-2796.2004.01388.xGoogle Scholar
Petersen, R.C. (2007). Mild cognitive impairment. Continuum: Lifelong Learning in Neurology, 13(2), (Dementia) 15–38.Google Scholar
Rosen, W.G., Mohs, R.C., Davis, K.L. (1984). A new rating scale for Alzheimer's Disease. American Journal of Psychiatry, 141, 1356–1364.Google Scholar
Schmand, B., Jonker, C., Hooijer, C., Lindeboom, J. (1996). Subjective memory complaints may announce dementia. Neurology, 46(1), 121–125.Google Scholar
Simões, M.R., Freitas, S., Santana, I., Firmino, H., Martins, C., Nasreddine, Z., Vilar, M. (2008). Montreal Cognitive Assessment (MoCA): Versão portuguesa [Montreal Cognitive Assessment (MoCA): Portuguese version]. Coimbra, Portugal: Serviço de Avaliação Psicológica da Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra [Psychological Assessment Department, Faculty of Psychology and Educational Sciences, University of Coimbra].Google Scholar
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., Leirer, V.O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49.Google Scholar