Abstract

Abstract Objective: The auditory items of the Montreal Cognitive Assessment (MoCA-22) have been packaged for use with visually impaired individuals or via telehealth. The goal of study is to evaluate the convergent and discriminant validity of the MoCA-22 with cognition, behavioral-psychological symptoms, and instrumental activities of daily living in order to expand the clinimetric foundation of the MoCA-22. Method: From the National Alzheimer’s Coordinating Center database, we extracted a diverse group (n = 11,284; mean age = 69.2 ± 10.0 years; 57.6% female; 77.9% White; education level 15.9 ± 3.0 years;) who completed the MoCA during their first visit to an ADRC. Confirmatory factor analysis, Cronbach’s alpha, and McDonald’s omega were used to evaluate the fit and reliability of MoCA-22. Convergent/discriminant validity was evaluated via Spearman’s rho with factors derived from Version 3.0 of the Uniform Data Set’s Neuropsychological Battery (UDS3-NB), Functional Activities Questionnaire (FAQ), Geriatric Depression Scale (GDS-15), and collateral-report version of Neuropsychiatric Inventory (NPI-Q). Results: A single-factor adequately fit the data, and reliability estimates ranged from 0.81 to 0.87, suggesting the MoCA-22 can be interpreted individually. MoCA-22 showed convergent validity, with the strongest correlations with the UDS3-NB’s “general cognition” and “executive” factors (rhos = 0.67 and 0.69). Discriminant validity was demonstrated with its weakest correlations being with behavioral-psychological symptoms (self-reported depression rho = −0.23; collateral-reported neuropsychiatric symptoms rho = −0.42). Conclusion: The current study further supports use of the MoCA-22 when the evaluation context limits use of the MoCA’s visual items.

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