Regression-based normative data and equivalent scores for Trail Making Test (TMT): an updated Italian normative study

Abstract

Objective. The Montreal Cognitive Assessment (MoCA) is a screening test widely used in clinical practice and suited for detection of Mild Cognitive Impairment. Alternate forms of the MoCA were developed to avoid "learning effect" in serial assessments, and the present study aimed at investigating inter-form parallelism and at providing normative values for the Italian versions of MoCA 2 and 3. Method. Three separate convenience samples were recruited: the first (n= 78) completed three alternate MoCA versions for ascertaining inter-form parallelism; the second (n= 302) and the third (n= 413) samples were administered MoCA 2 or 3 to compute normative data. Results. A three-step procedure complemented by confirmatory factor analysis and a mixed factorial ANOVA suggested that the three MoCA versions are not strictly parallel. Multiple linear regression analysis revealed that age and education significantly influenced MoCA 2 and 3 total scores. No significant effect of sex was found. From the derived linear equation, correction grids for MoCA 2 and 3 raw scores were built and equivalent scores computed. Inferential cutoff for adjusted scores, estimated using a non-parametric technique, were 17.49 for MoCA 2 and 18.34 for MoCA 3. Correlation analysis showed strong correlations of MoCA 2 (r= 0.69, p< .001) and MoCA 3 (r= 0.61, p< .001) adjusted total scores with MMSE adjusted scores. Conclusion. The three MoCA forms are not strictly parallel. Specifically developed normative data must be adopted for using MoCA in serial cognitive assessments for clinical and research studies.

The Montreal Cognitive Assessment (MoCA): updated norms and psychometric insights into adaptive testing from healthy individuals in Northern Italy

“…It is furthermore worth highlighting that rapid sociodemographic changes may pose additional challenges to practitioners when drawing up-to-date clinical inferences since norms need to be frequently renewed [25].…”

Effectiveness of an Innovative Cognitive Treatment and Telerehabilitation on Subjects With Mild Cognitive Impairment: A Multicenter, Randomized, Active-Controlled Study

“…Cognitive tests were applied to assess a broad range of cognitive abilities commonly affected by MCI. The battery took approximately 90 min and included the MMSE (Folstein et al, 1975) for the assessment of global cognition; Raven's Colored Progressive Matrices for non-verbal reasoning (Basso et al, 1987); verbal fluency (phonemic, FPL; and semantic, FPC) (Novelli et al, 1986) and action and object naming subtests from the battery for the assessment of aphasic disorders (BADA, Miceli et al, 1994) for language production; the Rey-Osterrieth complex figure test-copy (Caffarra et al, 2002) and the Clock Drawing Test (CDT) (Shulman et al, 1993) for visuo-constructional abilities; the Trail Making Test (TMT) part A and part B (Giovagnoli et al, 1996;Siciliano et al, 2019) for attention functions; and the Rey Auditory Verbal Learning Test (RAVLT), immediate and delayed recall (Carlesimo et al, 1996), the Free and Cued Selective Reminding Test (FCSRT) (Frasson et al, 2011) and the Rey-Osterrieth complex figure test-recall (Caffarra et al, 2002) for episodic memory. All the tests were administered and scored according to standard procedures (Lezak et al, 2012) (see Tables 3, 4 for details).…”

Norms and standardizations in neuropsychology via equivalent scores: software solutions and practical guides

“…The present work provides practitioners in the neuropsychometric field a software solution (R scripts and user-friendly, online applets) for computing TLs and ES thresholds to norm neuropsychological tests, as well as for implementing regression-based steps that precede their calculation -this allowing to simplify and expedite the norming procedure, as well as to make it less subjected to "human" errors. This last assertion is especially relevant when taking into account socio-demographic changes that give rise to the need of updating neuropsychological test norms [18]. Indeed, several neuropsychological tests still rely on normative data collected decades ago [2,3,19].…”