Cognitive reserve estimated with a life experience questionnaire outperforms education in predicting performance on MoCA: Italian normative data

Abstract

Normative data of neuropsychological tests typically consider the effect of demographic variables like age and education on performance. However, a broad literature has shown that, after the school age, other cognitively stimulating experiences (e.g., occupational attainment and a variety of leisure-time activities) may increase and build up cognitive reserve (CR), which is positively associated with better performance in many neuropsychological tests. With these premises, we investigated the predictive capability of education and a life-experience proxy of CR on a widely used cognitive screening, i.e., the Montreal Cognitive Assessment (MoCA). Results show that models including the more comprehensive life-experience CR proxy performed better than models including Education. Based on the results of our analyses we provide normative data and cut-offs on 440 Italian individuals aged 50-90 years, by taking into account, for the first time for the Italian population, a CR index, together with demographic variables and Education, in the calculation of regression-based norms. Accounting for life-experience CR proxies can improve the accuracy of normative data and allow a finer estimation of cognitive performance, which lead to a more tailored approach to patient assessment.

Assessing Theory of Mind in Children: A Tablet-Based Adaptation of a Classic Picture Sequencing Task

“…That is, we used the linear regressions fitted in Experiment 1 to predict each participant's performance and compared it to their actual performance. To qualify this discrepancy, we followed Crawford & Garthwaithe's (2006) methodology, which was shown to be more robust than using the basic model standard error, using the R script developed by Arcara (Montemurro et al, 2022). This discrepancy can be expressed as an estimated percentile rank that ranges from 0 to 100.…”

Optimal MoCA cutoffs for detecting biologically-defined patients with MCI and early dementia

“…The example of Santangelo's normative data, which are currently used in both clinical and research environments of Northern Italy [43,44], reflects on the need for a national commitment that supports multicentric studies aimed at collecting largescale normative data for cognitive tests, taking into account, for instance, differences in cultural background, educational quality, language, communication style, occupational level, economic issues, cognitive reserve, and intellectual functioning [45]. Interestingly, a recent study by Montemurro et al [46] providing MoCA's normative data and clinical cutoffs for the Italian population highlighted that both sociodemographic variables and cognitive reserve predicted the variance of the MoCA score. These normative values were not tested in the present investigation since we covered only normative studies correcting raw scores for sex, age, and education and reporting unique correction factors/equivalent scores according to the classical regression-based procedures.…”

Education differentiates cognitive performance and resting state fMRI connectivity in healthy aging

“…In this context, the concept of cognitive reserve ( Lojo-Seoane et al, 2018 ) may help to explain differences in the way people get older and cope with different cognitive demands, which depend on the cognitive “resources” accrued during life ( Barulli and Stern, 2013 ). Interestingly, although many other proxies like occupational attainment or IQ may determine CR ( Lojo-Seoane et al, 2018 ; Montemurro et al, 2022 ), the quantity and type of achieved education is one of the most used. In this context, previous research has suggested that people with higher education tend to perform better in older age than those with lower education ( Lovden et al, 2020 ).…”