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Criterion and Convergent Validity of the Montreal Cognitive Assessment with Screening and Standardized Neuropsychological Testing
Author(s) -
Lam Benjamin,
Middleton Laura E.,
Masellis Mario,
Stuss Donald T.,
Harry Robin D.,
Kiss Alex,
Black Sandra E.
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12541
Subject(s) - dementia , neuropsychology , convergent validity , cognition , medicine , criterion validity , neuropsychological assessment , mini–mental state examination , receiver operating characteristic , montreal cognitive assessment , neuropsychological test , clinical psychology , psychometrics , psychiatry , construct validity , cognitive impairment , disease , internal consistency
Objectives To compare the validity of the Montreal Cognitive Assessment (Mo CA ) with the criterion standard of standardized neuropsychological testing and to compare the convergent validity of the Mo CA with that of existing screening tools and global measures of cognition. Design Cross‐sectional observational study. Setting Tertiary care hospital‐based cognitive neurology subspecialty clinic. Participants A convenience sample of 107 individuals with mild Alzheimer's disease ( AD , n = 75) or mild cognitive impairment ( MCI , n = 32) from the Sunnybrook Dementia Study. Measurements In addition to the Mo CA , all participants completed the Mini‐Mental State Examination ( MMSE ), the Mattis Dementia Rating Scale ( DRS ), and detailed neuropsychological testing. Results Convergent validity was supported, with Mo CA scores correlating well with the MMSE (correlation coefficient ( r ) = 0.66, P < .001) and the DRS ( r = 0.77, P < .001) and the Mo CA better associated with the DRS than did the MMSE . Criterion validity was supported, with Mo CA subscores according to cognitive domain correlating well with analogous neuropsychological tests and, in the case of memory (area under the receiver operating characteristic curve ( AUC ) = 0.86), executive ( AUC = 0.79), and visuospatial function ( AUC = 0.79), being reasonably sensitive to impairment in those domains. Conclusion The Mo CA is a valid assessment of cognition that shows good agreement with existing screening tools and global measures (convergent validity) and was superior to the MMSE in this regard. The Mo CA domain‐specific subscores align with performance on more‐detailed neuropsychological tests, suggesting not only good criterion validity for the Mo CA , but also that it may be useful in guiding further neuropsychological testing.