![]() Single-item-level analyses were performed by applying a two-parameter logistic IRT model for dichotomous outcomes via the R package ltm item difficulty and discrimination were thus computed. MoCA reliability was assessed via an internal consistency analysis (Cronbach’s α), whereas construct validity by means of a Principal Component Analysis (PCA). Sex differences were tested via independent sample t tests. Between-variables associations were thus tested via either parametric (Pearson’s) or non-parametric (Spearman’s) techniques. Normality checks on raw variables were performed descriptively, by evaluating skewness and kurtosis values, and graphically, by visually inspecting histograms and quantile-quantile plots). ![]() Participants provided informed consent and signed a data treatment disclaimer for research purposes. All of these studies were approved by the Research Evaluation Committee of the Department of Psychology of University of Milano-Bicocca on behalf of the Ethical Committee of the same Institution. Data were derived from three different normative studies where the MoCA was administered cognitive screening aims the MoCA was administered as the first test in every study, adopting the same procedure (as detailed below), the same sampling criteria (as detailed above) and geographical coverage. Sample stratification is reported in Table Table1. Participants had normal or corrected-to-normal vision and/or hearing. Participants suffering from well-compensated metabolic/internal conditions were included. Exclusion criteria were: (a) a confirmed diagnosis of neurological or psychiatric disorders (b) general medical conditions possibly affecting cognition (i.e., non-compensated and/or severe metabolic/internal morbidities and systemic/organ failures) (c) intake of psychotropic drugs. The present study thus aimed at: (i) providing updated, region-specific normative data for the Italian MoCA and its sub-tests (ii) comparing existing norms for the MoCA in the Italian population to those drawn from a region-specific Italian sample (iii) providing IRT-based information regarding sensitivity and discriminative capability of MoCA items in an Italian population sample.įive hundred and seventy nine healthy Italian native speakers were recruited in Lombardy, Northern Italy. It is furthermore worth highlighting that rapid socio-demographic changes may pose additional challenges to practitioners when drawing up-to-date clinical inferences since norms need to be frequently renewed. Therefore, providing region-/culture-specific psychometric fine-grained outcomes and normative data can ameliorate I-level cognitive testing in both clinical and research contexts. ![]() Cultural differences within a same country have been indeed highlighted as a relevant confounding predictor when interpreting test scores. įurther improvements to adaptive testing may come from deriving norms that account for inter-regional socio-demographic heterogeneity. IRT-based analyses indeed proved to yield relevant insights to performance interpretations for instance, executive- and memory-related items were often shown to be highly informative. To this last end, Item Response Theory (IRT) analyses have been conducted on MoCA items to assess both their sensitivity and discriminative capability. Moreover, information regarding single items can further help practitioners interpret test scores by qualitatively assigning different weights to different items. A widespread approach that allows a flexible use of cognitive screening tests is to provide norms for their domain-specific sub-tests. Psychometric investigations on the MoCA have been carried out both at the sub-test and the single-item levels. In Italy, the MoCA has been adapted and standardized-and both its statistical properties and clinical usability thoroughly examined. The MoCA is a rapid (5–10’) screening test which evaluates both non-instrumental (executive functioning, attention) and instrumental (language, memory, visuo-spatial abilities, orientation) domains. The Montreal Cognitive Assessment (MoCA) is one of the most widespread and psychometrically robust screening tools for cognitive impairments of graded severity. Fine-grained, adaptive psychometric approaches can thus help solve interpretation issues to facilitate diagnostic processes by magnifying informativity. Compared to screening tests for dementia, those aimed at detecting mild-to-moderate cognitive impairment may be harder for practitioners to interpret because of (a) the magnitude of the target construct (i.e., the deficit) being less obvious and (b) the amount of information provided by the test being limited. ![]() Cognitive screening/first-level tests allow an estimate of global efficiency/functioning by adequately balancing between informativity and practicality of usage.
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