Interchangeability of two versions of the Montreal Cognitive Assessment for the longitudinal evaluation of patients with breast cancer

PURPOSE

The cognitive performance of patients with breast cancer (BCa) may be affected by cancer and its treatments. The Montreal Cognitive Assessment (MoCA) is a widely used cognitive impairment screening tool, but practice effects must be considered for longitudinal assessments. Since learning effects could be overcome through the alternate use of two versions of the MoCA, we aimed to explore their interchangeability by comparing their overall, and domain- and task-specific, scores among patients with BCa.

METHODS

BCa patients from the NEON-BC cohort were evaluated with the MoCA, version 7.1, after diagnosis and after 1 year. At the 3-year follow-up (n = 422), the 7.1 and 7.3 versions were applied at the beginning and at the end (approximately 1 h later) of this evaluation, respectively. Agreements between versions, regarding total, sub-domain, and task scores, were assessed using Bland-Altman plots and intraclass correlation coefficients (ICC).

RESULTS

The mean total scores were not statistically different between versions and the ICC was 0.890. The Bland-Altman limits of agreement were - 3.70 to 3.88. For women with midrange scores, total scores were significantly higher in version 7.1. There were significant differences in the percentage of correct answers in 7 out of 12 tasks, being the highest for the copy of a geometric figure (more than twofold higher with version 7.3). In version 7.1, the language and memory domains presented higher scores and lower visuospatial ability.

CONCLUSION

Despite similar overall scores being obtained with the two versions of the MoCA, there were item-specific differences that may compromise their interchangeable use.

Development and Psychometric Evaluation of Alternate Short Forms of the Action Naming Test

OBJECTIVE

The action naming test (ANT) is a confrontation naming task used to assess the ability to name action words. This study aimed to create two short forms of the ANT and assess their equivalence, reliability, and comparability to the long form.

METHODS

In total, 100 healthy adults (31 females and 69 males), aged 34-89 years (M = 64 and SD = 10.4) were recruited. Short forms were developed using a split-half procedure.

RESULTS

No significant differences were observed between short forms on mean performance and distribution of scores for correct spontaneous responses, responses after semantic cue and total correct responses after cueing, but a higher number of accurate responses were prompted after phonemic cueing for Form A. Significant strong correlations between short forms and with the full form were encountered, although a weak correlation was found between short forms on performance after semantic cueing. IQ and age were significant predictors of action word retrieval. Whereas IQ also predicted post-cueing performance in all ANT forms, age predicted performance only for Form B.

CONCLUSION

The two ANT short forms are equivalent when considering total spontaneous responses and total correct responses after cueing, but semantic and phonemic cues evoked different responses on the two forms. The two short forms were also affected differently by demographics. When the psychometric equivalence of Forms A and B was examined, the strict conditions for parallel forms were not met for all performance indices. Therefore, these newly developed short versions should be considered as alternate forms.