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Trajectory and variability characterization of the Montreal cognitive assessment in older adults

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Abstract

Background

The Montreal cognitive assessment (MoCA) has become one of the most widely used cognitive screening instruments since its initial publication. To date, only a handful of studies have explored longitudinal characteristics of the MoCA.

Aim

The aim of this study is to characterize the trajectory of MoCA performance across a broad age continuum of older adults.

Methods

Data from 467 cognitively normal participants were used in this analysis. The sample was grouped into four strata based on the participants’ age at baseline (60–69, 70–79, 80–89, and 90–99). Mixed model repeated measures (MMRM) analysis and mixed-effects spline models were used to characterize the trajectory of MoCA scores in each age stratum and in the entire sample. Intrasubject standard deviation (ISD) was used to characterize the natural variability of individual MoCA performance over time.

Results

The ISD values for each of the age strata indicated that year-to-year individual variation on the MoCA ranged from zero to three points. MMRM analysis showed that the 60–69 stratum remained relatively stable over time while the 70–79 and 80–89 strata both showed notable decline relative to baseline performance. The mixed-effects spline model showed that MoCA performance declines linearly across the older adult age span.

Discussion

Among cognitively normal older adults MoCA performance remains relatively stable over time, however across the older adult age-span MoCA performance declines in a linear fashion. These results will help clinicians better understand the normal course of MoCA change in older adults while researchers may use these results to inform sample size estimates for intervention studies.

Conclusion

This study provides an enhanced view of the MoCA’s intraindividual trajectory in normal elderly aged 60 and older.

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Authors and Affiliations

  1. Banner Alzheimer’s Institute, 901 E. Willetta St., Phoenix, AZ, USA

    Michael Malek-Ahmadi

  2. Banner Sun Health Research Institute, Center for Healthy Aging, Sun City, AZ, USA

    Kathy O’Connor, Sharon Schofield & Edward Zamrini

  3. College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA

    David W. Coon

Authors
  1. Michael Malek-Ahmadi
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  2. Kathy O’Connor
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  3. Sharon Schofield
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  4. David W. Coon
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  5. Edward Zamrini
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Corresponding author

Correspondence to Michael Malek-Ahmadi.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All participants signed an informed consent form prior to participating.

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Malek-Ahmadi, M., O’Connor, K., Schofield, S. et al. Trajectory and variability characterization of the Montreal cognitive assessment in older adults. Aging Clin Exp Res 30, 993–998 (2018). https://doi.org/10.1007/s40520-017-0865-x

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  • DOI: https://doi.org/10.1007/s40520-017-0865-x

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