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Correction to: The Toronto cognitive assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment

  • Morris Freedman
  • Larry Leach
  • M. Carmela Tartaglia
  • Kathryn A. Stokes
  • Yael Goldberg
  • Robyn Spring
  • Nima Nourhaghighi
  • Tom Gee
  • Stephen C. Strother
  • Mohammad O. Alhaj
  • Michael Borrie
  • Sultan Darvesh
  • Alita Fernandez
  • Corinne E. Fischer
  • Jennifer Fogarty
  • Barry D. Greenberg
  • Michelle Gyenes
  • Nathan Herrmann
  • Ron Keren
  • Josh Kirstein
  • Sanjeev Kumar
  • Benjamin Lam
  • Suvendrini Lena
  • Mary Pat McAndrews
  • Gary Naglie
  • Robert Partridge
  • Tarek K. Rajji
  • William Reichmann
  • M. Uri Wolf
  • Nicolaas P. L. G. Verhoeff
  • Jordana L. Waserman
  • Sandra E. Black
  • David F. Tang-Wai
Open Access
Correction
  • 83 Downloads

Erratum

Upon publication of this article [1], it was brought to our attention that one of the 303 participants in the normative study should have been deleted from the database. Therefore, we reanalyzed the data with this individual removed. This resulted in minor numerical changes affecting tables, figures, and text. In addition, we added IQ data that were omitted in seven participants with normal cognition. This resulted in minor changes affecting Table 9. There were also minor typographical corrections made in the tables.

There was no significant impact on the analyses or findings reported in the paper from any of the revisions. The changes are as follows:

Table 2
  • Due to deletion of the single participant who should have been omitted from the database, the sample size was changed from 303 to 302 in the 50–89 year old group and from 76 to 75 in the 50–59 year old group. The number of males in each group was reduced by 1. The Mean (SD) TorCA Sum scores were revised in the 50–89 and 50–59 year old groups.

  • The cut-off scores for the impaired, borderline, and normal limits ratings for the Sum Index were revised in the 50–59 year old group.

  • The cut-off scores for the impaired and borderline ratings for the Delayed Memory Recognition Index were revised in the 70–79 year old group.

  • The cut-off scores for the impaired and borderline ratings for the Visuospatial Index were revised in the 70–79 and 80–89 year old groups.

Table 4
  • The cut-off scores for the below normal and borderline ratings for Clock Drawing were revised in the 50–89 year old group.

Table 5
  • The cut-off score for the borderline rating for Digit Span Backwards was revised for the 70–79 year old group.

  • The cut-off scores for the borderline and normal limits ratings for Digit Span Backwards were revised for the 80–89 year old group.

Table 6
  • The cut-off score for the borderline rating for Repetition was revised for the 50–89 year old group.

Table 7
  • The Test2-Test1 Mean Difference was revised from 2.8 to 2.4 for the Memory – Immediate Recall Index.

Table 9
  • There was a revision to the demographic information in which IQ data for seven participants with normal cognition were omitted. With the addition of these seven participants, there was a change in the Mean IQ (SD). The t-test comparing the IQ of participants with aMCI to those with normal cognition was recalculated with these seven individuals included. There was a minor change in the degrees of freedom and the p-value.

  • One participant with aMCI was not given the verbal component of the IQ estimate due to non-exclusionary English as a second language considerations. However, a comparable estimate of IQ was within the range exhibited by the remaining aMCI participants. This was added in a footnote.

Figure 1
  • The sample size was changed from 303 to 302

Figure 4

Due to a change in cut-off scores:
  • The rating for MDRec in the 70–79 year old group was changed from an orange triangle to a blue dot, i.e., from below normal limits to borderline.

  • The rating for MDRec in the Index Plot was changed from an orange triangle to a blue dot, i.e., from below normal limits to borderline.

Text (page 5, column 2, paragraph 2)

Due to the change in sample size from 303 to 302, there was a change in the degrees of freedom, F values, Cohen’s d, and number of points higher on Sum Index in women than men. The revised text is:

The Sum Index was significantly affected by age (F(3,298) = 7.27, p = 0.001) (Table 2). There was a significant but small effect size (Cohen’s d = 0.29) [20] for gender. Women scored a mean of 5.5 (SED = 2.2) points higher than men (F(1,300) = 6.24, p = 0.013). Age and education were weakly, but significantly, correlated with Sum Index (r = 0.24 and 0.23, both p < 0.001), each accounting for approximately 5% of the variance.

The revised tables and figures are shown on the following pages.

The revised tables are:

Table 2

Toronto Cognitive Assessment (TorCA) group profiles and normative data

Group profile

Age group

50–89 years

50–59 years

60–69 years

70–79 years

80–89 years

N

302

75

77

75

75

Male/female

103/199

28/47

22/55

20/55

33/42

Years of education, median (range)

16 (8–20)

16 (12–20)

16 (11–20)

16 (9–20)

14 (8–20)

TorCA Sum Index, mean (standard deviation)

292.8 (18.4)

297.6 (18.6)

296.9 (16.7)

290.5 (16.6)

286.0 (19.4)

TorCA Sum Index, median

295

301

298

291

289

Normative Data

Percentile range

Rating

50–89 years

50–59 years

60–69 years

70–79 years

80–89 years

 Sum Index

≤ 5

Impaired

< 261

< 266

< 272

< 262

< 257

6–24

Borderline

261–281

266–287

272–287

262–280

257–272

≥ 25

Normal limits

> 281

> 287

> 287

> 280

> 272

 Orientation

≤ 5

Impaired

< 10

< 10

< 10

< 10

< 10

6–24

Borderline

10

10

10

10

10

≥ 25

Normal limits

> 10

> 10

> 10

> 10

> 10

 Immediate Memory Recall

≤ 5

Impaired

< 15

< 17

< 16

< 15

< 14

 

6–24

Borderline

15–18

17–20

16–18

15–17

14–16

 

≥ 25

Normal limits

> 18

> 20

> 18

> 17

> 16

 Delayed Memory Recall

≤ 5

Impaired

< 10

< 14

< 12

< 8

< 6

 

6–24

Borderline

10–14

14–16

12–15

8–12

6–12

 

≥ 25

Normal limits

> 14

> 16

> 15

> 12

> 12

 Delayed Memory Recognition

≤ 5

Impaired

< 19

< 20

< 19

< 18

< 18

 

6–24

Borderline

19

20

19

18–19

18

 

≥ 25

Normal limits

> 19

21

> 19

> 19

> 18

 Visuospatial

≤ 5

Impaired

< 25

< 27

< 25

< 24

< 24

6–24

Borderline

25–27

27–28

25–27

24–27

24–27

≥ 25

Normal limits

> 27

> 28

> 27

> 27

> 27

 Working Memory/Attention/Executive Control

≤ 5

Impaired

< 99

< 98

< 102

< 99

< 98

 

6–24

Borderline

99–106

98–105

102–107

99–106

98–105

 

≥ 25

Normal limits

> 106

> 105

> 107

> 106

> 105

 Language

≤ 5

Impaired

< 71

< 63

< 74

< 74

< 66

6–24

Borderline

71–78

63–78

74–80

74–78

66–76

≥ 25

Normal limits

> 78

> 78

> 80

> 78

> 76

Table 4

Normative data for subtests within domains: Visuospatial

  

Toronto Cognitive Assessment Visuospatial test ratings

Percentile

Rating

Benson Figure Copy

Clock Drawing

Ages 50–89 years

 ≤ 5

Below normal

< 14

< 10

 6–24

Borderline

14

10–12

 ≥ 25

Within normal limits

> 14

> 12

Ages 50–59 years

 ≤ 5

Below normal

< 15

< 11

 6–24

Borderline

15

11–12

 ≥ 25

Within normal limits

> 15

> 12

Ages 60–69 years

 ≤ 5

Below normal

< 14

< 10

 6–24

Borderline

14

10–12

 ≥ 25

Within normal limits

> 14

> 12

Ages 70–79 years

 ≤ 5

Below normal

< 14

< 10

 6–24

Borderline

14

10–12

 ≥ 25

Within normal limits

> 14

> 12

Ages 80–89 years

 ≤ 5

Below normal

< 13

< 9

 6–24

Borderline

13–14

9–12

 ≥ 25

Within normal limits

> 14

> 12

Table 5

Normative data for subtests within domains: Working Memory/Attention/Executive Control

 

Toronto Cognitive Assessment Working Memory/Attention/Executive Control Test Ratings

Percentile

Rating

Serial Subtractions 7 s

Serial Subtractions 3 s

Serial Subtractions Total

Digit Span Forwards

Digit Span Backwards

Digit Span Total

Trails A Time

Trails A Score

Trails B Time

Trails B Score

Trails Time Difference

Alternating Sequences

Similarities

Ages 50–89 years

 ≤ 5

Below normal

< 9

< 11

< 21

< 5

< 4

< 10

> 67

< 24

> 163

< 22

> 107

< 2

< 7

 6–24

Borderline

9–10

11–12

21–23

5

4

10

67–47

163–107

22

107–63

7–8

 ≥ 25

Within normal limits

> 10

> 12

> 23

> 5

> 4

> 10

< 47

24

< 107

> 22

< 63

2

> 8

Ages 50–59 years

 ≤ 5

Below normal

< 9

< 11

< 21

< 5

< 4

< 10

> 67

< 24

> 163

< 22

> 107

< 2

< 7

 6–24

Borderline

9–10

11–12

21–23

5

4

10

67–47

163–107

22

107–63

7–8

 ≥ 25

Within normal limits

> 10

> 12

> 23

> 5

> 4

> 10

< 47

24

< 107

> 22

< 63

2

> 8

Ages 60–69 years

 ≤ 5

Below normal

< 10

< 11

< 21

< 5

< 4

< 9

> 59

< 24

> 146

< 24

> 100

< 2

< 9

 6–24

Borderline

10

11–12

21–23

5

4

9–10

59–43

146–91

100–53

9

 ≥ 25

Within normal limits

> 10

> 12

> 23

> 5

> 4

> 10

< 43

24

< 91

24

< 53

2

> 9

Ages 70–79 years

 ≤ 5

Below normal

< 9

< 11

< 20

< 5

< 4

< 10

> 86

< 24

> 196

< 23

> 137

0

< 8

 6–24

Borderline

9–11

11

20–23

5

4

10

86–49

196–111

23

137–65

1

8

 ≥ 25

Within normal limits

> 11

> 11

> 23

> 5

> 4

> 10

< 49

24

< 111

24

< 65

2

> 8

Ages 80–89 years

 ≤ 5

Below normal

< 9

< 11

< 22

< 5

< 4

< 9

> 73

< 24

> 198

< 21

> 159

0

< 7

 6–24

Borderline

9–10

11–12

22–23

5

4

9

73–53

198–120

21–22

159–85

1

7–8

 ≥ 25

Within normal limits

> 10

> 12

> 23

> 5

> 4

> 9

< 53

24

< 120

> 22

< 85

2

> 8

Table 6

Normative data for subtests within domains: Language

 

Toronto Cognitive Assessment Language Test Ratings:

Percentile

Rating

F-words

Animal names

Naming

Repetition

Single word comprehension

Reading single word comprehension

Sentence comprehension

Single word reading

Semantic knowledge

Ages 50–89 years

 ≤ 5

Below normal limits

< 10

< 14

< 13

< 8

< 8

< 2

< 5

< 11

< 9

 6–24

Borderline

10–12

14–16

13

8

5–6

11

9

 ≥ 25

Normal limits

> 12

> 16

> 13

> 8

8

2

> 6

12

> 9

Ages 50–59 years

 ≤ 5

Below normal limits

< 8

< 13

< 9

< 5

< 8

< 2

< 5

< 9

< 9

 6–24

Borderline

8–11

13–18

9–13

5–7

5–6

9–11

9

 ≥ 25

Normal limits

> 11

> 18

> 13

> 7

8

2

> 6

12

10

Ages 60–69 years

 ≤ 5

Below normal limits

< 10

< 14

< 13

< 8

< 8

< 2

< 6

< 12

< 9

 6–24

Borderline

10–12

14–17

13

8

6–7

9

 ≥ 25

Normal limits

> 12

> 17

> 13

> 8

8

2

8

12

10

Ages 70–79 years

 ≤ 5

Below normal limits

< 10

< 14

< 13

< 8

< 8

< 2

< 5

< 12

< 9

 6–24

Borderline

10–12

14–16

13

8

5–6

9

 ≥ 25

Normal limits

> 12

> 16

> 13

> 8

8

2

> 6

12

10

Ages 80–89 years

 ≤ 5

Below normal limits

< 11

< 11

< 12

< 8

< 8

< 2

< 4

< 11

< 9

 6–24

Borderline

11–12

11–15

12

8

4–5

11

9

 ≥ 25

Normal limits

> 12

> 15

> 12

> 8

8

2

> 5

12

10

Table 7

Toronto Cognitive Assessment (TorCA) Test–Retest Results

TorCA index

Test 1 mean (SE)

Test 2 mean (SE)

Test 2–Test 1 mean difference (SED)

t(27) (p value)

Stability (p value)

% change

Orientation

11.2 ± 0.2

11.3 ± 0.2

0.1 ± 0.2

0.5 (0.631)

0.10

(0.607)

0.1

Memory—Immediate Recall

19.5 ± 0.7

21.9 ± 0.7

2.4 ± 0.5

4.6

(0.0001)

0.73

(0.0001)

14.3

Memory—Delayed Recall

15.8 ± 0.9

17.5 ± 0.8

1.7 ± 0.5

3.4

(0.002)

0.83

(0.0001)

10.7

Memory—Delayed Recognition

20.2 ± 0.2

20.4 ± 0.2

0.2 ± 0.2

0.9

(0.363)

0.57

(0.001)

1.0

Visuospatial

28.6 ± 0.4

28.4 ± 0.4

− 0.2 ± 0.3

− 0.7

(0.5)

0.68

(0.0001)

0.7

Executive Controla

111.0 ± 1.2

112.0 ± 1.3

1.0 ± 1.3

0.9

(0.4)

0.52

(0.004)

1.0

Language

84.4 ± 1.3

83.1 ± 1.3

− 1.3 ± 0.9

− 1.4

(0.2)

0.75

(0.0001)

1.5

Sum

290.7 ± 3.2

294.0 ± 3.4

3.3 ± 1.4

2.4

(0.023)

0.92

(0.0001)

1.1

Test 1 and Test 2 mean indices and test–retest correlations (test stability) expressed as Pearson r

Interpretation of stability coefficients (Pearson r): very good, ≥ 0.90; good, 0.80–0.89; acceptable, 0.70–0.79; low, < 0.70

SE standard error, SED standard error of the difference

aWorking Memory/Attention/Executive Control

Table 9

Normal cognition and aMCI group demographics and TorCA indices comparisons

Group demographics

NC

aMCI

 

N

57

50

 

 Male/female

19/38

27/23

χ2 = 4.6

p = 0.031

 Age, mean (SD)

75.3 (7.9)

77.7 (6.5)

t(105) = 1.68

p = 0.097

 Years of education, mean (SD)

15.02 (3.2)

15.5 (3.4)

t(105) = 0.72

p = 0.47

 IQ, mean (SD)

122.81 (13.54)*

121.33 (13.98)

t(104) = 0.55

p = 0.58

TorCA index group comparisons

NC (SD)

aMCI (SD)

t(105) (p value**)

Effect size, Hedge’s g (95% CI)

 Orientation

11.58 (0.76)

10.38 (1.69)

4.84

(0.0001)

− 0.93

(− 1.33, − 0.53)

 Memory—Immediate Recall

20.77 (4.45)

14.18 (3.29)

8.62

(0.0001)

− 1.66

(− 2.10, − 1.22)

 Memory—Delayed Recall

16.86 (4.85)

6.66 (4.65)

11.07

(0.0001)

− 2.13

(− 2.60, − 1.65)

 Memory—Delayed Recognition

20.19 (1.33)

17.42 (2.42)

7.45

(0.0001)

−1.43

(− 1.86, − 1.01)

 Visuospatial

29.79 (1.80)

30.02 (2.16)

0.602

(0.549)

0.12

(− 0.26, 0.50)

 Working Memory/Attention/Executive Control

108.47 (10.30)

107.34 (8.17)

0.625

(0.534)

− 0.12

(− 0.50, 0.26)

 Language

80.16 (8.34)

76.90 (6.23)

2.26

(0.026)

− 0.42

(− 0.81, − 0.04)

 Sum

287.82 (23.92)

262.86 (17.63)

6.07

(0.0001)

− 1.17

(− 1.58, − 0.76)

aMCI amnestic mild cognitive impairment, CI confidence interval, NC normal cognition, SD standard deviation, TorCA Toronto Cognitive Assessment

*One participant with aMCI was not given the verbal component of the IQ estimate due to non-exclusionary English as a second language considerations. A comparable estimate of IQ was within the range exhibited by the remaining aMCI participants

**Significance tests corrected for multiple comparisons using Bonferroni correction at p ≤ 0.05/7 (0.007)

The revised figures are:

Fig. 1

Flow chart of participants for normative study

Fig. 4

iPad summary score sheet showing domain scores and numerical and graphic percentile ratings. Probability of aMCI shown as 93.7%. aMCI amnestic mild cognitive impairment

In addition to the above, we have provided an annotated pdf as a Additional file 1 documenting the changes. The original article can be found online at  https://doi.org/10.1186/s13195-018-0382-y

Notes

Authors’ information

Tom Gee is now at Indoc Research, Toronto, ON, Canada. Barry D. Greenberg is now at Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Supplementary material

13195_2018_446_MOESM1_ESM.pdf (1.1 mb)
Additional file 1: Annotated pdf documenting changes to original article. (PDF 1130 kb)

Reference

  1. 1.
    Freedman M, et al. The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment. Alzheimers Res Ther. 2018;10(1):65.  https://doi.org/10.1186/s13195-018-0382-y.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© The Author(s). 2018

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • Morris Freedman
    • 1
    • 2
    • 3
    • 4
    • 5
  • Larry Leach
    • 4
    • 6
  • M. Carmela Tartaglia
    • 1
    • 4
    • 7
    • 8
  • Kathryn A. Stokes
    • 2
  • Yael Goldberg
    • 2
  • Robyn Spring
    • 3
  • Nima Nourhaghighi
    • 4
    • 9
  • Tom Gee
    • 3
  • Stephen C. Strother
    • 3
    • 4
    • 10
  • Mohammad O. Alhaj
    • 2
    • 11
  • Michael Borrie
    • 12
    • 13
  • Sultan Darvesh
    • 14
  • Alita Fernandez
    • 2
  • Corinne E. Fischer
    • 4
    • 15
    • 18
  • Jennifer Fogarty
    • 12
    • 13
  • Barry D. Greenberg
    • 4
    • 16
  • Michelle Gyenes
    • 2
  • Nathan Herrmann
    • 4
    • 9
    • 17
    • 18
  • Ron Keren
    • 4
    • 16
    • 18
  • Josh Kirstein
    • 2
  • Sanjeev Kumar
    • 4
    • 18
    • 19
  • Benjamin Lam
    • 1
    • 17
    • 20
  • Suvendrini Lena
    • 1
    • 4
    • 19
  • Mary Pat McAndrews
    • 7
    • 21
    • 22
  • Gary Naglie
    • 2
    • 3
    • 4
    • 23
  • Robert Partridge
    • 7
  • Tarek K. Rajji
    • 4
    • 18
    • 19
    • 24
  • William Reichmann
    • 2
    • 4
    • 18
  • M. Uri Wolf
    • 2
    • 4
    • 18
  • Nicolaas P. L. G. Verhoeff
    • 2
    • 4
    • 18
  • Jordana L. Waserman
    • 2
  • Sandra E. Black
    • 1
    • 4
    • 9
    • 17
    • 20
    • 25
  • David F. Tang-Wai
    • 1
    • 4
    • 7
    • 19
    • 21
  1. 1.Department of Medicine (Neurology)University of TorontoTorontoCanada
  2. 2.Baycrest Health SciencesTorontoCanada
  3. 3.Rotman Research Institute of Baycrest CentreTorontoCanada
  4. 4.Toronto Dementia Research AllianceTorontoCanada
  5. 5.Mt. Sinai HospitalTorontoCanada
  6. 6.Department of PsychologyGlendon CollegeTorontoCanada
  7. 7.Toronto Western Hospital, University Health NetworkTorontoCanada
  8. 8.Tanz Centre for Research in Neurodegenerative DiseasesTorontoCanada
  9. 9.Sunnybrook Research InstituteTorontoCanada
  10. 10.Department of Medical BiophysicsUniversity of TorontoTorontoCanada
  11. 11.Canada International Scientific Exchange ProgramTorontoCanada
  12. 12.Lawson Health Research InstituteLondonCanada
  13. 13.Parkwood InstituteLondonCanada
  14. 14.Department of Medicine (Neurology and Geriatric Medicine) and Department of Medical NeuroscienceDalhousie UniversityHalifaxCanada
  15. 15.Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoCanada
  16. 16.University Health NetworkTorontoCanada
  17. 17.Sunnybrook Health Sciences CentreTorontoCanada
  18. 18.Department of PsychiatryUniversity of TorontoTorontoCanada
  19. 19.Centre for Addiction and Mental HealthTorontoCanada
  20. 20.Hurvitz Brain Sciences Program, Sunnybrook Health Sciences CentreTorontoCanada
  21. 21.Krembil Research InstituteUniversity Health NetworkTorontoCanada
  22. 22.Department of PsychologyUniversity of TorontoTorontoCanada
  23. 23.Department of Medicine (Geriatric Medicine) and Institute of Health PolicyUniversity of TorontoTorontoCanada
  24. 24.Campbell Family Mental Health Research InstituteTorontoCanada
  25. 25.LC Campbell Cognitive Neurology Research UnitTorontoCanada

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