Tracking cognition with the T‐MoCA in a racially/ethnically diverse older adult cohort

Abstract

Abstract Introduction We investigated the utility of the Telephone‐Montreal Cognitive Assessment (T‐MoCA) to track cognition in a diverse sample from the Einstein Aging Study. Methods Telephone and in‐person MoCA data, collected annually, were used to evaluate longitudinal cognitive performance. Joint models of T‐MoCA and in‐person MoCA compared changes, variance, and test‐retest reliability measured by intraclass correlation coefficient by racial/ethnic group. Results There were no significant differences in baseline performance or longitudinal changes across three study waves for both MoCA formats. T‐MoCA performance improved over waves 1–3 but declined afterward. Test‐retest reliability was lower for the T‐MoCA than for the in‐person MoCA. In comparison with non‐Hispanic Whites, non‐Hispanic Blacks and Hispanics performed worse at baseline on both MoCA formats and showed lower correlations between T‐MoCA and in‐person versions. Conclusions The T‐MoCA provides valuable information on cognitive change, despite racial/ethnic disparities and practice effects. We discuss implications for health disparity populations. Highlights We assessed the comparability of Telephone‐Montreal Cognitive Assessment (T‐MoCA) and in‐person MoCA for tracking cognition. Changes within 3 years in T‐MoCA were similar to that for the in‐person MoCA. T‐MoCA is subject to practice effects and shows difference in performance by race/ethnicity. Test‐retest reliability of T‐MoCA is lower than that for in‐person MoCA.

Keywords

• cognitive screening
• health disparities
• intraclass correlation coefficient
• Montreal Cognitive Assessment (MoCA)
• neuropsychology
• practice effects