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Measuring Cognition in a Geriatric Outpatient Clinic: Rasch Analysis of the Montreal Cognitive Assessment

Divisions of Geriatrics and Clinical Epidemiology, Faculty of Medicine, McGill University, and the Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada, lisa.koski{at}mcgill.ca

Haiqun Xie, MD

Divisions of Geriatrics and Clinical Epidemiology, Faculty of Medicine, McGill University, and the Research Institute of the McGill University Health Centre, Montreal, Quebec

Lois Finch, PhD

Divisions of Geriatrics and Clinical Epidemiology, Faculty of Medicine, McGill University, and the Research Institute of the McGill University Health Centre, Montreal, Quebec

Objective: To evaluate the psychometric properties of the Montreal Cognitive Assessment as a quantitative measure of cognitive ability. Data analyzed: A total of 222 cases extracted from a clinical database (57-91 years) of patients screened for cognitive impairment in outpatient geriatric assessment clinics. Data collected: Demographic information and individual item responses to Montreal Cognitive Assessment. Results: Comparison of the data with a unidimensional Rasch model indicated that the total score obtained by summing across all items yields a reliable (0.75) quantitative estimate of global cognitive ability. All items fit the model and together spanned a range of difficulty from -3.75 to +2.88 logits. Items were assessed for differential item functioning across such patient characteristics as age, education, and language spoken. We provide a table for converting Montreal Cognitive Assessment total scores onto a linearly scaled score, with guidelines for interpreting changes in Montreal Cognitive Assessment score in terms of their statistical significance. Conclusions: The Montreal Cognitive Assessment can provide a reliable and valid quantitative estimate of cognitive ability in a geriatric cognitive disorders clinic setting.

Key Words: MoCA • Rasch analysis • cognition • aging • geriatric • assessment

This version was published on September 1, 2009

Journal of Geriatric Psychiatry and Neurology, Vol. 22, No. 3, 151-160 (2009)
DOI: 10.1177/0891988709332944


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