T-MoCA: A valid phone screen for cognitive impairment in diverse community samples

Abstract

Introduction: There is an urgent need to validate telephone versions of widely used general cognitive measures, such as the Montreal Cognitive Assessment (T-MoCA), for remote assessments. Methods: In the Einstein Aging Study, a diverse community cohort (n = 428; mean age = 78.1; 66% female; 54% non-White), equivalence testing was used to examine concordance between the T-MoCA and the corresponding in-person MoCA assess- ment. Receiver operating characteristic analyses examined the diagnostic ability to dis- criminate between mild cognitive impairment and normal cognition. Conversion meth- ods from T-MoCA to the MoCA are presented. Results: Education, race/ethnicity, gender, age, self-reported cognitive concerns, and telephone administration difficulties were associated with both modes of administra- tion; however, when examining the difference between modalities, these factors were not significant. Sensitivity and specificity for the T-MoCA (using Youden’s index opti- mal cut) were 72% and 59%, respectively. Discussion: The T-MoCA demonstrated sufficient psychometric properties to be use- ful for screening of MCI, especially when clinic visits are not feasible