Given that the impact of demographic factors on neurocognitive test performance and the mandate to use appropriate normative standards are well established in the field of neuropsychology ( Manly, 2001 Heaton, Lee, & Grant, 2009), there is a need to develop normative data specific to minority groups to establish guidelines for appropriate interpretation of cognitive screening results. The accurate interpretation of cognitive assessment measures depends upon the normative comparison group being utilized, and if the normative sample does not resemble the individual being assessed, there is a risk of misclassification of impairment ( Casaletto, et al., 2015). MoCA scores were significantly correlated with age ( r = −0.31, p ≤. The mean age of the sample was 50 years ( SD = 11, range 18–75), and the average education level was 12.92 years ( SD = 1.96). Of the 1,419 participants, 64% were women. Resultsĭemographic characteristics are presented in Table 1. The suggested 1-point correction for 12 years of education. The MoCA was administered by trained personnel. The individual MoCA items have been described in detail elsewhere ( Nasreddine, et al., 2005). The MoCA is a 30-point screening tool that requires approximately 10–15 min to administer and evaluates aspects of attention, orientation, language, verbal memory, visuospatial, and executive function. All participants provided written informed consent to participate, and the study protocol was approved by the Institutional Review Board of UT Southwestern Medical Center. Following these exclusions, there were 1,419 African American subjects available for this study analyses. Participants who self-identified as White, Hispanic or Other ( n = 1235) were excluded. Forty-five duplicate entries were removed and another 29 were deleted due to missing data that prevented the calculation of an MoCA total score. One participant was excluded because he requested that his data should not be used. Thirty-seven individuals were excluded due to stroke history. Participants for this study met the following inclusion criteria: self-identified as African American, able to provide informed consent, and completed a valid MoCA test. The MoCA was administered to 2,766 participants. African Americans were oversampled to ensure approximately 50% of African American representation ( Victor, et al., 2004). This investigation was conducted as part of a longitudinal, population-based, multi-ethnic study of factors contributing to the development of cardiovascular disease. The aim of this study was to extend our prior MoCA normative work ( Rossetti, Lacritz, Cullum, & Weiner, 2011) by providing preliminary normative and descriptive data for the MoCA specific to the African American subset of our community-based cohort. There may be sociocultural and/or varying educational experiences across groups that are not completely controlled for through statistical covariance or by applying adjustments to scores derived from predominantly white education-based norms ( Touradj, Manly, Jacobs, & Stern, 2001). Interpretation of test scores based on data from a sample that is not representative of the individual can result in a disproportionate number of cognitively normal ethnic minority individuals inaccurately classified as impaired and overestimate the level of cognitive impairment in ethnic minorities with dementia ( Pedraza, et al., 2012). For example, the mini-mental state examination ( Folstein, Folstein, & McHugh, 1975), perhaps the most widely used cognitive screening tool, has shown diminished diagnostic utility when used to evaluate ethnic minorities ( Escobar, et al., 1986 Bohnstedt, Fox, & Kohatsu, 1994). The need for normative information for cognitive assessment measures in minority groups is well established ( Welsh, et al., 1995 Casaletto, et al., 2015). Despite the increasing use of the MoCA in clinical and research settings, normative data for the MoCA specific to African Americans and other ethnic minority groups are lacking, with only one study providing MoCA performance data in a cohort of 414 African Americans with Type 2 diabetes ( Sink, et al., 2015). Normative studies, Assessment, Aging, Minority, Mild cognitive impairment IntroductionĬognitive screening measures are effective in discriminating cognitive impairment from normal aging, and the Montreal Cognitive Assessment (MoCA) ( Nasreddine, et al., 2005) is a popular, sensitive screening tool.
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