Andersson Björn, Luo Hao, Wong Gloria H Y, Lum Terry Y S
Centre for Educational Measurement, University of Oslo, Oslo, Norway.
Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, SAR China.
Front Psychiatry. 2021 Sep 14;12:705188. doi: 10.3389/fpsyt.2021.705188. eCollection 2021.
Bridging scores generated from different cognitive assessment tools is necessary to efficiently track changes in cognition across the continuum of care. This study linked scores from the Montreal Cognitive Assessment-5 min (MoCA 5-min) to the interRAI cognitive Performance Scale (CPS), commonly adopted tools in clinical and long-term care settings, respectively. We included individual-level data from persons who participated in a home- and community-based care program for older people with mild impairment in Hong Kong. The program used the interRAI-Check Up instrument for needs assessment and service matching between 2017 and 2020. Each participant's cognitive performance was assessed using CPS, CPS Version 2 (CPS2), and MoCA 5-min. We performed equipercentile linking with bivariate log-linear smoothing to establish equivalent scores between the two scales. 3,543 participants had valid data on both scales; 66% were female and their average age was 78.9 years (SD = 8.2). The mean scores for MoCA 5-min, CPS, and CPS2 were 18.5 (SD = 5.9), 0.7 (SD = 0.7), and 1.3 (SD = 1.1), respectively. A CPS or CPS2 score of 0 (intact cognition) corresponds to MoCA 5-min scores of 24 and 25, respectively. At the higher end, a CPS score of 3 (moderately impaired) and a CPS2 score of 5 (moderately impaired Level-2) corresponded to MoCA 5-min scores of 0 and 1, respectively. The linking functions revealed the floor and ceiling effects that exist for the different scales, with CPS and CPS2 measuring more-severe cognitive impairment while the MoCA 5-min was better suited to measure mild impairment. We provided score conversions between MoCA 5-min and CPS/CPS2 within a large cohort of Hong Kong older adults with mild physical or cognitive impairment. This enabled continuity in repeated assessment with different tools and improved comparability of cognitive scores generated from different tools from diverse populations and research cohorts.
为了在连续护理过程中有效跟踪认知变化，有必要对不同认知评估工具生成的衔接分数进行分析。本研究将蒙特利尔认知评估-5分钟版（MoCA 5分钟版）的分数与相互关系认知表现量表（CPS）相联系，这两种工具分别在临床和长期护理环境中广泛应用。我们纳入了参与香港一项针对轻度认知障碍老年人的居家和社区护理项目的个人层面数据。该项目在2017年至2020年期间使用相互关系检查工具进行需求评估和服务匹配。使用CPS、CPS第2版（CPS2）和MoCA 5分钟版对每位参与者的认知表现进行评估。我们采用双变量对数线性平滑的等百分位链接法来建立两个量表之间的等效分数。3543名参与者在两个量表上均有有效数据；其中66%为女性，平均年龄为78.9岁（标准差=8.2）。MoCA 5分钟版、CPS和CPS2的平均分数分别为18.5（标准差=5.9）、0.7（标准差=0.7）和1.3（标准差=1.1）。CPS或CPS2得分为0（认知完好）分别对应MoCA 5分钟版得分为24和25。在较高分数端，CPS得分为3（中度受损）和CPS2得分为5（中度受损2级）分别对应MoCA 5分钟版得分为0和1。链接函数揭示了不同量表存在的地板效应和天花板效应，CPS和CPS2更适合测量重度认知障碍，而MoCA 5分钟版更适合测量轻度认知障碍。我们在一大群有轻度身体或认知障碍的香港老年人中提供了MoCA 5分钟版与CPS/CPS2之间的分数转换。这使得使用不同工具进行重复评估时具有连续性，并提高了来自不同人群和研究队列的不同工具所产生的认知分数的可比性。
