Assessment of general cognitive MMSE Moca tics

When approaching cognitive screening through IRT, two item features are of major interest: difficulty, that is the level of latent ability required for an individual to “pass” an item, and discrimination, namely the capability of an item to discriminate between individuals having different levels of ability. IRT allows assessing item measurement properties in relation to the underlying trait that they are meant to target. Ī possible approach to overcome such issues is to deliver item-level information in the framework of Item Response Theory (IRT). However, it also showed relevant ceiling effects, which may negatively impact the interpretation of its scores, as it has been highlighted for the in-person version of the MMSE. In Italy, the telephone-based MMSE (Itel-MMSE) has shown good validity, reliability, and diagnostic properties. Within the international literature on telephone-based cognitive screening tools, versions of the renowned Mini-Mental State Examination (MMSE ) administrable via the telephone are highly represented. Moreover, telephone-based cognitive screening are useful for the implementation of epidemiological studies on cognitive impairment and dementia prevention campaigns. In the context of remote neurological and geriatric healthcare, telephone-based cognitive screening tests allow to the cognitive evaluation assessment of populations having poor access to in-person services due to either logistical issues (e.g., motor disabilities) or unequal geographical coverage of clinics. Items assessing attention and, to a lesser extent, spatial orientation appear to be the most informative. However, the present findings should not lead practitioners to aprioristically equate ceiling effects/low informativity to clinical uselessness. The Itel-MMSE appears to be most informative in low-performing healthy individuals. Both the whole test and its items proved to be scarcely informative, especially for medium-to-high levels of ability, except for attention and spatial orientation subtests, which consistently yielded the highest discriminative capability. Unidimensionality was violated both model and item fit were poor a few items showed statistical dependence. With respect to the Itel-MMSE total score, ceiling effects were found in 92.7% of participants. Informativity levels were also assessed graphically. Construct unidimensionality, statistical independence of items, and model and item fit were tested. A two-parameter logistic IRT model was implemented to assess item discrimination and difficulty of the Itel-MMSE. Methodsįive-hundred and sixty-seven healthy Italian adults (227 males, 340 females mean age: 51 ± 17 years, range 18–96 mean education: 13.31 ± 4.3 years). In address to overcome such an issue, this study aimed at providing item-level insights on the Itel-MMSE through Item Response Theory (IRT) analyses.

The Italian telephone-based Mini-Mental State Examination (Itel-MMSE), despite being psychometrically sound, has shown relevant ceiling effects, which may negatively impact the interpretation of its scores.

Assessment of general cognitive MMSE Moca tics