Exploring the measurement properties of the Montreal Cognitive Assessment in a population of people with cancer

Support Care Cancer. 2015 Sep;23(9):2779-87. doi: 10.1007/s00520-015-2643-7. Epub 2015 Feb 14.

Abstract

Background: Cancer and cancer-related treatments are associated with a constellation of physical and psychological changes. Treatments associated with noncentral nervous system neoplasms can have short- and long-term effects on cognition, affecting quality of life in people with cancer. Clinical measurement tools specific to cancer-related mild cognitive impairment (MCI) are lacking. The Montreal Cognitive Assessment (MoCA) has been validated in a geriatric population and used in studies assessing MCI in persons with cancer, but no studies have yet shown its psychometric properties when used with this population.

Purpose: The purpose of this study is to explore the psychometric properties of the MoCA within a population of persons with noncentral nervous system cancer.

Methods: A total of 74 participants were included from persons attending a Cancer Nutrition-Rehabilitation Program at the McGill University Health Centre. Rasch analyses were conducted.

Results: The MoCA data fit all the properties of the Rasch model with a person separation index of 1.04 and person reliability of 0.52. The MoCA items were found to measure a unidimensional construct and spanned 6.57 logits, with item difficulty levels between 2.49 and -4.08 logits. However, the MoCA presented a lack of items of higher difficulty, as person cognitive ability levels ranged from -0.51 to 5.17 logits.

Conclusion: Within the limits of a small sample size, the results of this exploratory study suggest the possibility that the MoCA, when used within a population of persons with cancer, may meet criteria for unidimensionality and adequate item fit but may present weaknesses when used with participants of higher cognitive abilities.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Cognition / drug effects
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / complications
  • Neoplasms / drug therapy
  • Neoplasms / psychology*
  • Neuropsychological Tests*
  • Psychometrics / methods*
  • Quality of Life / psychology*
  • Reproducibility of Results

Substances

  • Antineoplastic Agents