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Alzheimers Res Ther. 2018 Jul 18;10(1):65. doi: 10.1186/s13195-018-0382-y.

The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment.

Freedman M1,2,3,4,5, Leach L6,7, Carmela Tartaglia M8,6,9,10, Stokes KA11, Goldberg Y11, Spring R12, Nourhaghighi N6,13, Gee T12, Strother SC12,6,14, Alhaj MO11,15, Borrie M16,17, Darvesh S18, Fernandez A11, Fischer CE6,19,20, Fogarty J16,17, Greenberg BD6,21, Gyenes M11, Herrmann N6,13,22,20, Keren R6,21,20, Kirstein J11, Kumar S6,20,23, Lam B8,22,24, Lena S8,6,23, McAndrews MP9,25,26, Naglie G11,12,6,27, Partridge R9, Rajji TK6,20,23,28, Reichmann W11,6,20, Uri Wolf M11,6,20, Verhoeff NPLG11,6,20, Waserman JL11, Black SE8,6,13,22,24,29, Tang-Wai DF8,6,9,23,25.

Author information

1
Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada. mfreedman@baycrest.org.
2
Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada. mfreedman@baycrest.org.
3
Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada. mfreedman@baycrest.org.
4
Toronto Dementia Research Alliance, Toronto, ON, Canada. mfreedman@baycrest.org.
5
Mt. Sinai Hospital, Toronto, ON, Canada. mfreedman@baycrest.org.
6
Toronto Dementia Research Alliance, Toronto, ON, Canada.
7
Department of Psychology, Glendon College, Toronto, ON, Canada.
8
Department of Medicine (Neurology), University of Toronto, Toronto, ON, Canada.
9
Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
10
Tanz Centre for Research in Neurodegenerative Diseases, Toronto, ON, Canada.
11
Baycrest Health Sciences, 3560 Bathurst Street, Toronto, ON, M6A 2E1, Canada.
12
Rotman Research Institute of Baycrest Centre, Toronto, ON, Canada.
13
Sunnybrook Research Institute, Toronto, ON, Canada.
14
Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
15
Canada International Scientific Exchange Program, Toronto, ON, Canada.
16
Lawson Health Research Institute, London, ON, Canada.
17
Parkwood Institute, London, ON, Canada.
18
Department of Medicine (Neurology and Geriatric Medicine) and Department of Medical Neuroscience, Dalhousie University, Halifax, NS, Canada.
19
Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
20
Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
21
University Health Network, Toronto, ON, Canada.
22
Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
23
Centre for Addiction and Mental Health, Toronto, ON, Canada.
24
Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
25
Krembil Research Institute, University Health Network, Toronto, ON, Canada.
26
Department of Psychology, University of Toronto, Toronto, ON, Canada.
27
Department of Medicine (Geriatric Medicine) and Institute of Health Policy, University of Toronto, Toronto, ON, Canada.
28
Campbell Family Mental Health Research Institute, Toronto, ON, Canada.
29
LC Campbell Cognitive Neurology Research Unit, Toronto, ON, Canada.

Abstract

BACKGROUND:

A need exists for easily administered assessment tools to detect mild cognitive changes that are more comprehensive than screening tests but shorter than a neuropsychological battery and that can be administered by physicians, as well as any health care professional or trained assistant in any medical setting. The Toronto Cognitive Assessment (TorCA) was developed to achieve these goals.

METHODS:

We obtained normative data on the TorCA (n = 303), determined test reliability, developed an iPad version, and validated the TorCA against neuropsychological assessment for detecting amnestic mild cognitive impairment (aMCI) (n = 50/57, aMCI/normal cognition). For the normative study, healthy volunteers were recruited from the Rotman Research Institute registry. For the validation study, the sample was comprised of participants with aMCI or normal cognition based on neuropsychological assessment. Cognitively normal participants were recruited from both healthy volunteers in the normative study sample and the community.

RESULTS:

The TorCA provides a stable assessment of multiple cognitive domains. The total score correctly classified 79% of participants (sensitivity 80%; specificity 79%). In an exploratory logistic regression analysis, indices of Immediate Verbal Recall, Delayed Verbal and Visual Recall, Visuospatial Function, and Working Memory/Attention/Executive Control, a subset of the domains assessed by the TorCA, correctly classified 92% of participants (sensitivity 92%; specificity 91%). Paper and iPad version scores were equivalent.

CONCLUSIONS:

The TorCA can improve resource utilization by identifying patients with aMCI who may not require more resource-intensive neuropsychological assessment. Future studies will focus on cross-validating the TorCA for aMCI, and validation for disorders other than aMCI.

KEYWORDS:

Cognitive assessment; Diagnosis; Mild cognitive impairment; Normative study; TorCA; Toronto Cognitive Assessment; Validation

PMID:
30021658
PMCID:
PMC6052695
DOI:
10.1186/s13195-018-0382-y
[Indexed for MEDLINE]
Free PMC Article

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