Concordância, reprodutibilidade e usabilidade do questionário Montreal Cognitive Assessment (MOCA) em formato eletrônico (Appsheet) para rastrear comprometimento cognitivo em pessoas idosas

Abstract

Cognitive assessment plays a crucial role in detecting mild cognitive impairment and neurological diseases, as well as monitoring cognitive deficits in the elderly. The Montreal Cognitive Assessment (MoCA) has become one of the widely used cognitive screening instruments and is considered sensitive in detecting level cognitive impairment. While the original paper-and-pencil version is commonly used in clinical and research settings, a mobile-based version (Appsheet) can offer advantages in terms of storage, reliability, and efficiency. This study aimed to analyze the agreement between the instruments (paper vs. digital), and evaluate the reproducibility and usability of the mobile instrument. A total of 118 elderly women living in the community, aged between 60 and 79 years, participated in a two-stage collection. In the first stage, both the paper and digital versions of the MoCA were randomly administered. Subsequently, a portion of these participants were randomly selected for a cell-phone only retest, lasting two weeks later. Data analysis included agreement coefficients, Cronbach's alpha for internal consistency, mean squared differences, means and standard deviation to track cognitive level impairment. The results revealed substantial agreement (ccc=0,777;p<0,001) and moderate to high internal consistency (α=0,736). High agreement was observed in reproducibility in different age groups, 60 to 69 years (ccc=0,752;p<0,001) and 70 to 79 years (ccc=0,772 ;p<0,001) , and usability was evaluated as excellent (76,25). These findings provide evidence that the electronic version of the MoCA (DS-MoCA) is a valid alternative for cognitive assessment in older women.