Date of Award

12-2021

Document Type

Doctoral Research Project

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Anthony LoGalbo

Second Advisor

Frank Webbe

Third Advisor

David Wilder

Fourth Advisor

Robert A. Taylor

Abstract

Object: The present study examines the clinical utility of combining a cognitive screener, Montreal Cognitive Assessment (MoCA), with a measure of adaptive functioning, Texas Functional Living Scale (TFLS), to diagnose memory disorders when differentiating between cognition within normal limits (WNL), mild cognitive impairment (MCI), and Alzheimer’s disease (AD). Method: A total of 207 Health First Memory Disorder Clinic patients, ages 64-94, were included in the study. Participants were screened using the MoCA and then they completed a brief neuropsychological evaluation, which included the TFLS. Participants were only included if they received a diagnosis of cognition WNL, MCI, or AD. They also had to meet criteria for each MoCA total and TFLS T-score cut-off for each diagnostic category (WNL: MoCA = ≥ 26, TFLS T = ≥ 44, MCI: MoCA = 19-25, TFLS T = 37-43, AD: MoCA ≤ 18, TFLS T = ≤36). Results: Results of the present study revealed that the combined MoCA and TFLS score had statistically significant amount of agreement based on a chi-square analysis when compared to the overall diagnosis as determined by the Brief Neuropsychological Evaluation (BNE). Additionally, the MoCA and TFLS combined score was a statistically significant predictor of the diagnostic outcome. Correlational analysis revealed that the diagnosis based on the MoCA + TFLS combination score had a statistically significant moderate positive relationship with the diagnosis based on the BNE. Furthermore, the TFLS subtest that had the strongest relationship with a diagnosis of AD was the Memory subtest. Conclusion: When differentiating between patients who have a diagnosis of cognition WNL, MCI, and AD, the MoCA and TFLS alone can give us similar information as a full battery of testing (BNE). Therefore, if this is used as an alternative mode of testing, more patients can be tested in a day, thereby reducing wait time between the initial visit and the cognitive evaluation, as well as diminishing the waitlist. As a result, diagnoses of mild cognitive impairment or Alzheimer’s disease can be detected earlier, and appropriate interventions can be introduced sooner.

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