Comparison of an Electronic and Paper-based Montreal Cognitive Assessment Tool

This pilot study compared a novel electronic Montreal Cognitive Assessment (eMoCA) tool to the original paper-based MoCA. Potential participants were approached at primary care practices, a geriatric day hospital, and a university campus. Each of the 401 participants were randomly assigned to either the eMoCA (N=182) or MoCA (N=219). Scores were adjusted by self-reported demographic and health information using regression analysis. The difference in average scores (26.21±3.11 for the MoCA group and 24.84±4.21 for the eMoCA group) was found to be statistically significant. Controlling for the effect of potential covariate factors with regression analyses, the adjusted difference is -0.90 (95% confidence interval, -1.45 to -0.35). This difference may be due to factors related to use of the electronic device or software usability. However, the standardized, self-administered eMoCA may offer an opportunity for health systems to screen for early changes in cognitive function in primary care settings and offer greater access to assessment for rural or remote communities. Population-level research may be required to identify whether the score difference between test versions requires a downward adjustment to the eMoCA score taken as indicative of cognitive impairment.