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  3. Education, Sex, And Age Shape Rey Complex Figure Performance In Cognitively Normal Adults: An Interpretable Machine Learning Study.
  1. Home
  3. Education, Sex, And Age Shape Rey Complex Figure Performance In Cognitively Normal Adults: An Interpretable Machine Learning Study.

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Education, Sex, and Age Shape Rey Complex Figure Performance in Cognitively Normal Adults: An Interpretable Machine

Albert J B Lee1, Benjamin Zhao1, James J Lah2

  • 1Laboratory for Pathology Dynamics, Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30332, USA.

Journal of Clinical Medicine
|November 13, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Demographic factors like education, sex, and age significantly impact cognitive test performance on the Montreal Cognitive Assessment (MoCA) and Rey Complex Figure (CF) tests. Adjusting for these factors is crucial for accurate neuropsychological assessment interpretation.

Keywords:
Montreal Cognitive Assessment (MoCA)Rey Complex Figure (CF)Rey–Osterrieth Complex Figure (ROCF)artificial intelligencedemographic differencesmachine learningneuropsychological assessment

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Area of Science:

  • Neuropsychology
  • Cognitive Science
  • Psychometrics

Background:

  • Demographic factors (education, sex, age) impact cognitive test performance.
  • The influence on Montreal Cognitive Assessment (MoCA) and Rey Complex Figure (CF) tests is not fully understood in healthy adults.
  • Accurate interpretation of neuropsychological assessments requires understanding demographic influences.

Purpose of the Study:

  • Characterize the impact of education, sex, and age on MoCA and CF performance in a large, healthy sample.
  • Identify key cognitive features influenced by demographic variables.
  • Inform normative standards and clinical interpretation of these widely used cognitive tests.

Main Methods:

  • Analysis of data from 926 cognitively healthy adults (MoCA score ≥ 24).
  • Utilized supervised machine learning and statistical models to identify predictive features.
  • Quantified feature importance for accuracy and time-based measures, adjusting for demographics.

    • Main Results:

    • Higher education correlated with longer encoding times and better recall.
    • Sex differences observed in visuospatial detail recall and language subtests (women showed advantages).
    • Age impacted task completion speed and spatial memory accuracy.

    Conclusions:

    • Education, sex, and age systematically influence MoCA and CF performance in cognitively healthy individuals.
    • Findings underscore the necessity of incorporating demographic adjustments into cognitive assessment norms.
    • Improved diagnostic precision and interpretability of cognitive assessments can be achieved through demographic considerations.