| Early and accurate diagnosis of dementia is imperative for patients' overall wellbeing and improved quality of life. Current cognitive screening tools lack sufficient diagnostic accuracy to consistently diagnose mild and uncommon presentations of dementia. Additionally, most current screening instruments are not designed to assist with differential diagnosis and consist of tasks that are influenced by sociodemographic factors. Thus, the purpose of the present study was to develop and preliminarily validate a cognitive screening instrument that can facilitate early and accurate diagnosis of mild and atypical presentations of dementia. The Colorado Cognitive Assessment (CoCA) differs from other cognitive screens in that it assesses a broad range of cognitive domains; consists of tasks that were designed to be minimally influenced by education, sex, and culture; contains tasks that maximize attainment of qualitative features of performance to guide differential diagnosis; and is validated using modern psychometrics. The confirmatory factor analysis (CFA) model of the CoCA revealed excellent fit in a sample of 151 community dwelling older adults. Measurement equivalence analyses revealed that the items on the CoCA were invariant to sex, age, education, and mood. In comparison, a CFA model of the Montreal Cognitive Assessment (MoCA) had worse fit and was biased by age, education, and depressive symptomatology. The CoCA demonstrated adequate convergent validity with the MoCA and NAB Judgment subtest, and divergent validity with the Geriatric Depression Scale-15 (GDS-15) and Geriatric Anxiety Scale-10 (GAS-10). Results provide preliminary evidence for the CoCA as a reliable and comprehensive cognitive screen. Future research is needed to validate the CoCA cross-sectionally and longitudinally in diverse non-clinical and clinical samples. |
