We aimed to compare the concordance between the Montreal Cognitive Assessment (MoCA) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), as cognitive screening tools to detect mild cognitive impairment (MCI) in a South African adult community sample (N = 370).

The MoCA showed acceptable internal consistency, agreement with the RBANS and good criterion-related validity. The MoCA demonstrated fair performance, compared to the RBANS, for predicting MCI, with AUCs of 0.711 (English) and 0782 (Afrikaans). Using the recommended cut-off score of 26/30, the MoCA showed high sensitivity but low specificity. Sensitivity and specificity were optimal when the cut-off scores were lowered to 25/30 (English) and 24/30 (Afrikaans). MoCA scores were significantly associated with language, sex, age and education.

While these findings demonstrate applicability of the MoCA in screening for and identifying mild cognitive difficulty in this population, our findings suggest that modifications are needed to improve differentiating between normal aging and MCI. Until a culturally adapted version of the MoCA is developed and validated for this population we suggest lowering the cut-off score to 25/30 (English) and 24/30 (Afrikaans) to reduce false positive NCD diagnoses. Demographic factors (age, sex, language and education) also need to be considered.

In a psychosocial treatment study, knowing which participants are likely to put forth adequate effort to maximize their treatment, such as attending group sessions and completing homework assignments, and knowing which participants need additional motivation before engagement in treatment is a crucial component to treatment success. This study examined the ability of the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) Effort Index (EI), a newly developed measure of suboptimal effort that is embedded within the RBANS, to predict group attendance in a sample of 128 middle-aged and older adults with schizophrenia. This study was the first to evaluate the EI with a schizophrenia sample. While the EI literature recommends a cutoff score of >3 to be considered indicative of poor effort, a cutoff of >4 was identified as the optimal cutoff for this sample. Receiver Operating Characteristics curve analyses were conducted to determine if the EI could predict participants who had high versus low attendance. Results indicated that the EI was successfully able to discriminate between group attendance, and this measure of effort appears to be most valuable as a tool to identify participants who will have high attendance. Of interest, overall cognitive functioning and symptoms of psychopathology were not predictive of group attendance. (JINS, 2013, 19, 1–8)

Repeated neuropsychological assessments are common with older adults, and the determination of clinically significant change across time is an important issue. Regression-based prediction formulas have been utilized with other patient and healthy control samples to predict follow-up test performance based on initial performance and demographic variables. Comparisons between predicted and observed follow-up performances can assist clinicians in determining the significance of change in the individual patient. In the current study, multiple regression-based prediction equations for the 5 Indexes and Total Score of the RBANS were developed for a sample of 223 community dwelling older adults. These algorithms were then validated on a separate elderly sample (N = 222). Minimal differences were present between observed and predicted follow-up scores in the validation sample, suggesting that the prediction formulas are clinically useful for practitioners who assess older adults. A case example is presented that illustrates how the algorithms can be used clinically. (JINS, 2004, 10, 828–834.)