Background: The Montreal Cognitive Assessment (MoCA) was developed to enable earlier detection of mild cognitive impairment (MCI) relative to familiar multi-domain tests like the Mini-Mental State Exam (MMSE). Clinicians need to better understand the relationship between MoCA and MMSE scores. Methods: For this cross-sectional study, we analyzed 219 healthy control (HC), 299 MCI, and 100 Alzheimer's disease (AD) dementia cases from the Alzheimer's Disease Neuroimaging Initiative (ADNI)-GO/2 database to evaluate MMSE and MoCA score distributions and select MoCA values to capture early and late MCI cases. Stepwise variable selection in logistic regression evaluated relative value of four test domains for separating MCI from HC. Functional Activities Questionnaire (FAQ) was evaluated as a strategy to separate dementia from MCI. Equi-percentile equating produced a translation grid for MoCA against MMSE scores. Receiver Operating Characteristic (ROC) analyses evaluated lower cutoff scores for capturing the most MCI cases. Results: Most dementia cases scored abnormally, while MCI and HC score distributions overlapped on each test. Most MCI cases scored >= 17 on MoCA (96.3 %) and >= 24 on MMSE (98.3 %). The ceiling effect (28-30 points) for MCI and HC was less using MoCA (18.1 %) versus MMSE (71.4 %). MoCA and MMSE scores correlated most for dementia (r = 0.86; versus MCI r = 0.60; HC r = 0.43). Equi-percentile equating showed a MoCA score of 18 was equivalent to MMSE of 24. ROC analysis found MoCA >= 17 as the cutoff between MCI and dementia that emphasized high sensitivity (92.3 %) to capture MCI cases. The core and orientation domains in both tests best distinguished HC from MCI groups, whereas comprehension/executive function and attention/calculation were not helpful. Mean FAQ scores were significantly higher and a greater proportion had abnormal FAQ scores in dementia than MCI and HC. Conclusions: MoCA and MMSE were more similar for dementia cases, but MoCA distributes MCI cases across a broader score range with less ceiling effect. A cutoff of >= 17 on the MoCA may help capture early and late MCI cases; depending on the level of sensitivity desired, >= 18 or 19 could be used. Functional assessment can help exclude dementia cases. MoCA scores are translatable to the MMSE to facilitate comparison.

Individuals with Alzheimer's disease (AD) present with a wide variety of symptoms, including sleep disruption and sleep disorders. Conversely, disordered sleep has been associated with an increased risk of developing AD. Both conditions individually have adverse effects on attention, which can be further divided into selective, sustained, divided, and alternating attention. The neural mechanisms underpinning sleep problems in AD involve the disruption of the circadian system. This review comprehensively discusses the types of attention impairments, the relationship between AD pathology and sleep disruption, and the effect of sleep issues on attention in AD. Recommendations for future research include addressing the lack of consistency among study designs and outcomes, and the need to continue exploring the biology of sleep and attention in AD.

Assessment of attention is a key issue in the study of neuropsychological development. In this study we collected Hebrew norms for four frequently used attention tests (Trail Making, Digit-Symbol, Digit Span, and Digit Cancellation), analyzed the developmental sensitivity of each test and traced changes in attention across ages. The tests were administered to 809 boys and girls ranging in age from 8 to 17, divided into 10 age cohorts. The results indicate that, although all tests showed age effects, Digit-Symbol and Digit Cancellation tests were most developmentally sensitive. Another interesting finding was that younger age groups (8-11) are more dissociable by attention tests than older age groups (12-17), indicating that changes in attention are more pronounced in the early years and stabilize in later years.

Letter cancellation tasks are paper and pencil tests widely used in clinical and research settings as quick measures of attention/concentration, visual-spatial scanning abilities, and visual-spatial dysfunctions such as spatial neglect. Despite their popularity, only a few studies have investigated effects of age on letter cancellation performance and no comprehensive large-scale adult life-span norms are available for any of the letter cancellation tasks. We have developed a letter cancellation test, and we report a normative data obtained from a partially stratified sample of 351 healthy adults between 18 and 91 years of age. The results show the expected large age-related decline in the speed of letter cancellation performance and no age-related differences in spatial distribution of cancellation errors. We also provide various equations for precise predictions of Cancel H test performance. The results of correlational analyses show high reliability and provide evidence for both convergent and divergent validity of our letter cancellation task.

Recollection and familiarity are independent processes that contribute to memory performance. Recollection is dependent on attentional control, which has been shown to be disrupted in early stage Alzheimer's disease (AD), whereas familiarity is independent of attention. The present longitudinal study examines the sensitivity of recollection estimates based on Jacoby's (1991) process dissociation procedure to AD-related biomarkers in a large sample of well-characterized cognitively normal middle-aged and older adults (N = 519) and the extent to which recollection discriminates these individuals from individuals with very mild symptomatic AD (N = 64).Participants studied word pairs (e.g., knee bone), then completed a primed, explicit, cued fragment-completion memory task (e.g., knee b_n_). Primes were either congruent with the correct response (e.g., bone), incongruent (e.g., bend), or neutral (e.g., &&&). This design allowed for the estimation of independent contributions of recollection and familiarity processes, using the process dissociation procedure.Recollection, but not familiarity, was impaired in healthy aging and in very mild AD. Recollection discriminated cognitively normal individuals from the earliest detectable stage of symptomatic AD above and beyond standard psychometric tests. In cognitively normal individuals, baseline CSF measures indicative of AD pathology were related to lower initial recollection and less practice-related improvement in recollection over time. Finally, presence of amyloid plaques, as imaged by PIB-PET, was also related to less improvement in recollection over time.These findings suggest that attention-demanding memory processes, such as recollection, may be particularly sensitive to both symptomatic and preclinical AD pathology. (PsycINFO Database Record(c) 2017 APA, all rights reserved).