Literature DB >> 30526675

Correction to: The Toronto cognitive assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment.

Morris Freedman1,2,3,4,5, Larry Leach6,7, M Carmela Tartaglia8,6,9,10, Kathryn A Stokes11, Yael Goldberg11, Robyn Spring12, Nima Nourhaghighi6,13, Tom Gee12, Stephen C Strother12,6,14, Mohammad O Alhaj11,15, Michael Borrie16,17, Sultan Darvesh18, Alita Fernandez11, Corinne E Fischer6,19,20, Jennifer Fogarty16,17, Barry D Greenberg6,21, Michelle Gyenes11, Nathan Herrmann6,13,22,20, Ron Keren6,21,20, Josh Kirstein11, Sanjeev Kumar6,20,23, Benjamin Lam8,22,24, Suvendrini Lena8,6,23, Mary Pat McAndrews9,25,26, Gary Naglie11,12,6,27, Robert Partridge9, Tarek K Rajji6,20,23,28, William Reichmann11,6,20, M Uri Wolf11,6,20, Nicolaas P L G Verhoeff11,6,20, Jordana L Waserman11, Sandra E Black8,6,13,22,24,29, David F Tang-Wai8,6,9,23,25.   

Abstract

Upon publication of this article [1], it was brought to our attention that one of the 303 participants in the normative study should have been deleted from the database.

Entities:  

Year:  2018        PMID: 30526675      PMCID: PMC6286597          DOI: 10.1186/s13195-018-0446-z

Source DB:  PubMed          Journal:  Alzheimers Res Ther            Impact factor:   6.982


Erratum

Upon publication of this article [1], it was brought to our attention that one of the 303 participants in the normative study should have been deleted from the database. Therefore, we reanalyzed the data with this individual removed. This resulted in minor numerical changes affecting tables, figures, and text. In addition, we added IQ data that were omitted in seven participants with normal cognition. This resulted in minor changes affecting Table 9. There were also minor typographical corrections made in the tables. There was no significant impact on the analyses or findings reported in the paper from any of the revisions. The changes are as follows: Table 2 Due to deletion of the single participant who should have been omitted from the database, the sample size was changed from 303 to 302 in the 50–89 year old group and from 76 to 75 in the 50–59 year old group. The number of males in each group was reduced by 1. The Mean (SD) TorCA Sum scores were revised in the 50–89 and 50–59 year old groups. The cut-off scores for the impaired, borderline, and normal limits ratings for the Sum Index were revised in the 50–59 year old group. The cut-off scores for the impaired and borderline ratings for the Delayed Memory Recognition Index were revised in the 70–79 year old group. The cut-off scores for the impaired and borderline ratings for the Visuospatial Index were revised in the 70–79 and 80–89 year old groups. Table 4 The cut-off scores for the below normal and borderline ratings for Clock Drawing were revised in the 50–89 year old group. Table 5 The cut-off score for the borderline rating for Digit Span Backwards was revised for the 70–79 year old group. The cut-off scores for the borderline and normal limits ratings for Digit Span Backwards were revised for the 80–89 year old group. Table 6 The cut-off score for the borderline rating for Repetition was revised for the 50–89 year old group. Table 7 The Test2-Test1 Mean Difference was revised from 2.8 to 2.4 for the Memory – Immediate Recall Index. Table 9 There was a revision to the demographic information in which IQ data for seven participants with normal cognition were omitted. With the addition of these seven participants, there was a change in the Mean IQ (SD). The t-test comparing the IQ of participants with aMCI to those with normal cognition was recalculated with these seven individuals included. There was a minor change in the degrees of freedom and the p-value. One participant with aMCI was not given the verbal component of the IQ estimate due to non-exclusionary English as a second language considerations. However, a comparable estimate of IQ was within the range exhibited by the remaining aMCI participants. This was added in a footnote. Figure 1 The sample size was changed from 303 to 302 Figure 4 Due to a change in cut-off scores: The rating for MDRec in the 70–79 year old group was changed from an orange triangle to a blue dot, i.e., from below normal limits to borderline. The rating for MDRec in the Index Plot was changed from an orange triangle to a blue dot, i.e., from below normal limits to borderline. Text (page 5, column 2, paragraph 2) Due to the change in sample size from 303 to 302, there was a change in the degrees of freedom, F values, Cohen’s d, and number of points higher on Sum Index in women than men. The revised text is: The Sum Index was significantly affected by age (F(3,298) = 7.27, p = 0.001) (Table 2). There was a significant but small effect size (Cohen’s d = 0.29) [20] for gender. Women scored a mean of 5.5 (SED = 2.2) points higher than men (F(1,300) = 6.24, p = 0.013). Age and education were weakly, but significantly, correlated with Sum Index (r = 0.24 and 0.23, both p < 0.001), each accounting for approximately 5% of the variance. The revised tables and figures are shown on the following pages. The revised tables are: Toronto Cognitive Assessment (TorCA) group profiles and normative data Normative data for subtests within domains: Visuospatial Normative data for subtests within domains: Working Memory/Attention/Executive Control Normative data for subtests within domains: Language Toronto Cognitive Assessment (TorCA) Test–Retest Results Test 1 and Test 2 mean indices and test–retest correlations (test stability) expressed as Pearson r Interpretation of stability coefficients (Pearson r): very good, ≥ 0.90; good, 0.80–0.89; acceptable, 0.70–0.79; low, < 0.70 SE standard error, SED standard error of the difference aWorking Memory/Attention/Executive Control Normal cognition and aMCI group demographics and TorCA indices comparisons aMCI amnestic mild cognitive impairment, CI confidence interval, NC normal cognition, SD standard deviation, TorCA Toronto Cognitive Assessment *One participant with aMCI was not given the verbal component of the IQ estimate due to non-exclusionary English as a second language considerations. A comparable estimate of IQ was within the range exhibited by the remaining aMCI participants **Significance tests corrected for multiple comparisons using Bonferroni correction at p ≤ 0.05/7 (0.007) The revised figures are: Flow chart of participants for normative study iPad summary score sheet showing domain scores and numerical and graphic percentile ratings. Probability of aMCI shown as 93.7%. aMCI amnestic mild cognitive impairment In addition to the above, we have provided an annotated pdf as a Additional file 1 documenting the changes. The original article can be found online at 10.1186/s13195-018-0382-y Annotated pdf documenting changes to original article. (PDF 1130 kb)
Table 2

Toronto Cognitive Assessment (TorCA) group profiles and normative data

Group profileAge group
50–89 years50–59 years60–69 years70–79 years80–89 years
N 30275777575
Male/female103/19928/4722/5520/5533/42
Years of education, median (range)16 (8–20)16 (12–20)16 (11–20)16 (9–20)14 (8–20)
TorCA Sum Index, mean (standard deviation)292.8 (18.4)297.6 (18.6)296.9 (16.7)290.5 (16.6)286.0 (19.4)
TorCA Sum Index, median295301298291289
Normative DataPercentile rangeRating50–89 years50–59 years60–69 years70–79 years80–89 years
 Sum Index≤ 5Impaired< 261< 266< 272< 262< 257
6–24Borderline261–281266–287272–287262–280257–272
≥ 25Normal limits> 281> 287> 287> 280> 272
 Orientation≤ 5Impaired< 10< 10< 10< 10< 10
6–24Borderline1010101010
≥ 25Normal limits> 10> 10> 10> 10> 10
 Immediate Memory Recall≤ 5Impaired< 15< 17< 16< 15< 14
6–24Borderline15–1817–2016–1815–1714–16
≥ 25Normal limits> 18> 20> 18> 17> 16
 Delayed Memory Recall≤ 5Impaired< 10< 14< 12< 8< 6
6–24Borderline10–1414–1612–158–126–12
≥ 25Normal limits> 14> 16> 15> 12> 12
 Delayed Memory Recognition≤ 5Impaired< 19< 20< 19< 18< 18
6–24Borderline19201918–1918
≥ 25Normal limits> 1921> 19> 19> 18
 Visuospatial≤ 5Impaired< 25< 27< 25< 24< 24
6–24Borderline25–2727–2825–2724–2724–27
≥ 25Normal limits> 27> 28> 27> 27> 27
 Working Memory/Attention/Executive Control≤ 5Impaired< 99< 98< 102< 99< 98
6–24Borderline99–10698–105102–10799–10698–105
≥ 25Normal limits> 106> 105> 107> 106> 105
 Language≤ 5Impaired< 71< 63< 74< 74< 66
6–24Borderline71–7863–7874–8074–7866–76
≥ 25Normal limits> 78> 78> 80> 78> 76
Table 4

Normative data for subtests within domains: Visuospatial

Toronto Cognitive Assessment Visuospatial test ratings
PercentileRatingBenson Figure CopyClock Drawing
Ages 50–89 years
 ≤ 5Below normal< 14< 10
 6–24Borderline1410–12
 ≥ 25Within normal limits> 14> 12
Ages 50–59 years
 ≤ 5Below normal< 15< 11
 6–24Borderline1511–12
 ≥ 25Within normal limits> 15> 12
Ages 60–69 years
 ≤ 5Below normal< 14< 10
 6–24Borderline1410–12
 ≥ 25Within normal limits> 14> 12
Ages 70–79 years
 ≤ 5Below normal< 14< 10
 6–24Borderline1410–12
 ≥ 25Within normal limits> 14> 12
Ages 80–89 years
 ≤ 5Below normal< 13< 9
 6–24Borderline13–149–12
 ≥ 25Within normal limits> 14> 12
Table 5

Normative data for subtests within domains: Working Memory/Attention/Executive Control

Toronto Cognitive Assessment Working Memory/Attention/Executive Control Test Ratings
PercentileRatingSerial Subtractions 7 sSerial Subtractions 3 sSerial Subtractions TotalDigit Span ForwardsDigit Span BackwardsDigit Span TotalTrails A TimeTrails A ScoreTrails B TimeTrails B ScoreTrails Time DifferenceAlternating SequencesSimilarities
Ages 50–89 years
 ≤ 5Below normal< 9< 11< 21< 5< 4< 10> 67< 24> 163< 22> 107< 2< 7
 6–24Borderline9–1011–1221–23541067–47163–10722107–637–8
 ≥ 25Within normal limits> 10> 12> 23> 5> 4> 10< 4724< 107> 22< 632> 8
Ages 50–59 years
 ≤ 5Below normal< 9< 11< 21< 5< 4< 10> 67< 24> 163< 22> 107< 2< 7
 6–24Borderline9–1011–1221–23541067–47163–10722107–637–8
 ≥ 25Within normal limits> 10> 12> 23> 5> 4> 10< 4724< 107> 22< 632> 8
Ages 60–69 years
 ≤ 5Below normal< 10< 11< 21< 5< 4< 9> 59< 24> 146< 24> 100< 2< 9
 6–24Borderline1011–1221–23549–1059–43146–91100–539
 ≥ 25Within normal limits> 10> 12> 23> 5> 4> 10< 4324< 9124< 532> 9
Ages 70–79 years
 ≤ 5Below normal< 9< 11< 20< 5< 4< 10> 86< 24> 196< 23> 1370< 8
 6–24Borderline9–111120–23541086–49196–11123137–6518
 ≥ 25Within normal limits> 11> 11> 23> 5> 4> 10< 4924< 11124< 652> 8
Ages 80–89 years
 ≤ 5Below normal< 9< 11< 22< 5< 4< 9> 73< 24> 198< 21> 1590< 7
 6–24Borderline9–1011–1222–2354973–53198–12021–22159–8517–8
 ≥ 25Within normal limits> 10> 12> 23> 5> 4> 9< 5324< 120> 22< 852> 8
Table 6

Normative data for subtests within domains: Language

Toronto Cognitive Assessment Language Test Ratings:
PercentileRatingF-wordsAnimal namesNamingRepetitionSingle word comprehensionReading single word comprehensionSentence comprehensionSingle word readingSemantic knowledge
Ages 50–89 years
 ≤ 5Below normal limits< 10< 14< 13< 8< 8< 2< 5< 11< 9
 6–24Borderline10–1214–161385–6119
 ≥ 25Normal limits> 12> 16> 13> 882> 612> 9
Ages 50–59 years
 ≤ 5Below normal limits< 8< 13< 9< 5< 8< 2< 5< 9< 9
 6–24Borderline8–1113–189–135–75–69–119
 ≥ 25Normal limits> 11> 18> 13> 782> 61210
Ages 60–69 years
 ≤ 5Below normal limits< 10< 14< 13< 8< 8< 2< 6< 12< 9
 6–24Borderline10–1214–171386–79
 ≥ 25Normal limits> 12> 17> 13> 88281210
Ages 70–79 years
 ≤ 5Below normal limits< 10< 14< 13< 8< 8< 2< 5< 12< 9
 6–24Borderline10–1214–161385–69
 ≥ 25Normal limits> 12> 16> 13> 882> 61210
Ages 80–89 years
 ≤ 5Below normal limits< 11< 11< 12< 8< 8< 2< 4< 11< 9
 6–24Borderline11–1211–151284–5119
 ≥ 25Normal limits> 12> 15> 12> 882> 51210
Table 7

Toronto Cognitive Assessment (TorCA) Test–Retest Results

TorCA indexTest 1 mean (SE)Test 2 mean (SE)Test 2–Test 1 mean difference (SED)t(27) (p value)Stability (p value)% change
Orientation11.2 ± 0.211.3 ± 0.20.1 ± 0.20.5 (0.631)0.10(0.607)0.1
Memory—Immediate Recall19.5 ± 0.721.9 ± 0.72.4 ± 0.54.6(0.0001)0.73(0.0001)14.3
Memory—Delayed Recall15.8 ± 0.917.5 ± 0.81.7 ± 0.53.4(0.002)0.83(0.0001)10.7
Memory—Delayed Recognition20.2 ± 0.220.4 ± 0.20.2 ± 0.20.9(0.363)0.57(0.001)1.0
Visuospatial28.6 ± 0.428.4 ± 0.4− 0.2 ± 0.3− 0.7(0.5)0.68(0.0001)0.7
Executive Controla111.0 ± 1.2112.0 ± 1.31.0 ± 1.30.9(0.4)0.52(0.004)1.0
Language84.4 ± 1.383.1 ± 1.3− 1.3 ± 0.9− 1.4(0.2)0.75(0.0001)1.5
Sum290.7 ± 3.2294.0 ± 3.43.3 ± 1.42.4(0.023)0.92(0.0001)1.1

Test 1 and Test 2 mean indices and test–retest correlations (test stability) expressed as Pearson r

Interpretation of stability coefficients (Pearson r): very good, ≥ 0.90; good, 0.80–0.89; acceptable, 0.70–0.79; low, < 0.70

SE standard error, SED standard error of the difference

aWorking Memory/Attention/Executive Control

Table 9

Normal cognition and aMCI group demographics and TorCA indices comparisons

Group demographicsNCaMCI
N5750
 Male/female19/3827/23χ2 = 4.6p = 0.031
 Age, mean (SD)75.3 (7.9)77.7 (6.5)t(105) = 1.68p = 0.097
 Years of education, mean (SD)15.02 (3.2)15.5 (3.4)t(105) = 0.72p = 0.47
 IQ, mean (SD)122.81 (13.54)*121.33 (13.98)t(104) = 0.55p = 0.58
TorCA index group comparisonsNC (SD)aMCI (SD)t(105) (p value**)Effect size, Hedge’s g (95% CI)
 Orientation11.58 (0.76)10.38 (1.69)4.84(0.0001)− 0.93(− 1.33, − 0.53)
 Memory—Immediate Recall20.77 (4.45)14.18 (3.29)8.62(0.0001)− 1.66(− 2.10, − 1.22)
 Memory—Delayed Recall16.86 (4.85)6.66 (4.65)11.07(0.0001)− 2.13(− 2.60, − 1.65)
 Memory—Delayed Recognition20.19 (1.33)17.42 (2.42)7.45(0.0001)−1.43(− 1.86, − 1.01)
 Visuospatial29.79 (1.80)30.02 (2.16)0.602(0.549)0.12(− 0.26, 0.50)
 Working Memory/Attention/Executive Control108.47 (10.30)107.34 (8.17)0.625(0.534)− 0.12(− 0.50, 0.26)
 Language80.16 (8.34)76.90 (6.23)2.26(0.026)− 0.42(− 0.81, − 0.04)
 Sum287.82 (23.92)262.86 (17.63)6.07(0.0001)− 1.17(− 1.58, − 0.76)

aMCI amnestic mild cognitive impairment, CI confidence interval, NC normal cognition, SD standard deviation, TorCA Toronto Cognitive Assessment

*One participant with aMCI was not given the verbal component of the IQ estimate due to non-exclusionary English as a second language considerations. A comparable estimate of IQ was within the range exhibited by the remaining aMCI participants

**Significance tests corrected for multiple comparisons using Bonferroni correction at p ≤ 0.05/7 (0.007)

  1 in total

1.  The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment.

Authors:  Morris Freedman; Larry Leach; M Carmela Tartaglia; Kathryn A Stokes; Yael Goldberg; Robyn Spring; Nima Nourhaghighi; Tom Gee; Stephen C Strother; Mohammad O Alhaj; Michael Borrie; Sultan Darvesh; Alita Fernandez; Corinne E Fischer; Jennifer Fogarty; Barry D Greenberg; Michelle Gyenes; Nathan Herrmann; Ron Keren; Josh Kirstein; Sanjeev Kumar; Benjamin Lam; Suvendrini Lena; Mary Pat McAndrews; Gary Naglie; Robert Partridge; Tarek K Rajji; William Reichmann; M Uri Wolf; Nicolaas P L G Verhoeff; Jordana L Waserman; Sandra E Black; David F Tang-Wai
Journal:  Alzheimers Res Ther       Date:  2018-07-18       Impact factor: 6.982

  1 in total

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