HEPPI: a randomized controlled trial of the efficacy of a cognitive-emotional intervention for homebound older adults.

OBJECTIVES: This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms. METHODS: Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767. RESULTS: Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention. CONCLUSIONS: This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health.

Feasibility, Acceptability, and Preliminary Efficacy of A Cognitive-Emotional Intervention Program in Homebound Older Adults: A Pilot Randomized Controlled Trial.

OBJECTIVES: To conduct a pilot randomized controlled trial to assess the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI) among homebound older adults with mild cognitive impairment and depressive or anxious symptomatology. METHODS: Fifty-one participants were randomly assigned to the intervention group or to the wait-list control group and completed baseline and post-intervention assessments. Feasibility and acceptability were the primary outcomes. Secondary outcomes included changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and at an individual level (Reliable Change Index). RESULTS: The HEPPI was a feasible and acceptable non-pharmacological intervention. Compared to the wait-list control group, the intervention group showed significant improvement in cognitive, emotional, and functional domains at post-intervention. Differences between groups in the distributions by clinical change categories were observed. CONCLUSIONS: Results provide evidence of the HEPPI's feasibility, acceptability, and preliminary efficacy in increasing the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology. CLINICAL IMPLICATIONS: Home-delivered cognitive-emotional interventions may be a promising and acceptable mental health approach for homebound older adults, improving their cognitive and emotional functioning.

The European Portuguese WHOQOL-OLD module and the new facet Family/Family life: reliability and validity studies.

PURPOSE: The aim of this study was to examine the psychometric properties of the European Portuguese version of the World Health Organization Quality of Life-Older Adults Module (WHOQOL-OLD). The European Portuguese WHOQOL-OLD includes a new identified facet, Family/Family life. METHODS: A convenience sample of older adults was recruited (N = 921). The assessment protocol included demographics, self-perceived health, depressive symptoms (GDS-30), cognitive function (ACE-R), daily life activities (IAFAI), health status (SF-12) and QoL (WHOQOL-Bref, EUROHIS-QOL-8 and WHOQOL-OLD). RESULTS: The internal consistency was excellent for the total 24-item WHOQOL-OLD original version and also for the final 28-item European Portuguese WHOQOL-OLD version. The test-retest reliability for total scores was good. The construct validity of the European Portuguese WHOQOL-OLD was supported in the correlation matrix analysis. The results indicated good convergent/divergent validity. The WHOQOL-OLD scores differentiated groups of older adults who were healthy/unhealthy and without/mild/severe depressive symptoms. The new facet, Family/Family life, presented evidence of good reliability and validity parameters. CONCLUSION: Comparatively to international studies, the European Portuguese WHOQOL-OLD version showed similar and/or better psychometric properties. The new facet, Family/Family life, introduces cross-cultural specificity to the study of QoL of older adults and generally improves the psychometric robustness of the WHOQOL-OLD.

Homebound elderly people psychotherapeutic intervention (HEPPI): Exploring the mediating role of loneliness.

OBJECTIVES: The present study aimed to explore whether the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered ten-week cognitive-emotional intervention, was effective in reducing self-reported loneliness among homebound older adults presenting mild cognitive impairment and psychological symptomatology. Effects of HEPPI in total, social, and emotional loneliness, compared with a treatment-as-usual group, were investigated at post-intervention and 3-month follow-up. In addition, the potential role of social and emotional loneliness as mediators of the HEPPI impact on episodic memory and symptoms of depression and anxiety was examined. METHODS: This study built upon the data of a previously conducted randomized controlled trial. Participants were randomly assigned to the HEPPI group (n = 98) or the treatment-as-usual group (n = 101) and completed baseline, post-intervention, and 3-month follow-up assessments, including measures of loneliness (UCLA - Loneliness scale), episodic memory (Wechsler Memory Scale-III), depressive symptoms (Geriatric Depression Scale-30), and anxiety symptoms (Geriatric Anxiety Inventory). Data were analyzed on an intention-to-treat basis employing linear mixed models and mediation analyses for repeated measures. CLINICALTRIALS: gov identifier: NCT05499767. RESULTS: Compared with usual care controls, the HEPPI participants reported a significant immediate decrease in total and social loneliness, but these effects were not maintained at a 3-month follow-up. The reduction in immediate perceived social loneliness significantly mediated the improvement of depressive symptoms. CONCLUSIONS: The current findings suggest that HEPPI potentially reduced total and social loneliness of the homebound older population immediately post-intervention, and such decrease in social loneliness may be a relevant mechanism for improving their short-term depressive symptomatology.

Chronotype, Time of Day, and Children's Cognitive Performance in Remote Neuropsychological Assessment.

Research on the influence of chronotype and time of day (TOD) on cognitive performance, especially in children, is limited. We explored potential interactive effects, hypothesizing that performance differs when comparing preferred vs. non-preferred TOD. In total, 76 morning-type (MT = 37) or evening-type (ET = 39) children from the third and fourth grades (48.7% girls; M age = 8.05; SD age = 0.51), identified through the Children Chronotype Questionnaire, completed two 30-min neuropsychological assessment sessions via videoconference on the first (9:00) or last hour (16:00) of the school day. The protocol included neuropsychological tests targeting memory, language, and attention/executive domains. The results revealed an interactive effect of medium size between chronotype and TOD on a Rapid Alternating Stimulus (Naming) Task. MT and ET performed faster in asynchrony conditions (morning for ET; afternoon for MT). Additionally, ET outperformed MT in a Backward Digit Span Task, irrespective of TOD. TOD also influenced performance on an Alternating Verbal Fluency Task, with both MT and ET children performing better in the morning. These results underscore the importance of chronotype and TOD in children's cognitive performance, particularly in working memory and verbal fluency. Children assessed during non-preferred TOD exhibited better performance on some cognitive tasks, challenging the assumption that optimal times always yield superior results.

Factor structure and measurement invariance of the BRIEF2 Parent Form across gender in a Portuguese sample.

This study aimed to investigate the factor structure and the measurement invariance across gender of the BRIEF2 Parent Form in Portuguese typically developing children. Participants were 700 typically developing children (n = 352 girls and n = 348 boys) aged 6-16 years. Confirmatory factor analysis was used to test five competing factor models. Consistent with the BRIEF2 original dimensional structure, the three-factor model demonstrated the most adequate fit to the data. The measurement invariance of the three-factor model across gender was supported (configural, metric, and partial scalar invariance). Overall, the BRIEF2 Parent Form showed adequate psychometric properties, suggesting that it is a useful instrument to assess everyday executive functioning based on reports of behaviors observed by parents in healthy Portuguese children.

BRIEF-A: Factor structure and measurement invariance across self-report and informant forms.

OBJECTIVE: This study analyzes the psychometric properties of the two forms (self-report and informant) of the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A) in a sample of healthy Portuguese adults. METHOD: The participants were 608 adults, 304 of whom answered the self-report form (ages 18-59; 137 male and 167 female) and 304 who answered the informant form (ages 18-70; 110 male and 194 female). RESULTS: The internal consistency for the indexes and the Global Executive Composite was very good (≥.90), whereas for the scales they were either acceptable (between .70 and .80) or good (≥.80), except for the Inhibit scale in both forms. Confirmatory factor analysis was used to test seven competing factor models for each of the forms. The original two-factor model (Behavioral Regulation and Metacognition Indexes) showed a slightly better model fit than the three-factor model (Behavioral Regulation, Emotional Regulation, and Metacognition Indexes) in both forms. The multiple-group analysis of the two-correlated-factor model across forms was supported (configural, metric, and partial scalar invariance). CONCLUSIONS: Overall, the BRIEF-A showed adequate psychometric properties, suggesting that it is a useful instrument to assess everyday executive functioning in healthy Portuguese adults.

NeuroAIreh@b: an artificial intelligence-based methodology for personalized and adaptive neurorehabilitation.

Cognitive impairments are a prevalent consequence of acquired brain injury, dementia, and age-related cognitive decline, hampering individuals' daily functioning and independence, with significant societal and economic implications. While neurorehabilitation represents a promising avenue for addressing these deficits, traditional rehabilitation approaches face notable limitations. First, they lack adaptability, offering one-size-fits-all solutions that may not effectively meet each patient's unique needs. Furthermore, the resource-intensive nature of these interventions, often confined to clinical settings, poses barriers to widespread, cost-effective, and sustained implementation, resulting in suboptimal outcomes in terms of intervention adaptability, intensity, and duration. In response to these challenges, this paper introduces NeuroAIreh@b, an innovative cognitive profiling and training methodology that uses an AI-driven framework to optimize neurorehabilitation prescription. NeuroAIreh@b effectively bridges the gap between neuropsychological assessment and computational modeling, thereby affording highly personalized and adaptive neurorehabilitation sessions. This approach also leverages virtual reality-based simulations of daily living activities to enhance ecological validity and efficacy. The feasibility of NeuroAIreh@b has already been demonstrated through a clinical study with stroke patients employing a tablet-based intervention. The NeuroAIreh@b methodology holds the potential for efficacy studies in large randomized controlled trials in the future.

Healthcare decision-making capacity in old age: A qualitative study.

Objectives: Research about decision-making capacity has been growing in the last decades. That relates to more concerns regarding patients' autonomy, and an increase in diseases that can negatively impact capacity. This research aims to: explore perceptions, legal aspects, and assessment procedures related to healthcare decision-making capacity in older adults with cognitive impairment; and study the first version of a new assessment instrument of this capacity. Method: Nine focus groups were conducted, including healthcare, law and justice, nursing home professionals, institutionalized older adults, and dwelling older adults. Focus group discussions followed semi-structured interview scripts, specifically developed for each group. After group discussions, the assessment instrument was presented, and participants were asked to evaluate each item relevance and comprehensibility. Qualitative coding of the transcriptions was performed with resource to MAXQDA, using direct content analysis. Results: Six primary themes emerged from the qualitative analysis: Decision-making capacity features; Abilities implied in decision-making; Factors influencing decision-making; Obstacles to decision-making; Legal aspects; and Assessment procedures. Discussion: Results corroborate previous theoretical formulations of capacity. Generally, research results have implications for clinical and assessment practices, as well as preventive strategies that can improve older adult's decision-making capacity. Assessment procedures of capacity should include a thorough protocol for the assessment of cognition, functionality, depressive symptoms, and decision-making abilities. In this respect, the need for an assessment tool that can provide valid information during evaluation processes is highlighted. Concerning the strategies to promote decision-making capacity, these rely on improving older adult's health literacy and healthcare providers communication skills, as well as conduct actions to reduce stigma toward people with dementia.

Feasibility, Acceptability, and Preliminary Impact of Full-Body Interaction on Computerized Cognitive Training Based on Instrumental Activities of Daily Living: A Pilot Randomized Controlled Trial with Chronic Psychiatric Inpatients.

Objective: To conduct a pilot randomized control trial to assess the feasibility and acceptability of full-body interaction cognitive training (FBI-CT) inspired by instrumental activities of daily living in chronic psychiatric inpatients and to explore its preliminary impact on cognitive and noncognitive outcomes. Materials and Methods: Twenty psychiatric inpatients met the inclusion criteria and were randomly allocated to the FBI-CT group (n = 10) or the tablet-based CT group (T-CT) (n = 10). Neuropsychological assessments were performed at baseline, postintervention, and 3-month follow-up. Results: Both groups presented high completion rates at postintervention and follow-up. Participants reported high satisfaction following the interventions, with the FBI-CT group exhibiting slightly higher satisfaction. A within-group analysis showed significant improvements in the FBI-CT group for processing speed and sustained attention for short periods (P = 0.012), verbal memory (P = 0.008), semantic fluency (P = 0.027), depressive symptoms (P = 0.008), and quality of life (P = 0.008) at postintervention. At 3-month follow-up, this group maintained verbal memory improvements (P = 0.047) and depressive symptoms amelioration (P = 0.026). The T-CT group revealed significant improvements in sustained attention for long periods (P = 0.020), verbal memory (P = 0.014), and executive functions (P = 0.047) postintervention. A between-group analysis demonstrated that the FBI-CT group exhibited greater improvements in depressive symptoms (P = 0.042). Conclusions: Overall, we found support for the feasibility and acceptability of both training approaches. Our findings show promise regarding the preliminary impact of the FBI-CT intervention, but due to study limitations such as the small sample size, we cannot conclude that FBI-CT is a more effective approach than T-CT for enhancing cognitive and noncognitive outcomes of chronic psychiatric inpatients. Clinical trials (number: NCT05100849).

Factor Structure and Measurement Invariance of the Coimbra Neuropsychological Assessment Battery (BANC).

OBJECTIVE: This study aimed to investigate the factor structure of the Coimbra Neuropsychological Assessment Battery (BANC), which is an individually administered battery designed to assess a wide range of neurocognitive functions in children. METHOD: Using the standardization sample of the BANC, a confirmatory factor analysis and a multiple-group analysis were conducted to examine the factor structure and the measurement invariance of three main domains (Memory, Language, and Attention/Executive Functions) in 833 children aged 7-15 years. RESULTS: Consistent with the BANC's conceptualization, the three-correlated-factor model demonstrated the most adequate fit to the data. The measurement invariance of the three-correlated-factor model across two age-groups (7-9 years and 10-15 years) was supported (configural, metric, and partial scalar invariance). CONCLUSION: Overall, the BANC shows adequate psychometric properties and provides useful information regarding the children's neuropsychological functioning.

Homebound Elderly People Psychotherapeutic Intervention (HEPPI): study protocol for a randomized controlled trial / Intervenção psicoterapêutica com adultos idosos confinados no domicílio: protocolo para um ensaio clínico randomizado controlado

Objective: To present the study protocol for the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention aimed at homebound older adults with mild cognitive impairment and depression and/or anxiety symptoms. Methods: A two-arm, open-label, parallel-group randomized controlled trial will be conducted to compare the effects of HEPPI with treatment as usual. Homebound older adults will be recruited from the community through contact with their health care networks in mainland Portugal. All participants will complete baseline, post-intervention, and 3-month follow-up assessments. Primary outcomes will be changes in episodic memory and depression and anxiety symptoms. Secondary outcomes will include changes in general cognition, attentional control, subjective memory complaints, quality of life, functional status, and loneliness. Relevance: The availability of evidence-based home-delivered non-pharmacological interventions meeting the cognitive and emotional needs of the homebound older population could improve their access to mental health care resources and increase their mental health and quality of life.

Objetivo: Apresentar o protocolo do estudo da Homebound Elderly People Psychotherapeutic Intervention (HEPPI), uma intervenção cognitivo-emocional, realizada no domicílio, dirigida a adultos idosos confinados no domicílio com declínio cognitivo leve e sintomatologia depressiva e/ou ansiógena. Métodos: Será realizado um ensaio clínico randomizado, controlado e aberto, com o objetivo de comparar os efeitos da intervenção HEPPI com um grupo de tratamento usual. Os idosos confinados no domicílio serão recrutados na comunidade, em Portugal continental, por meio de contato com sua rede de prestação de cuidados de saúde. Todos os participantes serão avaliados em três momentos: pré-intervenção, pós-intervenção e três meses depois da intervenção. As alterações na memória episódica e na sintomatologia depressiva e ansiógena serão os desfechos primários, já os secundários serão constituídos pelas alterações no funcionamento cognitivo geral, controle atencional, queixas subjetivas de memória, qualidade de vida, capacidade funcional e solidão. Relevância: A disponibilidade de intervenções não farmacológicas em domicílio com evidência empírica, que atendam às necessidades cognitivas e emocionais dos adultos idosos confinados no domicílio, poderá facilitar o seu acesso a recursos de saúde mental, bem como melhorar sua saúde mental e qualidade de vida.

Estudo de evidências de validade discriminante para o Desenho da Família Cinética / Study of evidence of discriminant validity for the Kinetic Family Drawing Test / Estudio de evidencias de validez discriminante para el Dibujo de la Familia Kinética

Esta pesquisa teve como objetivo principal investigar evidências de validade discriminante para o Desenho da Família Cinética. Pretendeu também analisar a influência de variáveis sociodemográficas, bem como a frequência e capacidade de discriminação de cada item de análise dessa técnica projetiva. Participaram 112 crianças de 9 a 12 anos pertencentes a dois grupos critério, sendo 80 da amostra normativa e 32 da amostra clínica (com problemas de aprendizagem). Os instrumentos utilizados foram o Desenho da Família Cinética, sua folha de correção e as Matrizes Progressivas e Coloridas de Raven. Os dados foram analisados por meio de estatísticas descritivas e inferenciais com o auxílio do software SPSS. Os principais resultados mostraram que a variável sociodemográfica Idade gerou efeito nos resultados obtidos; houve diferença estatisticamente significativa entre os grupos-critério, corroborando para as evidências de validade discriminante; e apenas 38,46% dos itens de análise obtiveram diferença estatisticamente significativa entre os grupos critério. (AU)

This study aimed to investigate evidence of discriminant validity for the Kinetic Family Drawing test. It also intended to analyze the influence of sociodemographic variables, to evaluate the frequency and discriminatory capacity of each analysis item of this projective technique. Participants were 112 children from 9 to 12 years of age, belonging to two criterion groups, 80 from the normative sample and 32 from the clinical sample (with learning problems). The instruments used were the Kinetic Family Drawing test, its correction sheet and Raven's Progressive and Colored Matrices. Data were analyzed through descriptive and inferential statistics using the SPSS software. The main results showed that the sociodemographic variable age influenced the results obtained; there was a statistically significant difference between the criterion groups, corroborating the evidence of discriminant validity; while only 38.46% of the analysis items obtained statistically significant difference between the criterion groups. (AU)

Esta investigación tuvo como objetivo principal investigar las evidencias de validez discriminatorias para el Dibujo de la Familia Kinética. También se pretendía analizar la influencia de las variables sociodemográficas, así como evaluar la frecuencia y la capacidad discriminatoria de cada ítem de análisis de esta técnica proyectiva. Participaron un total de 112 niños de 9 a 12 años, pertenecientes a dos grupos de criterios, 80 de la muestra normativa y 32 de la muestra clínica (con problemas de aprendizaje). Los instrumentos utilizados fueron el Dibujo de la Familia Kinética, su hoja de corrección y las Matrices Progresivas Coloreadas de Raven. Los datos se analizaron mediante estadística descriptiva e inferencial con la ayuda del software SPSS. Los principales resultados mostraron que la variable sociodemográfica edad tuvo un efecto sobre los resultados obtenidos; hubo una diferencia estadísticamente significativa entre los grupos de criterios, corroborando la evidencia de validez discriminante; y solo el 38.46% de los ítems de análisis obtuvieron diferencias estadísticamente significativas entre los grupos de criterios. (AU)

The Adults and Older Adults Functional Assessment Inventory: A Rasch Model Analysis.

Functional assessment methods are an important element in multidimensional neuropsychological evaluations, particularly in older adults. The Adults and Older Adults Functional Assessment Inventory is a new measure of basic and instrumental activities of daily living. Rasch model analyses were used to analyze the psychometric characteristics of the instrument in a sample of 803 participants. The original categories did not provide an optimal assessment of functional incapacity. The scale was dichotomized to achieve a better reliability score and item fit. The final 50 items revealed a moderately high variability in item difficulty, acceptable fits to items and persons, and a good Person Separation Reliability score. The scores were able to discriminate between normal controls and clinical patients. None of the items showed Differential Item Functioning associated with age, gender, or education. The instrument is able to achieve measures of functional incapacity with the useful properties of the Rasch model.

Estudos de fidedignidade para o Desenho da Família Cinética / Reliability studies for the Kinetic Family Drawing / Estudios de confiabilidad para el Dibujo Kinético de la Familia

Esta pesquisa teve como objetivo realizar estudos de fidedignidade para o Desenho da Família Cinética, sendo estes relativos aos parâmetros de fidedignidade entre avaliadores, intra-avaliador e estabilidade temporal/teste-reteste. Os instrumentos utilizados foram o Desenho da Família Cinética e o Teste das Matrizes Progressivas Coloridas de Raven. Participaram desses estudos dois juízes e 66 crianças, sendo 16 com problemas de aprendizagem. Para a análise de dados, utilizou-se o coeficiente kappa de Cohen, a correlação ρ de Spearman e a diferença estatística entre as médias dos pontos por meio do Teste Wilcoxon. Os resultados mostraram índices substanciais a perfeitos de concordância nos estudos de fidedignidade entre avaliadores e intra-avaliador para todos os itens de análise do Desenho da Família Cinética e, no teste-reteste, não houve diferenças estatisticamente significativas entre as médias das pontuações entre as duas aplicações. Conclui-se pela robustez psicométrica do Desenho da Família Cinética, em termos de indicadores de fidedignidade.(AU)

This study aimed to perform reliability analyses for the Kinetic Family Drawing, in relation to inter- and intra-rater reliability parameters and temporal/test-retest stability. The instruments used were the Kinetic Family Drawing and the Raven Colored Progressive Matrix Test. Twelve judges and 66 children participated in this study, 16 of whom had learning problems. For the data analysis, Cohen's kappa coefficient, Spearman's correlation coefficient ρ, and the statistical difference between the means of the points through the Wilcoxon test were used. The results showed substantial perfect agreement indices in the inter- and intra-rater reliability analyses for all items of the Kinetic Family Drawing, and in the test-retest there were no statistically significant differences between the mean scores of the two applications. The psychometric robustness of the Kinetic Family Drawing, in terms of reliability indicators, was confirmed.(AU)

Esta investigación tuvo como objetivo realizar estudios de confiabilidad para el Dibujo Kinético de la Familia, que se relaciona con los parámetros de referencia entre los evaluadores, intra-evaluadores y estabilidad temporal/test-retest. Los instrumentos utilizados fueron el Dibujo Kinético de la Familia y la Test de Matrices Progresivas de Raven. Participaron de los estudios 2 jueces y 66 niños, siendo que 16 de ellos poseían problemas de aprendizaje. Para el análisis de los datos, se utilizó el coeficiente kappa de Cohen, la correlación de Spearman ρ y la diferencia estadística entre las medias de los puntos por medio de la prueba de Wilcoxon. Los resultados mostraron índices de concordancia considerables en los estudios de confiabilidad entre evaluadores e intra-evaluadores para todos los ítems de análisis del Dibujo Kinético de la Familia y, en el test-retest, no hubo diferencias estadísticamente significativas entre las medias de las puntuaciones entre las dos aplicaciones. Se concluye por la robustez psicométrica del Dibujo Kinético de la Familia, en términos de indicadores de confiabilidad.(AU)

Estudos de adaptação do Montreal Cognitive Assessment (MoCA) para a população portuguesa / Adaptation studies of the Montreal Cognitive Assessment (MoCA) to the portuguese population

O Montreal Cognitive Assessment (MoCA) é um instrumento de rastreio cognitivo mais sensivel que o Mini-Mental State Examination (MMSE) aos estádios mais ligeiros de declínio, nomeadamente ao Défice Cognitivo Ligeiro (DCL), que frequentemente progride para Demência. Este trabalho descreve as etapas do processo de adaptação transcultural do MoCA para a população portuguesa e analisa a equivalência entre a versão original e a versão final portuguesa. O processo envolveu a tradução, retroversão, aperfeiçoamento linguístico do instrumento e manual, estudos com a versão experimental, revisão e ajustamento necessários para finalizar a versão portuguesa, e análise da equivalência com a original. Os estudos realizados evidenciaram as boas proriedades psicométricas dos resultados com a versão portuguesa do MoCA, a sua validade, utilidade clínica e equivalência com a prova original, nos diversos níveis considerados. O MoCA é um instrumento privilegiado na detecção precoce do declínio cognitivo e está convenientemente adaptado para a população portuguesa.(AU)

The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument with greater sensitivity than the Mini-Mental State Examination (MMSE) to milder stages of cognitive decline, especially to Mild Cognitive Impairment (MCI), which often progress do Dementia. This paper describes the stages of cultural adaptation of MoCA to the Portuguese population and analyzes the equivalence between the original and the Portuguese final version. The process involved translation, linguistic improvement of the instrument and manual, studies with the experimental version, revision and adjustments required to finalize the Portuguese version, and analysis of equivalence to the original version. Studies corroborate MoCA's good psychometric properties, its validity, clinical utility, and equivalence to the original instrument in various levels considered. The MoCA is a privileged instrument for early detection of cognitive decline that is properley adapted to the Portuguese population. (AU)