Validation of the Telephone MoCA in iRBD and Parkinson's Disease with Conversion to the Standard MoCA.
- 1Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
- 2Population Health Sciences, University of Bristol, Bristol, UK.
Abstract
Background
Telephone-based cognitive assessment may improve follow-up when face-to-face testing is impractical. The Telephone Montreal Cognitive Assessment (T-MoCA) omits visually dependent items from the standard MoCA, but its validity in isolated REM sleep behavior disorder (iRBD) and Parkinson's disease (PD), remains uncertain.Objectives
To assess agreement between the T-MoCA and face-to-face MoCA-22 in iRBD and PD, and derive and externally validate a MoCA-22 to MoCA-30 conversion.Methods
In the Oxford Parkinson's Disease Centre (OPDC) Discovery Cohort, 137 participants (38 controls, 47 iRBD, 52 PD) completed T-MoCA and MoCA-22 assessments. Agreement was evaluated using Lin's concordance correlation coefficient, Bland-Altman analysis, and equivalence testing with ±1-point bounds. Equipercentile equating with log-linear smoothing was used to derive a MoCA-22 to MoCA-30 conversion using Discovery data (3561 tests), with validation in Tracking Parkinson's (5767 tests) and Parkinson's Progression Markers Initiative (5047 tests).Results
T-MoCA and face-to-face MoCA-22 scores were statistically equivalent, with minimal bias; 83.3% of scores differed by ≤1 point. However, concordance between test formats was moderate (Lin's CCC = 0.58). Across 14,375 MoCA assessments, equipercentile equating outperformed proportional scaling in development and validation cohorts. Propagating T-MoCA-MoCA-22 variability resulted in wider prediction intervals for T-MoCA-derived MoCA-30 estimates, indicating individual-level uncertainty, with intervals estimable only for T-MoCA scores ≥17 due to sparse data.Conclusions
At group level, T-MoCA is a valid remote measure of non-visual MoCA domains in iRBD and PD. The equating function supports cohort-level harmonization of MoCA-22 and MoCA-30 scores, while individual T-MoCA-derived MoCA-30 estimates should be interpreted with caution.
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BibTeX
@article{hillegondsberg2026validation,
title = {{Validation of the Telephone MoCA in iRBD and Parkinson's Disease with Conversion to the Standard MoCA.}},
author = {Ludo van Hillegondsberg and Tanja Zerenner and Michael Lawton and Karolien Groenewald and Jamil Razzaque and Jessica Welch and Yoav Ben-Shlomo and Michele Hu},
journal = {Movement disorders clinical practice},
year = {2026},
month = oct,
doi = {10.1002/mdc3.70905},
url = {https://europepmc.org/article/MED/42963896},
note = {CC BY},
}
RIS
TY - JOUR
TI - Validation of the Telephone MoCA in iRBD and Parkinson's Disease with Conversion to the Standard MoCA.
AU - Ludo van Hillegondsberg
AU - Tanja Zerenner
AU - Michael Lawton
AU - Karolien Groenewald
AU - Jamil Razzaque
AU - Jessica Welch
AU - Yoav Ben-Shlomo
AU - Michele Hu
PY - 2026
DA - 2026/10/30
JO - Movement disorders clinical practice
DO - 10.1002/mdc3.70905
UR - https://europepmc.org/article/MED/42963896
AB - Background Telephone-based cognitive assessment may improve follow-up when face-to-face testing is impractical. The Telephone Montreal Cognitive Assessment (T-MoCA) omits visually dependent items from the standard MoCA, but its validity in isolated REM sleep behavior disorder (iRBD) and Parkinson's disease (PD), remains uncertain.Objectives To assess agreement between the T-MoCA and face-to-face MoCA-22 in iRBD and PD, and derive and externally validate a MoCA-22 to MoCA-30 conversion.Methods In the Oxford Parkinson's Disease Centre (OPDC) Discovery Cohort, 137 participants (38 controls, 47 iRBD, 52 PD) completed T-MoCA and MoCA-22 assessments. Agreement was evaluated using Lin's concordance correlation coefficient, Bland-Altman analysis, and equivalence testing with ±1-point bounds. Equipercentile equating with log-linear smoothing was used to derive a MoCA-22 to MoCA-30 conversion using Discovery data (3561 tests), with validation in Tracking Parkinson's (5767 tests) and Parkinson's Progression Markers Initiative (5047 tests).Results T-MoCA and face-to-face MoCA-22 scores were statistically equivalent, with minimal bias; 83.3% of scores differed by ≤1 point. However, concordance between test formats was moderate (Lin's CCC = 0.58). Across 14,375 MoCA assessments, equipercentile equating outperformed proportional scaling in development and validation cohorts. Propagating T-MoCA-MoCA-22 variability resulted in wider prediction intervals for T-MoCA-derived MoCA-30 estimates, indicating individual-level uncertainty, with intervals estimable only for T-MoCA scores ≥17 due to sparse data.Conclusions At group level, T-MoCA is a valid remote measure of non-visual MoCA domains in iRBD and PD. The equating function supports cohort-level harmonization of MoCA-22 and MoCA-30 scores, while individual T-MoCA-derived MoCA-30 estimates should be interpreted with caution.
SN - 2330-1619
ER -