Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 Feb;46(2):697-704.
doi: 10.1007/s10072-024-07775-3. Epub 2024 Sep 24.

Validation and convergent validity of the Boston cognitive assessment (BOCA) in an Italian population: a comparative study with the Montreal cognitive assessment (MoCA) in Alzheimer's disease spectrum

Alessandro Padovani  1   2   3   4   5 , Salvatore Caratozzolo  6   7   8 , Alice Galli  1   2   3   4 , Luca Crosani  2 , Silvio Zampini  1   2 , Maura Cosseddu  1   2 , Rosanna Turrone  1   2 , Andrea Zancanaro  1   2 , Bianca Gumina  1   2 , Barbara Vicini-Chilovi  1   2 , Alberto Benussi  1   2 , Andrey Vyshedskiy  9   10 , Andrea Pilotto  1   2   3   4
Affiliations
Comparative Study

Validation and convergent validity of the Boston cognitive assessment (BOCA) in an Italian population: a comparative study with the Montreal cognitive assessment (MoCA) in Alzheimer's disease spectrum

Alessandro Padovani et al. Neurol Sci. 2025 Feb.

Abstract

Background: The Boston Cognitive Assessment (BOCA) is a self-administered online test developed for cognitive screening and longitudinal monitoring of brain health in an aging population. The study aimed to validate BOCA in an Italian population and to investigate the convergent validity with the Montreal Cognitive Assessment (MOCA) in healthy ageing population and patients within the Alzheimer Disease spectrum.

Methods: BOCA was administered to 150 participants, including cognitively healthy controls (HC, n = 50), patients with mild cognitive impairment (MCI, n = 50), and dementia (DEM, n = 50). The BOCA reliability was assessed using (i) Spearman's correlation analysis between subscales; (ii) Cronbach's alpha calculation, and (iii) Principal Component Analysis. Repeated-measures ANOVA was employed to assess the impact of the sequence of test administrations between the groups. BOCA performance between HS, MCI and DEM and within different severity subgroups were compared using Kruskall Wallis test. Furthermore, a comparison was conducted between MCI patients who tested positive for amyloid and those who tested negative, utilizing Mann Whitney's U-test.

Results: Test scores were significantly different between patients and controls (p < 0.001) suggesting good discriminative ability. The Cronbach's alpha was 0.82 indicating a good internal consistency of the BOCA subscales and strong-to-moderate Spearman's correlation coefficients between them. BOCA total and subscores differ across different MoCA severity subgroups and demonstrated strong correlation with MoCA scores (rho = 0.790, p < 0.001).

Conclusions: The Italian version of the BOCA test exhibited validity, feasibility, and accurate discrimination closely performing as MoCA.

Keywords: Alzheimer’s disease; Amyloid; BOCA; Digital cognitive testing; MoCa.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing Interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Correlation between MoCA and BOCA tests. Scatterplot representing the Spearman’s correlation between the two tests in the whole sample
Fig. 2
Fig. 2
BOCA subscales correlation matrix. Heatmap representing significant Spearman correlations between BOCA subscales. Darker color represents a stronger relationship between variables. * = p < 0.05; **= p < 0.01; ***= p < 0.001
See this image and copyright information in PMC

References

    1. Koo BM, Vizer LM (2019) Mobile technology for cognitive assessment of older adults: a scoping review. Innov Aging 3:igy038 - PMC - PubMed
    1. Samaroo A, Amariglio RE, Burnham S Diminished learning over repeated exposures (LORE) in preclinical Alzheimer’s disease. Alzheimer’sDementia:, Diagnosis et al (2020) Assessment & Disease Monitoring 12:e12132 - PMC - PubMed
    1. Öhman F, Hassenstab J, Berron D Current advances in digital cognitive assessment for preclinical Alzheimer’s disease. Alzheimer’sDementia:, Diagnosis et al (2021) Assessment & Disease Monitoring 13:e12217 - PMC - PubMed
    1. Zygouris S, Tsolaki M (2015) Computerized cognitive testing for older adults: a review. Am J Alzheimers Dis Other Demen 30:13–28 - PMC - PubMed
    1. Santangelo G, Siciliano M, Pedone R et al (2015) Normative data for the Montreal Cognitive Assessment in an Italian population sample. Neurol Sci 36:585–591 - PubMed

LinkOut - more resources